Using Diamox to Aid Acclimatization when Climbing Kilimanjaro

Reaching Kilimanjaro’s peak at 19,341 feet above sea level places it in the “extreme altitude” category. Unlike Everest, supplemental oxygen isn’t necessary to conquer Uhuru Peak safely.

Nevertheless, altitude sickness and related complications remain significant obstacles to summit success. Even the fittest trekkers can fall victim to altitude sickness. While gradual acclimatization is optimal, allowing your body time to adjust, a medication called Diamox can aid this process.

Note: The information in this article is not intended for diagnosing, treating, preventing, or curing any condition. Always consult a healthcare professional before applying the suggestions mentioned here.

Understanding Diamox

Diamox, or acetazolamide, is a medication primarily used to treat glaucoma, certain forms of epilepsy, and edema caused by heart failure or drugs. Within the climbing community, it’s used to expedite acclimatization during a well-planned ascent.

This prescription-only oral medication requires consultation with your doctor to determine its suitability. Individuals with pre-existing conditions, kidney or liver issues, may find it unsuitable.

According to the Wilderness Medical Society, Diamox can notably reduce the onset and severity of altitude sickness by accelerating the body’s adaptation mechanisms. Studies have shown that trekkers taking low doses of Diamox, in conjunction with proper acclimatization measures, are less prone to developing mountain sickness, and if they do, it’s usually milder.

Diamox functions as a preventive measure (prophylaxis) and does not cure altitude sickness.

How Diamox Works

Acetazolamide is a sulfonamide medication that prompts the kidneys to excrete bicarbonate. This action rebalances the blood’s acidity, simulating a buildup of carbon dioxide and prompting increased breathing. The diuretic effect leads to increased urination, helping to counteract night time periodic breathing patterns.

Taking Diamox results in deeper breathing and more frequent urination.

Diamox’s Side Effects & Interactions

Commonly reported side effects by climbers include:

  • Increased urination: Stay well-hydrated to balance the diuretic effect.
  • Altered taste perception: Diamox may change the taste of certain foods and beverages.
  • Tingling or numbness in extremities, mainly hands, feet, or face.
  • Occasional nausea, gastric issues, dizziness, or confusion. A trial dose before climbing helps rule out adverse reactions.
  • Diamox can interact with other medications. Check labels of prescription and non-prescription drugs for interactions and consult your doctor.

Diamox Dosage on Kilimanjaro

As recommended by the Wilderness Medical Society, start with 125mg of Diamox twice daily, two days before your climb begins. Dr. Peter Hackett of the Institute for Altitude Medicine agrees. Some individuals find half this dose effective for prophylaxis.

Common Myths About Diamox

Dispelling common misconceptions surrounding Diamox:

  • Myth: Diamox masks altitude sickness symptoms.
  • Reality: Diamox accelerates natural acclimatization and won’t hide actual sickness symptoms.
  • Myth: Diamox guarantees freedom from altitude sickness.
  • Reality: Diamox enhances acclimatization but doesn’t eliminate the risk of AMS.
  • Myth: Diamox prevents AMS progression during ascent.
  • Reality: Diamox can’t shield you from AMS if symptoms are already present.
  • Myth: Diamox is essential for Kilimanjaro summits.
  • Reality: Many climbers successfully summit without Diamox.
  • Myth: Diamox is cheating for acclimatization.
  • Reality: Diamox aids natural acclimatization – a prudent choice.
  • Myth: Stopping Diamox worsens symptoms.
  • Reality: Discontinuing Diamox reverts to natural acclimatization pace, with no worsening of symptoms.

Choosing Diamox: Is it Right for You?

Only your doctor can decide. If you’re allergic to sulfa drugs, Diamox may not be suitable. Whether to take it depends on personal preferences and your doctor’s advice.

Consider a trial run of Diamox under medical guidance to detect potential side effects well before your Kilimanjaro climb.

Natural Alternatives for Acclimatization

While various “natural” remedies exist, Diamox’s consistent results set it apart. Some alternatives include:

  • Gingko Biloba: Mixed results, conflicting studies.
  • Coca Leaves: Correlation with AMS alleviation but inconclusive causation.
  • Beetroot: Limited studies on AMS prevention.
  • Garlic: Anecdotal support for increased blood flow.

Important Notes

  • Ibuprofen is commonly recommended for minor pain relief but consult your guide before taking.
  • Malaria risks exist, especially around Moshi or Arusha. Consult a doctor about anti-malarial options.
  • Anti-malarials don’t guarantee protection; follow mosquito bite prevention.


  • Prioritize gradual acclimatization.
  • Stay hydrated, especially with Diamox.
  • Report any symptoms to your guide.
  • Feel free to reach out for assistance in choosing your route or planning your Tanzanian adventure.