The Complete Guide To Treat AMS, HAPE, & HACE: Proven Remedies For High Altitude Sickness

Trekking at high altitudes is an amazing experience, but it comes with serious risks. In this guide, I will explain how to treat altitude sickness, introduce three life-saving medications every trekker must carry, and provide step-by-step instructions on how to use them.

• Understanding Altitude Sickness
• 3 Life-Saving-Drugs Every Trekker Must Carry
• How To Treat Acute Mountain Sickness
• How To Cure High-Altitude Pulmonary Edema
• How To Cure High Altitude Cerebral Edema
• Conclusion: Staying Safe At High Altitudes

Understanding Altitude Sickness 

Altitude sickness occurs when your body struggles to adapt to lower oxygen levels at high elevations. Symptoms like headaches, dizziness, nausea, and fatigue can appear above 8,000 feet. If ignored, these symptoms can be fatal. Here is a brief description of altitude sickness and their types.

Acute Mountain Sickness (AMS)

AMS is a type of altitude illness, typically occurring at the height of 8,000 feet above sea level. It happens because your body is unable to adapt quickly to reduced oxygen levels. You can identify signs of AMS by headache, nausea, dizziness, fatigue, and loss of appetite. AMS can be mild to moderate and often improves with rest, hydration, and descent to lower altitudes.

High Altitude Pulmonary Edema (HAPE)

HAPE is a severe form of high altitude sickness that happens due to the low oxygen levels, and fluid accumulation in your lungs. This condition may develop if you have ignored the previous symptoms of AMS and continued your trek without proper acclimatization.

The identifiable symptoms include shortness of breath, chest tightness, rapid breathing, blue nails/lips, and coughing. 

HAPE is a life-threatening mountain sickness and requires immediate descends and medical attention. 

High Altitude Cerebral Edema (HACE)

HACE is the worst kind of mountain sickness which affects your brain and leads to swelling. This happens due to the dilation of your brain’s blood vessels. 

HACE’s symptoms can include confusion, loss of coordination, inability to walk, severe headache, and even loss of consciousness. If left untreated, HACE can be fatal. An emergency descent and medical treatment are essential.

For a more detailed explanation of altitude sickness, check out my previous article:

What Is Acute Mountain Sickness? Its Causes, Symptoms, and Prevention Tips.

3 Life-Saving-Drugs Every Trekker Must Carry

Now let’s talk about three life-saving drugs that every trekker must carry:

Diamox (Acetazolamide) 

Diamox (Acetazolamide) helps speed up the acclimatization process by thinning the blood, making it easier to adapt to high altitudes.

Dexamethasone (Dex)

Dex is a steroid that reduces inflammation, providing enough time to descend safely when symptoms worsen.

Nifedipine

This medication stabilizes symptoms of HAPE by lowering blood pressure and giving you crucial time for an emergency evacuation.

Important Note: These medications are available in India without a prescription, but consulting a doctor before using them is highly recommended. 

How To Treat Acute Mountain Sickness 

There is no guarentee when you you will get AMS. It can occur to any trekker at any stage of their trek. That’s why I will explain the treatment of AMS from the beginning stage of your trek. 

The Triple One Test 

If you’ve been hiking for just 2-3 hours from the base camp and already feel exhausted, struggling to catch your breath, and experiencing a headache at an altitude of less than 8,000 feet, could these be signs of altitude sickness?

Well, it can be, but this might be dehydration in such a short period. So what you need to do is to inform your trekking buddy or guide. Take out your water bottle, take a Disprin table, and rest for one hour. Your headache should be completely gone by now. If you don’t feel any headache then you can continue your journey ahead. 

However, if you have even mild headache symptoms, you must start your curative course of Diamox and descend to a safer altitude of at least 8,000 feet. If a painkiller does not relieve your headache, it may be an early sign of altitude sickness. At this point, you should abandon your trek and return to base camp.

Important Note:- This process is only useful for day 1 of the trek. If you feel the symptoms of AMS at any other stages of the trek then you must start treating your symptoms for AMS. 

How To Take Curative Course Of Diamox? 

If you are still experiencing headaches and other signs of altitude sickness, it’s time to inform your guide and start the curative course of Diamox. Your guide will help you recover from AMS; all you need to do is follow their instructions.

However, if you are a solo trekker and hiking without a guide, you can follow the process below (assuming you have the required medicines):

1. Take one pill of Diamox 250 mg. If you have Diamox 500 mg, take half a tablet with 500 ml of water, and then rest for one hour. Rest is crucial because it helps relax your body and increase the oxygen level in your blood.
2. After one hour of taking Diamox, the symptoms of AMS should begin to fade.
3. Now, move to the next campsite and rest properly, as this will help your body acclimatize. 
4. After 4 hours from the first dose, take another tablet of Diamox 250 mg with plenty of water. The water may taste different, but stay well hydrated and continue to rest.
5. Now, monitoring your symptoms over the next few hours is crucial. If you feel better within 2 hours of your second dose, it indicates that your body is beginning to adjust to the high altitude. However, I highly advise that you continue your preventive course of Diamox by taking one 250 mg tablet every 12 hours until you complete your trek.
6. Suppose, you are still experiencing the signs of AMS after 2 hours of your second dose. Then I don’t worry. Just take one more tablet of Diamox 250 mg along with one tablet of Dexamethasone (Dex) 1 mg around 9 PM. It will help your body to reduce inflammation, allowing you to feel better and enjoy a good night’s sleep.
7. The next morning, you need to decide whether you should continue your journey or not. Be honest with yourself, if you are completely recovered from the altitude sickness then you may continue your trek. 

On the other hand, if you still have minute symptoms of AMS or anything that is not good then I highly advise you to start losing your altitude asap. Your safety must be your top priority and do not stop until you have descended to at least 8,000 feet.

Should You Start Your Trek With The Preventive Course Of Diamox? 

I’ve noticed that many trekkers, often stick to very tight schedules. This can leave little room for our bodies to acclimatize, increasing the risk of developing AMS. In such cases, a preventive course of Diamox might be a lifesaver. However, always consult with your doctor before you start your trek to ensure it’s right for you.

If you are on a tight schedule and wish to give it a try then you can begin the Diamox course from the Day one of your trek. If you have 125 mg tablets, take one tablet every 12 hours.

In case, you’re using 250 mg tablets, simply take half a tablet every 12 hours from the start of your trek until the end. This approach could make a significant difference in keeping you safe and comfortable at high altitudes.

Important Note:- Diamox is not a complete substitute for acclimatization and it does not give you a free pass to rush over the entire trek. You need to follow the recommended guidelines and rest as much as possible. 

What Are The Side Effects Of Diamox? 

Diamox does not have any major side effects. However, some trekkers may experience tingling sensations on their lips and fingertips, and the water might taste different. 

Also, Diamox makes you urinate more frequently than normal, which is not a side effect. It dilutes your blood, allowing you to breathe more frequently, and removes the bicarbonates from your blood stream through the urination process. 

How To Cure High-Altitude Pulmonary Edema (HAPE)

HAPE is an advanced type of mountain sickness that is associated with your lungs. Trekkers with high-altitude pulmonary edema experience a dry cough, breathlessness, chest tightness, and gasping for air while sitting & walking. The advanced stages of AMS often lead to HAPE but in some cases, it can develop into a more fatal type of altitude sickness known as HACE. 

There is no preventive cure for HAPE that’s why we will talk about the curative course of treatment for high-altitude pulmonary edema. 

How To Take Curative Course Of HAPE?

Now, let me tell you how you can treat high-altitude pulmonary edema using Nifedipine & Diamox:

First of all, if you notice any signs of high-altitude pulmonary edema then inform your guide and follow their instructions. They will have proper training and sufficient resources like medicians and canned oxygen to start the treatment and immediate evacuation. 

What should you do if trekking alone or with friends?

In case, you are trekking alone then things can get nasty for you but don’t worry. You can follow this guide to cure the initial symptoms of HAPE: 

1. First, take one Nifedipine 20 mg tablet and Diamox 500 mg. If you have Nifedipine 10 mg then thake one pill and take another one after 20 minutes. 
2. As you already know, HAPE causes fluid buildup in the lungs. Nifedipine helps lower blood pressure, while Diamox thins the blood, reducing pressure around the lungs and easing symptoms.
3. Once you have taken these life-saving drugs, you will have three to four hours to descend to the 8,000 feet.
4. After the six hours of consuming the first dose repeat the same dose again and do not stop anywhere until you have reached your base camp. 

Important Note:- Most of the trekkers recover from this situation at a lower altitude and with the help of this guide, you will recover from this too.

How To Cure High Altitude Cerebral Edema 

HACE doesn’t have a definite cure, but recognizing the early signs can be the difference between life and death. The moment you suspect symptoms, your top priority should be descending to a safer altitude as fast as possible. This is where Diamox and Dexamethasone (Dex) become your lifeline. 

These medications won’t cure HACE, but they’ll buy you those critical extra hours, just enough time to get to safety before things take a turn for the worse. Think of them as your emergency parachute, giving you a fighting chance against the unpredictable dangers of high altitude.

How To Treat High-Altitude Cerebral Edema 

Severe headaches and disorientation on a trek aren’t just discomforts, they’re warning signs of HACE. If you experience these, act fast. Inform your guide, take your medication, and begin your descent immediately. You might not be able to descend alone so ask for help from your guide or friend. 

What should you do if trekking alone or with friends? 

But if you’re trekking solo, here’s what to do:

1. Take one Diamox 500 mg and one Dexamethasone 4 mg. Commonly known as Dex, this powerful steroid reduces inflammation and prevents swelling in your brain. 
2. Once you’ve taken the dose, don’t wait, start descending at once. This gives you a crucial four to five hours to descend to a safer altitude. Don’t stop abruptly, until you drop below 8,000 feet this may increase the risk 
3. Six hours later, repeat the dose and continue descending until you safely reach your first base camp. Every step down is a step toward survival.

Conclusion: Staying Safe At High Altitudes

High-altitude sickness can be life-threatening, but with proper knowledge and preparation, you can prevent and manage its risks. Therefore understanding the symptoms of AMS, HAPE, & HACE is crucial for timely intervention. Carrying these three life-saving medicines Diamox, Dexamethasone, and Nifedipine can provide life-saving support in emergencies. However, no medicine can replace proper acclimatization, hydration, and gradual ascent. 

Above all, your safety is in your hands. Always listen to your body and don’t unnecessarily push yourself. If you identify any signs of altitude sickness, follow your protocol and take proper medications. In case, the symptoms persist and your body does not allow you to continue the trek, start descending to a safer altitude and call off your trek. I hope this guide helps you to trek with confidence and stay prepared for any altitude-related challenges. If you want a deeper dive into assembling the perfect first-aid kit then feel free to check out my in-depth guide: The Expert’s High-Altitude Medical Kit: Essential Medicines & Life-Saving Drugs for Trekkers. Stay safe, and happy trekking!