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University of Cincinnati Academic Health Center
Publish Date: 01/14/99
Media Contact: AHC Public Relations, (513) 558-4553
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Study Shows High Altitude and Medication May Not Mix

Cincinnati—As vacationers head to high-altitude getaways this time of year, a new study from the University of Cincinnati (UC) College of Pharmacy found that high altitudes could change the effectiveness of certain medications.

Wolfgang Ritschel, MD, PhD, professor emeritus of pharmakinetics at UC, and researchers at the University of Chile in Santiago conducted the study, which was funded by the United States Fulbright Commission. The study investigated the effectiveness of Demerol, lithium, and acetazolamide on 36 males who either live at sea level and travel to high altitudes or live in high altitudes.

"In high altitudes, our bodies produce more red blood cells," says Ritschel. "All three drugs examined bind these cells. With an increase in red blood cells, the amount of the medication that attaches to each cell is increased. Hence the amount of free drugs in plasma is reduced, lessening the effectiveness of the medication."

The opposite reaction occurs with drugs that bind to plasma proteins. Our bodies produce less plasma proteins in high altitude. Plasma proteins decrease in high altitudes, explains Ritschel. Therefore, more free medication is available in the plasma, increasing the effectiveness of the drug. The increased potency of the drug could even turn toxic in high altitudes. High altitudes also affect the distribution of water in the body and the pH level of body fluids, which can also alter the effectiveness of medications.

According to Ritschel, "Research on the body’s reaction to medication is generally done on subjects who live at sea level, and these results are extrapolated to people at high altitudes. This study suggests that a dosage's clinical effectiveness should also be tested on people in high altitudes."

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