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Acetazolamide, which induces metabolic acidosis and increases ventilation, is prescribed widely to prevent acute mountain sickness. In this meta-analysis of 11 randomized controlled trials that involved more than 1500 participants, investigators assessed the efficacy of acetazolamide in preventing acute mountain sickness.
In all trials, participants were randomized to daily placebo or acetazolamide (250 mg, 500 mg, or 750 mg) and ascended to an elevation of >3000 m. The first dose was given the day of ascent in 5 trials and 1 day or more before ascent in 6; treatment duration (reported in 10 trials) ranged from 2 to 6 days. The combined incidence of acute mountain sickness was 33% in the control groups and 16% in the acetazolamide groups. At…