Inhaled Budesonide and Oral Dexamethasone Prevent Acute Mountain Sickness

Abstract

Both inhaled budesonide (200 μg, bid) and oral dexamethasone (4 mg, bid) were effective for the prevention of acute mountain sickness, especially its severe form, compared with placebo. Budesonide caused fewer adverse reactions than dexamethasone.

Sightings edited by Erik Swenson and Peter Bärtsch

“…The medications were taken during 3 days prior to a 2.5 hours flight from 500 to 3700 m and discontinued after arrival at 3700 m. The data of this partly open trial support the results of a study by the same group (Zheng et al, 2014) commented in a previous sighting of this journal. However, it is somewhat surprising and not clear why the combination of budesonide and formoterol was not effective.…”

Acute high-altitude sickness

“…In addition, safety with prolonged use at high altitude and, in particular the risk of gastrointestinal bleeding, remain unclear. Other recent studies have suggested that the inhaled steroid budesonide may have a role in AMS prophylaxis [123,124]. These studies raise important questions about lung involvement in the underlying pathophysiology of AMS [125], but have yet to be replicated and do not provide sufficient rationale for using this expensive medication in place of acetazolamide or dexamethasone.…”

Sightings edited by Erik R. Swenson and Peter Bärtsch

“…A recent study from China found that inhaled budesonide (200 ug twice a day), a potent glucocorticoid, was equally effective in preventing acute mountain sickness (AMS) as oral dexamethasone (4 mg twice a day) started one day before passive ascent by automobile to 3900 m and then continued for 3 days (Zheng et al, 2014). Both drugs halved the rate of AMS (60 vs 30%) when compared to placebo.…”