Drug prevention of high-altitude pulmonary oedema
There is no substitute for a sensible rate of ascent in preventing high-altitude pulmonary oedema (HAPE). Drug prevention of HAPE is indicated in adults with a history of HAPE; it has not been studied in childrenLuks, 2007. People with known pulmonary hypertension (or predisposition) should seek specialist advice before travel to high altitude.
For prevention of high-altitude pulmonary oedema in individuals who have been affected on a previous expedition, use:
nifedipine modified-release 30 mg orally, 12-hourly. Start the day before ascent. Continue nifedipine for 4 days after reaching final altitude (or until starting final descent if this occurs sooner)Luks, 2019. nifedipine nifedipinenifedipine
Other drugs that may have a role in HAPE prevention include phosphodiesterase (PDE5) inhibitors (tadalafil, sildenafil) or inhaled salmeterol, but these should only be used on specialist advice.