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Advice for high altitude travel
69-year-old female. Travelling to Leh (3,500m altitude) in 2 days. Current medications: Alprex (Alprazolam), Clonifit 0.25mg (Clonazepam), one cholesterol tablet, multivitamin. Planning to take Diamox for altitude sickness prevention. Is this safe? Any risk with two sedatives at high altitude?”
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If you have any disease before for which you have been prescribed 2 sedatives to take at a time then you should consult with your doctor before going on the trip but if there is no such condition then it is better to avoid 2 sedatives at a time.
Take Diamox 2 days before the trip to high altitude.
Do some breathing exercises for better oxygen supply.
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At this age, with two sedative which reduce oxygen concentration n at high altitude oxygen is also less, frost bite must be prevented as there is no treatment for that..
Proper rest advisable as u land in Leh. No hurry for site seeing.
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Diamox is safe for altitude.
Main risk = alprazolam + clonazepam together → more drowsiness, breathing suppression at high altitude.
Advice:
• Avoid taking both together
• Use minimal dose, only if needed (prefer night)
• Start Diamox 1 day before
If excessive sleepiness/breathing issue → seek help.
You can consult me for proper planning.
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Traveling to Leh at 69 is an exciting plan, but because you are taking both Alprex and Clonifit, you must take extra precautions. Here is a simplified breakdown of the risks and how to stay safe:
The Risk of Sedatives at High Altitude
Both Alprex and Clonifit are sedatives that can slow down your breathing. When you are at a high altitude like Leh, your body already has less oxygen. Taking these medications, especially at night, can further reduce your oxygen levels while you sleep. They can also make you feel drowsy or dizzy, which are the same warning signs we look for with altitude sickness. This makes it very hard to know if you are feeling unwell because of the medication or the altitude.
Recommendations for Safety
Consult Your Doctor on Dosing: Before you leave in 2 days, ask your doctor if you can temporarily reduce the dose of these sedatives or avoid taking them for the first 48 hours in Leh.
Diamox Usage: Diamox is generally safe and helpful for preventing altitude sickness, but it works best if started 24 hours before you land in Leh.
Strict Rest: Since you are flying from Noida (low altitude) directly to Leh (high altitude), you must spend the first 24–48 hours in complete rest. Do not plan any sightseeing during these first two days.
Hydration and Alcohol: Drink plenty of water and strictly avoid alcohol, as alcohol combined with your current medications at high altitude is very dangerous.
When to Seek Help
If you feel a severe headache that doesn't go away with rest, extreme breathlessness even while sitting, or if you feel very confused or lose your balance, seek medical help at the local Leh hospital immediately. They are very experienced with these issues.
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Thank you for putting your queries here
Since I have experience in Wilderness medicine so I will advice following
1. Check if you are having COPD or any other Respiratory disease
2. Check if you have any Blood pressure or taking any medicine
3. You should be stable if anything like that
4. 3500 fits is not that comes under high altitude to develop severe high altitude sickness
4. Safer side carry some medicine to accelerate the acclamization like Diamox
5. I advice not to use sedative if not necessary
Have a nice journey
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The combination of two benzodiazepines (alprazolam and clonazepam) with high-altitude travel (3,500m) carries significant risks that require a formal medical review.
Key Considerations:
Respiratory Depression: Both sedatives can suppress the respiratory drive. At high altitudes where oxygen levels are already low, this can be dangerous and may lead to severe hypoventilation during sleep.
Increased Fall Risk: Older adults are more sensitive to the sedative effects of these medications. High altitude and the side effects of Diamox (acetazolamide) can further increase dizziness, confusion, and the risk of falls.
Medication Interaction: Sedatives can potentially mask the early symptoms of Acute Mountain Sickness (AMS), such as headaches or sleep disturbances, which are critical warning signs.
Next Steps
Consult physician or a travel medicine specialist immediately to see if one or both sedatives can be safely reduced or tapered before your trip.
AMS Prevention: If cleared for Diamox, the typical adult dose is 125mg twice daily, starting 24–48 hours before ascent.
Gradual Acclimatization: Ensure at least 48 hours of rest upon arrival in Leh before any physical activit
Health Tips
consult directly for further queries
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Travelling to high altitude (like Leh at ~3500 m) at this age requires careful planning, especially with concurrent medications.
Acetazolamide (Diamox) is commonly used for prevention of acute mountain sickness and is generally safe if there is no history of sulfa allergy, significant kidney disease, or electrolyte imbalance.
However, the more important concern here is the use of two sedatives (Alprazolam and Clonazepam). At high altitude, oxygen levels are lower, and these medications can further suppress respiratory drive and increase risk of excessive sedation, confusion, and even breathing difficulty, particularly in elderly individuals. This combination should be used very cautiously.
Next Steps
- Consider reducing or avoiding one of the sedatives, especially during travel and initial days at high altitude (discuss with treating doctor)
- If starting Diamox, a common preventive dose is 125 mg twice daily, started 24 hours before ascent
- Ensure gradual acclimatization: rest for the first 24–48 hours after reaching Leh
- Maintain adequate hydration and avoid alcohol/sedatives excess
- Monitor for symptoms of altitude sickness: headache, nausea, dizziness, breathlessness
Health Tips
1) Avoid overexertion in the first couple of days
2) Seek immediate medical attention if there is persistent vomiting, severe headache, confusion, or breathlessness at rest
3) Oxygen support should be readily accessible at the destination
4) Elderly individuals should err on the side of caution and keep activity minimal initially
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Diamox is generally safe for altitude prevention. However, using Alprazolam + Clonazepam together at high altitude may increase drowsiness and affect breathing, especially at her age.
It’s better to minimize sedatives, ensure hydration, and monitor symptoms during travel.
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Acetazolamide is generally safe and effective for preventing Acute Mountain Sickness, provided there is no history of sulfa allergy, significant kidney disease, or severe lung issues. It is usually started 24 hours before ascent and helps in better acclimatization.
However, the main concern in this case is the use of two sedatives—Alprazolam and Clonazepam. At high altitude, oxygen levels are already low, and these medications can suppress breathing and cause excessive drowsiness, confusion, or worsen hypoxia. Using both together increases this risk further.
It is advisable to use the lowest effective dose of only one sedative, preferably at night if needed, and avoid daytime use. Close monitoring for symptoms like excessive sleepiness, breathlessness, or confusion is important.
If you can tell me detailed history of the patient and for what indications these drugs are being used, I’ll be able to guide you in a better way.
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Traveling to high altitudes like Leh (3,500m) at the age of 69 requires extreme caution, especially given your current medications. Taking two different sedatives (Alprazolam and Clonazepam) alongside Diamox (Acetazolamide) at such a high altitude poses a significant risk. Benzodiazepines are known to depress the respiratory drive, which is already under stress due to the low oxygen levels (hypoxia) at 3,500m. This combination can increase the risk of developing High Altitude Pulmonary Edema (HAPE) or Central Sleep Apnea, which are life-threatening conditions."
Next Steps
Diamox is the standard preventive treatment for Acute Mountain Sickness (AMS), but it works by increasing your breathing rate to compensate for low oxygen. Sedatives like Alprex and Clonifit do the exact opposite—they slow down your breathing. Combining them can neutralize the benefits of Diamox and lead to severe respiratory distress or extreme lethargy during your trip."
Health Tips
Before you depart in 2 days, please take the following steps:
Consult a Physician: You must speak with your treating doctor or a specialist to see if your sedative dosage can be safely tapered or paused during the trip.
Oxygen Saturation: Carry a portable pulse oximeter to monitor your oxygen levels regularly while in Leh.
Ascent Plan: Ensure you have at least 48 hours of complete rest in Leh for acclimatization before any physical activity.
Emergency Exit: If you experience extreme headache, breathlessness at rest, or mental confusion, you must descend to a lower altitude immediately."
Do connect and consult
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Hello,
Travel to high altitude areas such as Leh (≈3500 m) does carry a risk of acute mountain sickness.
Use of Diamox (acetazolamide) for prophylaxis is generally safe and effective when started 24–48 hours before ascent, provided there are no contraindications (such as sulfa allergy, severe kidney disease).
However, caution is advised in your case:
• You are already taking two sedative medications—Alprazolam and Clonazepam.
• At high altitude, oxygen levels are lower, and these medications can further depress respiration, cause excessive drowsiness, and increase risk of confusion or falls, especially in elderly individuals.
Recommendations:
• Avoid taking both sedatives together, particularly during travel and at high altitude.
• Use the lowest effective dose, only if absolutely necessary.
• Monitor for symptoms like excessive sleepiness, breathlessness, dizziness, or confusion.
• Stay well hydrated and avoid alcohol.
• Ascend gradually if possible and allow time for acclimatization.
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Why do you wish to take an extra sedative to sleep at high altitude? When you reach Leh, you will be made to acclimatization to that level of height. You shall rest in your room and will be given freshly made garlic leaves soup to curb nausea. You may still have a lot of thumping but it's ok. It will settle down in a day or two. Just take your regular medicines only. Rest people there are really helpful and will suggest local remedies for your concerns. You will get to drink hot kehwa all the time to keep you warm within.
If at all you need to prepare yourself, take good inners to protect you from loss of your body heat.
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