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High-altitude pulmonary edema (HAPE) is caused by exaggerated hypoxic pulmonary vasoconstriction. To compare prophylactic treatments for this condition, researchers in Switzerland conducted a double-blind, randomized trial of tadalafil (10 mg), dexamethasone (8 mg), and placebo in 29 adults with at least one prior episode of HAPE. Regimens, all twice daily, were started the morning of the day before ascent to a land altitude of 4559 meters (about 14,000 feet) and continued for the duration of a 2-day stay at that altitude.
Two of 10 tadalafil recipients withdrew from the study after developing severe acute mountain sickness (AMS) the evening they arrived at high altitude. Seven of 9 placebo recipients, 1 of the 8 remaining tadalafil recipien…