March 20, 2012

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By Amanda Gardner

TUESDAY, March 20, 2012 ( — Ibuprofen has been used for decades to treat pain. Now, research suggests the drug's anti-inflammatory properties also may help prevent the piercing headaches and other symptoms of altitude sickness.

A small new study, published this week in the Annals of Emergency Medicine, found that people who took four 600-milligram doses of ibuprofen over a 24-hour period in which they ascended to 12,570 feet above sea level were less likely to experience altitude sickness than people taking a placebo.

Sixty-nine percent of the participants who took placebo during the ascent developed the headaches, nausea, dizziness, and fatigue that characterize altitude sickness, also known as acute mountain sickness. By contrast, just 43% of people who took ibuprofen developed the condition.

The prospect of using an over-the-counter pain reliever to stave off altitude sickness is appealing, the researchers say, because the only two drugs currently approved to prevent and treat the condition, acetazolamide and dexamethasone, are prescription-only and carry a risk of side effects.

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In fact, many doctors are reluctant to prescribe acetazolamide or dexamethasone unless a person has experienced altitude sickness before, says Robert Roach, Ph.D., director of the Altitude Research Center at the University of Colorado School of Medicine, in Denver, who was not involved in the study.

Ibuprofen appears to be nearly as effective as acetazolamide and dexamethasone, so it may be an option for people traveling to high altitudes who don't yet know if they're susceptible, Roach adds.
In general, he says, 20% to 30% of people will experience altitude sickness at 7,000 feet, and up to 50% will get sick at 10,000 feet.

The study took place in California's White Mountains. Eighty-six men and women who lived close to sea level spent the night at 4,100 feet. In the morning, they drove to an elevation of 11,700 feet and proceeded to hike to 12,570 feet, where they again spent the night.

The participants took the four doses of ibuprofen (or placebo) about every six hours. Each 600-milligram dose was equivalent to three standard over-the-counter ibuprofen tablets.

The men and women had to be healthy enough to hike at a high elevation, but they weren't necessarily experienced hikers or mountain climbers. That suggests the ibuprofen regimen used in the study could be helpful for everyday tourists on ski or hiking vacations, not just elite climbers, says lead author Grant S. Lipman, M.D., a clinical assistant professor of emergency medicine at the Stanford University School of Medicine.

"We weren't just looking at people who went to Nepal," says Lipman, an avid climber himself. "This [study] was done in our own backyard, so it's very translatable."

Experts aren't certain what causes altitude sickness. One hypothesis is that lower oxygen levels at high elevations lead to leaks in the blood-brain barrier, which can cause the brain to swell. Ibuprofen, a non-steroidal anti-inflammatory drug, reduces swelling.

Long-standing advice to prevent altitude sickness includes ascending gradually; drinking lots of fluids; avoiding alcohol for the first day or two at altitude; avoiding medications that can affect breathing, such as sleeping pills and sedatives; and eating lots of carbs, which some researchers believe can improve respiratory function, Lipman says.

In rare cases, altitude sickness can cause potentially fatal brain swelling. Milder, more common symptoms usually go away in a few days—but that may be too long to wait for the trekker or skier with precious little vacation time, Lipman says.