Posch · Wilderness & environmental medicine 2018 · narrative review · n=17

The Effects of Acetazolamide on Exercise Performance at Sea Level and in Hypoxic Environments: A Review.

Cited 16 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Narrative review of 17 studies without formal systematic review or meta-analysis methodology reported

PubMed 30314664 · doi:10.1016/j.wem.2018.06.011 · record verified 2026-08-29

What was done

This review examined 17 peer-reviewed articles assessing the impact of acetazolamide, a carbonic anhydrase inhibitor used for acute mountain sickness prophylaxis, on submaximal and maximal exercise performance at sea level and at high altitude (>2500 m), along with its side-effect profile.

What was found

The abstract reports no numerical values or effect sizes. At sea level, acetazolamide consistently reduced time to exhaustion during both submaximal and maximal exercise. At altitude, findings across studies were highly variable, leaving the exact impact of acetazolamide on hypoxic exercise performance unresolved.

Why it matters

Although acetazolamide is commonly used to prevent acute mountain sickness, users should be aware that it impairs exercise performance at sea level and may not reliably preserve physical performance at altitude.

Limits

The abstract provides no quantitative data, effect sizes, or confidence intervals. Details regarding dosages, timing, participant demographics, exercise modalities, and search methodology are omitted, and existing altitude studies show high discordance.

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