Diamox, which contains acetazolamide, works by acidifying the blood through promoting the excretion of bicarbonate by the kidneys. This makes the blood more acidic, which tricks the body into thinking it has higher carbon dioxide levels. In response, the body increases respiration, leading to faster and deeper breathing that brings in more oxygen and gets rid of carbon dioxide. This process accelerates acclimatization to high altitude and helps prevent or reduce the symptoms of acute mountain sickness (AMS).

Mechanism of Action

• Diamox is a carbonic anhydrase inhibitor, which blocks this enzyme mainly in the kidneys.
• This inhibition prevents reabsorption of bicarbonate, sodium, and chloride, causing these ions to be excreted along with water (diuresis).
• The result is a mild metabolic acidosis (increased blood acidity).
• The acidosis stimulates an increase in ventilation (breathing rate and depth), improving oxygen uptake.

Effect on Altitude Sickness

• By increasing oxygen intake sooner, Diamox helps the body acclimatize faster to the lower oxygen levels found at high altitudes.
• It reduces symptoms like headaches, nausea, and dizziness associated with AMS.
• It also decreases cerebrospinal fluid production, helping prevent brain swelling in severe altitude sickness cases.

Summary

Diamox works through a chemical and physiological pathway to enhance oxygen absorption by inducing a mild acidosis, which then stimulates deeper and faster breathing. This makes it effective in accelerating acclimatization and mitigating altitude sickness symptoms.