Altitude sickness prevention guide

Altitude sickness prevention online in Virginia and West Virginia

Preventive travel-medicine prescriptions before an ascent, most commonly acetazolamide, for healthy adults and children 4 and older (with a parent or legal guardian) after emergency, cardiopulmonary, prior-HACE, and pregnancy screens are negative. This visit does not treat anyone who is already ill at altitude.

Start online

Start a $59 online review for Altitude sickness prevention.

Acute mountain sickness is common when travelers sleep above about 8,000 ft (2,500 m) or ascend rapidly. Preventive medicine started before the trip lowers the risk, but it never replaces gradual ascent, hydration, and descending if you feel unwell. Care is for planning ahead. If you are already at altitude and ill, that is an emergency, not a prevention visit.

If treatment is appropriate, your physician can send a non-controlled prescription to your pharmacy and provide portal instructions for the next step.

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Quick facts

You must be physically located in Virginia or West Virginia at the time of request.
Starts at $59
No insurance needed
No app download
Physician review around the clock
Non-controlled prescriptions can be sent to your pharmacy when appropriate
A work or school note can be included when medically appropriate
Response times apply 24/7, every day

Common symptoms

Planning to sleep above about 8,000 ft (2,500 m)
Flying or driving straight to high altitude
A prior episode of acute mountain sickness on a similar trip
Wanting prophylaxis started 24 hours before ascent

May fit online care

Adults & children 4+ (with a parent or legal guardian)
A healthy adult, or a healthy child 4+ with a parent or legal guardian, in Virginia or West Virginia
Planning ahead before the trip, not currently ill at altitude
No significant heart or lung disease, home oxygen, or sickle cell disease/trait
Not pregnant, possibly pregnant, trying to conceive, or breastfeeding

Look for another care setting

Already at altitude with headache, nausea, breathlessness, confusion, or unsteadiness
Any emergency sign: confusion, trouble walking, breathlessness at rest, pink/frothy sputum, blue lips, worst-ever headache, fainting, chest pain, stroke signs, or new vision loss
Significant heart or lung disease, home oxygen, pulmonary hypertension, or sickle cell disease/trait
Prior HACE or prior HAPE (arrange an in-person pre-travel assessment)

What to have ready

Your trip's target sleeping altitude and how fast you will ascend
Any prior altitude illness, including clinician records if you had HAPE
Your current medicines, especially nitrates, blood-pressure medicines, or alpha-blockers
Allergies, including any serious sulfa reaction

What happens next

Standard

$59

Within 6 hours

Priority

$99

Within 3 hours

Rush

$149

Within 1 hour

Start the request on the website, answer a few questions to check that this visit fits you, and choose how fast you want an answer (the response window). If your concern still fits this service, a physician reviews it and sends you a secure update after you sign in. When appropriate, non-controlled prescriptions can be sent to your pharmacy, and a basic work or school note can be included at physician discretion.

Your physician

Every visit is personally reviewed by Ankur Fadia, MD. He is board-certified, has extra training in heart care (a cardiology fellowship), and is a member of Alpha Omega Alpha, a medical honor society. He is licensed in Virginia and West Virginia, and your care is never handed off to someone else.

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What can be prescribed?

Acetazolamide 125 mg twice daily starting 24 hours before ascent is the standard first-line prevention (250 mg twice daily at physician discretion for an unavoidable rapid ascent). If you have a serious sulfa allergy or cannot take acetazolamide, dexamethasone 4 mg every 12 hours is the sulfa-free alternative. Each is a single, bounded course with no refills.

Can I get a HAPE-prevention medicine like nifedipine or tadalafil?

Not through this visit. These medicines lower blood pressure and need an in-person evaluation (a fuller checkup), so a traveler with a prior HAPE diagnosis (HAPE is fluid in the lungs from altitude, diagnosed before) should arrange an in-person pre-travel or altitude medicine assessment (a checkup before the trip) for HAPE-specific prophylaxis (medicine to prevent HAPE).

What if I am already at altitude and feeling sick?

That is active altitude illness, not prevention. Descend and get local emergency care. Confusion, trouble walking, breathlessness at rest, cough with pink or frothy sputum, blue lips, worst-ever headache, fainting, chest pain, stroke signs, or new vision loss at altitude are emergencies: descend immediately and call local emergency services (911 in the US).

Does the medicine mean I can ascend as fast as I want?

No. Prevention medicine lowers but does not eliminate risk, and dexamethasone in particular masks symptoms without helping you acclimatize. Ascend gradually, stay hydrated, avoid alcohol and sleeping pills, and do not climb higher on any day you feel unwell.

Is this available if I have heart or lung disease?

No. Significant heart or lung disease, home oxygen, severe COPD, pulmonary hypertension, or sickle cell disease/trait needs an in-person pre-travel assessment rather than an online prophylaxis prescription.

See travel medicine

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