Ibuprofen Reduces the Severity of Acute Mountain Sickness

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Ibuprofen Reduces the Severity of Acute Mountain Sickness

. . . and is likely as effective as acetazolamide or dexamethasone.

Researchers randomized 86 healthy nonacclimated adult volunteers to receive oral ibuprofen (600 mg) or placebo every 6 hours, beginning 6 hours before rapidly ascending from an altitude of 4100 feet to 12,570 feet in California. Outcome measures were incidence and severity of acute mountain sickness on the validated, self-reported, symptom-based Lake Louise Questionnaire. Acute mountain sickness was defined as a symptom score of >3 with headache and one other symptom.

Significantly fewer volunteers in the ibuprofen group than in the placebo group developed acute mountain sickness (43% vs. 69%; number needed to treat, 3.9). Among volunteers who developed mountain sickness, symptom severity was lower in the ibuprofen group, although the difference was not statistically significant.

Comment: The efficacy of prophylactic ibuprofen is similar to that of traditional altitude sickness prophylaxis with acetazolamide and dexamethasone. Given the more favorable safety profile of ibuprofen compared with acetazolamide and dexamethasone, ibuprofen seems to be the obvious choice until a head-to-head comparison demonstrates that one is clearly better.

— Richard D. Zane, MD, FAAEM

Published in Journal Watch Emergency Medicine June 22, 2012

Citation(s):

Lipman GS et al. Ibuprofen prevents altitude illness: A randomized controlled trial for prevention of altitude illness with nonsteroidal anti-inflammatories. Ann Emerg Med 2012 Jun; 59:484.

Medline abstract (Free)

Reader Remarks:

Review and add to remarks on this article

Treating symptoms vs physiology
Ryan Rose, 25 Jun 2012 12:46 PM EST
Specialty: Emergency Medicine
Wont using ibuprofen simply mask the symptoms of ams as it progresses? I thought the diamox and steroids were to... [more]
Headache & AMS
Rahnea Sunseri,MD, Member Wilderness Medical Society, 25 Jun 2012 12:58 PM EST
Specialty: Internal Medicine
Indeed, masking the sxs of altitude sickness is not the same as treating the disorder (cerebral edema & other changes).... [more]
Understanding the physiology & Pharmacology
E.J. Pasman, AMC Amsterdam, 5 Jul 2012 7:58 AM EST
Specialty: Anesthesiology
The use of Ibuprofen in AMS is, as said before, misleading. It is a downregulation of symptoms and is not... [more]
Ibuprofen for AMS
A J Voth, Edmonton, 17 Sep 2012 12:25 PM EST
Specialty: Internal Medicine
I agree with the doubts expressed by several MD ACC members about this paper. I would add another; 2400 mg... [more]

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