Altitude Sickness · Acetazolamide timing

When to start Diamox before altitude

By Bidwell Cranage, APRN, FNP-C, Member, International Society of Travel Medicine · Clinically reviewed by Ashley Cranage, APRN, FNP-C · Reviewed June 18, 2026

Start Diamox (acetazolamide) about one day (24 hours) before you begin your ascent, and continue it for the first 2 days at altitude (longer if you keep climbing higher). Starting it the day before gives it time to help your body acclimatize as you go up.

The timing at a glance

StageWhat to do
1 day before ascentStart acetazolamide
During ascentKeep taking it as you go up
First 2 days at altitudeContinue until you have acclimatized
Still climbing higher?Continue until you reach your highest sleeping elevation and have stayed a couple of days
Heading back downYou can stop once you are acclimatized or descending

The exact dose and schedule are set during your visit, but the pattern is the same: begin the day before, cover the climb, and continue through the first couple of days at your target height.

What if you forgot to start early

It still works. Acetazolamide does not only prevent altitude sickness, it also treats it once it has started, so if you forgot to begin the day before, start as soon as you can. Beginning late is far better than not at all. This is also why it is worth carrying a supply rather than hoping to find it at your destination.

Get it before you fly

Because you start it the day before you ascend, request acetazolamide online a few days before your trip so the prescription is filled and packed.

$45 flat visitNo videoNo subscriptionSent to your pharmacyYou pay the generic price, nothing added

A $45 asynchronous visit (no video, no membership) for adults in eligible states, reviewed by a licensed nurse practitioner. Tell us your destination and how fast you ascend, and we tailor the timing to your trip.

FAQ

When should I start taking Diamox?

Start acetazolamide (Diamox) about one day (24 hours) before you begin your ascent to altitude. Starting it the day before gives it time to help your body acclimatize as you go up.

How long do you take Diamox at altitude?

Continue Diamox for the first 2 days after reaching your target altitude, or until you have acclimatized. If you keep ascending to higher sleeping elevations, continue it until you reach your highest point and have stayed there a couple of days, then you can stop.

What if I forgot to start Diamox before my trip?

It still helps. If you did not start it the day before, begin as soon as you can. Acetazolamide also treats altitude sickness that has already started, not just prevents it, so starting late is better than not at all. Request the prescription a few days before travel so you have it in hand.

Can I get Diamox online before my trip?

Yes. Bidwell Health offers a $45 asynchronous online visit, no video and no subscription, for adults in eligible states. A licensed nurse practitioner reviews your trip and sends acetazolamide to your pharmacy when clinically appropriate, so you can start it the day before you ascend.

Start your $45 altitude visit ›

Related

Clinically reviewed by Bidwell Cranage, APRN, FNP-C, AANP board-certified Family Nurse Practitioner and Member, International Society of Travel Medicine.
Last reviewed: June 18, 2026 · References: Wilderness Medical Society Acute Altitude Illness guidelines (2024); CDC Yellow Book (High-Altitude Travel and Altitude Illness); DailyMed acetazolamide label.