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<jats:title>Abstract</jats:title><jats:p><jats:bold>Objective</jats:bold> To evaluate the efficacy of ginkgo biloba, acetazolamide, and their combination as prophylaxis against acute mountain sickness.</jats:p><jats:p><jats:bold>Design</jats:bold> Prospective, double blind, randomised, placebo controlled trial.</jats:p><jats:p><jats:bold>Setting</jats:bold> Approach to Mount Everest base camp in the Nepal Himalayas at 4280 m or 4358 m and study end point at 4928 m during October and November 2002.</jats:p><jats:p><jats:bold>Participants</jats:bold> 614 healthy western trekkers (487 completed the trial) assigned to receive ginkgo, acetazolamide, combined acetazolamide and ginkgo, or placebo, initially taking at least three or four doses before continued ascent.</jats:p><jats:p><jats:bold>Main outcome measures</jats:bold> Incidence measured by Lake Louise acute mountain sickness score ≥ 3 with headache and one other symptom. Secondary outcome measures included blood oxygen content, severity of syndrome (Lake Louise scores ≥ 5), incidence of headache, and severity of headache.</jats:p><jats:p><jats:bold>Results</jats:bold> Ginkgo was not significantly different from placebo for any outcome; however participants in the acetazolamide group showed significant levels of protection. The incidence of acute mountain sickness was 34% for placebo, 12% for acetazolamide (odds ratio 3.76, 95% confidence interval 1.91 to 7.39, number needed to treat 4), 35% for ginkgo (0.95, 0.56 to 1.62), and 14% for combined ginkgo and acetazolamide (3.04, 1.62 to 5.69). The proportion of patients with increased severity of acute mountain sickness was 18% for placebo, 3% for acetazoalmide (6.46, 2.15 to 19.40, number needed to treat 7), 18% for ginkgo (1, 0.52 to 1.90), and 7% for combined ginkgo and acetazolamide (2.95, 1.30 to 6.70).</jats:p><jats:p><jats:bold>Conclusions</jats:bold> When compared with placebo, ginkgo is not effective at preventing acute mountain sickness. Acetazolamide 250 mg twice daily afforded robust protection against symptoms of acute mountain sickness.</jats:p>

Original publication

DOI

10.1136/bmj.38043.501690.7c

Type

Journal article

Journal

BMJ

Publisher

BMJ

Publication Date

03/04/2004

Volume

328

Pages

797 - 797