title: Ibuprofen prevents altitude illness: a randomized controlled trial for prevention of altitude illness with nonsteroidal anti-inflammatories.
abstract: OBJECTIVE
  Acute mountain sickness occurs in more than 25% of the tens of millions of people who travel to high altitude each year. Previous studies on chemoprophylaxis with nonsteroidal anti-inflammatory drugs are limited in their ability to determine efficacy. We compare ibuprofen versus placebo in the prevention of acute mountain sickness incidence and severity on ascent from low to high altitude.
  
  
  METHODS
  Healthy adult volunteers living at low altitude were randomized to ibuprofen 600 mg or placebo 3 times daily, starting 6 hours before ascent from 1,240 m (4,100 ft) to 3,810 m (12,570 ft) during July and August 2010 in the White Mountains of California. The main outcome measures were acute mountain sickness incidence and severity, measured by the Lake Louise Questionnaire acute mountain sickness score with a diagnosis of ≥ 3 with headache and 1 other symptom.
  
  
  RESULTS
  Eighty-six participants completed the study; 44 (51%) received ibuprofen and 42 (49%) placebo. There were no differences in demographic characteristics between the 2 groups. Fewer participants in the ibuprofen group (43%) developed acute mountain sickness compared with those receiving placebo (69%) (odds ratio 0.3, 95% confidence interval 0.1 to 0.8; number needed to treat 3.9, 95% confidence interval 2 to 33). The acute mountain sickness severity was higher in the placebo group (4.4 [SD 2.6]) than individuals receiving ibuprofen (3.2 [SD 2.4]) (mean difference 0.9%; 95% confidence interval 0.3% to 3.0%).
  
  
  CONCLUSIONS
  Compared with placebo, ibuprofen was effective in reducing the incidence of acute mountain sickness.
authors.affiliation: Division of Emergency Medicine, Stanford University School of Medicine, Palo Alto, CA, USA. grant lip@hotmail.com
authors.forename: Grant S
authors.initials: GS
authors.lastname: Lipman
authors.forename: Nicholas C
authors.initials: NC
authors.lastname: Kanaan
authors.forename: Peter S
authors.initials: PS
authors.lastname: Holck
authors.forename: Benjamin B
authors.initials: BB
authors.lastname: Constance
authors.forename: Jeffrey H
authors.initials: JH
authors.lastname: Gertsch
mesh_terms: D000328:Adult; D000532:Altitude Sickness / Q000517:prevention & control*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007052:Ibuprofen / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D007052:Ibuprofen