If you’re heading for Everest Base Camp, you’ve probably heard about Diamox (Acetazolamide) — the altitude sickness pill that gets talked about as much as dal bhat. Some trekkers swear it’s a lifesaver. Others avoid it altogether. So what’s the real story?
Let’s unpack what experienced EBC trekkers have learned and how you can decide whether to start Diamox early or just keep it in your first-aid kit.
Quick Recap: What Does Diamox Do?
Diamox helps your body adjust to higher altitudes by boosting your breathing rate, which allows you to get more oxygen into your bloodstream. This can reduce the risk of Acute Mountain Sickness (AMS) — the nasty headaches, dizziness, and fatigue that can sneak up when you gain altitude too fast.
When Do Most Trekkers Start Taking It?
There’s no universal rule, but here are the most common approaches:
1. Start When You Arrive at Altitude
Some trekkers begin taking Diamox as soon as they land in Lukla (2,800m). The idea is to get ahead of the altitude rather than wait for symptoms. This proactive approach has helped many reach EBC comfortably, even with minor side effects like tingling fingers or frequent bathroom breaks.
2. Begin Around Namche Bazaar (3,400m)
Others prefer to wait until reaching Namche, a key acclimatization stop on most EBC routes. Starting the medication here gives your body time to adapt naturally at lower altitudes and step in with extra help only when you’re heading toward the steeper gains.
3. Only Take It If Symptoms Appear
Plenty of trekkers carry Diamox but only use it as a backup plan. If they start to experience AMS symptoms like persistent headaches or nausea, they take it then. This approach relies on careful self-monitoring and a slow, steady trekking pace.
4. Skip It Altogether
Some hikers choose not to use Diamox at all, relying on proper acclimatization, hydration, and a gentle pace to manage altitude. They emphasize listening to your body, allowing for extra rest days, and being willing to descend if symptoms worsen. For some, the side effects of Diamox feel too similar to AMS itself, making it harder to judge what’s going on.
Standard Dosage
Doctors generally recommend:
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125 mg (half tablet) twice daily
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Start around 2,500–3,000m, continue until you descend
But always consult with a medical professional before starting any altitude-related medication.
Are There Any Side Effects?
Yes — and they vary. Common ones include:
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Tingling or numbness in hands and feet
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More frequent urination (so plan your bathroom stops!)
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Altered taste — especially fizzy drinks
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Occasional nausea or dizziness
Keep in mind: some side effects can mimic AMS symptoms, which can cause confusion if you’re already not feeling great.
TrekHeaven’s Take: What Should You Do?
Here’s what we’ve gathered from dozens of trekkers and health experts:
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Pack Diamox in your medical kit, even if you don’t plan to take it immediately
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Don’t rush into using it unless you’re following a fast itinerary or have known altitude issues
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Start in Namche or earlier if you’re concerned about altitude or had trouble on previous high-altitude treks
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Focus on hydration, rest, and pacing — those are your best natural defenses
For most people on standard itineraries, it’s safe to monitor your body and only take Diamox if needed. But for peace of mind, starting early — especially from Lukla or Namche — can help ease the transition to higher altitudes.
Final Words: Know Yourself, Trek Smart
Altitude affects everyone differently. Some breeze through it; others struggle at 3,000m. Whether or not to take Diamox is a personal choice — but having it on hand and knowing how to use it wisely can make or break your trek.
No one goes to Everest to sit in a teahouse with a pounding headache. Prepare, listen to your body, and enjoy every step.
Need help building your custom EBC itinerary or prepping for high-altitude trekking? We’ve got route guides, gear checklists, and expert tips right here at TrekHeaven.
