Do You Need Diamox To Climb Kilimanjaro? (What I Did)
Short answer: I took Diamox on my Kilimanjaro climb and had zero side effects. I’d take it again. But it’s not magic – it helps your body acclimatise faster, it doesn’t cure altitude sickness.
Whether you need it depends on your route length, your body, and your risk tolerance. Here’s what I learned.
Table of Contents
What Diamox Actually Does
Diamox (generic name: acetazolamide) is a prescription medication that helps your body acclimatise to altitude faster. It does this by making your blood slightly more acidic, which triggers faster and deeper breathing. More breathing = more oxygen = better adjustment to thin air.
Key thing to understand: Diamox does not treat altitude sickness. If you’re already seriously sick at altitude, the only cure is descending. Diamox is a preventative – it speeds up the process your body goes through naturally.
Think of it as buying your body an extra day of acclimatisation. On a 5-day route where acclimatisation time is tight, that’s significant. On an 8-day route where you’re already climbing slowly? Less critical, but still useful insurance.
Side Effects (The Honest Version)
Everyone’s different. The most commonly reported side effects:
I had none of these. Zero. Not even the tingling that everyone warns about. My climbing partner had mild tingling in his fingertips for the first two days, then nothing. Two people in our group didn’t take it at all and were also fine.
The point: it’s individual. Some people hate it, some don’t notice it.
Should You Take It?
My take:
Definitely yes if you’re doing a 5-6 day route. The acclimatisation window is tight. Diamox genuinely helps.
Probably yes if it’s your first time at high altitude and you have no idea how your body handles it. The peace of mind alone is worth it.
Optional if you’re on an 8-day route and have previous high-altitude experience with no issues. You’ll likely be fine either way.
Consult your doctor if you have kidney issues, are allergic to sulfa drugs, or are taking other medications (particularly Malarone for malaria prevention – there’s an interaction worth discussing).
Heads up: If you’re also taking Malarone (a common malaria prophylactic for Tanzania), mention this to your doctor. Both drugs affect the kidneys. Most doctors still prescribe both together, but it’s worth the conversation.
What I Did (My Protocol)
I started taking Diamox two days before the climb began and continued through to summit day. Standard dose: 125mg twice daily (morning and evening). Some people take 250mg twice daily but the lower dose worked for me.
I also did the following, which honestly probably mattered more than the Diamox:
Result: I had a mild headache on Days 5-6 and my appetite vanished above 4,500m. But nothing that stopped me. Made the summit without drama.
Was that the Diamox, the 8-day route, or my genetics? Honestly no way to know. But I’d rather take a $10 medication with minimal side effects than gamble on the biggest hike of my life.
How To Get Diamox
Diamox is prescription-only in most countries. Options:
Option 1: Your GP at home. Book a travel medicine appointment 4-6 weeks before your trip. Tell them you’re climbing to 5,895m. They’ll prescribe it. In NZ and the UK this is straightforward. In the US you may need a travel clinic.
Option 2: Buy in Tanzania. Diamox is available over-the-counter in pharmacies in Moshi and Arusha for a few dollars. Quality is generally fine but if you prefer peace of mind, get it from home.
Tip: Start taking it 1-2 days before your climb begins, not on Day 1 at the gate. You want it in your system before you hit altitude.
Alternatives to Diamox
If you can’t or won’t take Diamox, the best alternatives are:
1. Choose a longer route. An 8-day route gives your body almost double the acclimatisation time of a 5-day. This is the single biggest factor. My route comparison explains why.
2. Walk slowly. Pole pole. Don’t race. The people who get sick fastest are usually the ones who went too hard on Day 1.
3. Stay hydrated. 3-4 litres per day minimum. Your body uses more water at altitude and dehydration worsens symptoms.
4. Ibuprofen for headaches. Fine for mild altitude headaches. But be careful – ibuprofen masks symptoms. If your headache is getting worse despite ibuprofen, that’s a sign you need to descend, not take more pills.
Tanzania Travel Planning Cheatsheet 🇹🇿
🚑 Should I buy travel insurance for Tanzania?
100% YES! — Tanzania has now introduceed “free” healthcare but it’s only for citiens! Tourists need travel insurance in case anything happens on your visit. Also be aware many policies won’t cover high altitude hiking as it’s a high risk activity!
(That’s right, check the t&c’s on your complimentary credit card insurance)
I highly recommend World Nomads as you can get specific add-ons for high altitude hiking UP TO 6000m (Which most travel insurance companies don’t offer!)
🎫 Do I need a visa for Tanzania?
Probably not — Tanzania now provide a visa on arrival (VoA) for most western countires which allows you stay for up to 90 days. However, some other countries do need a pre-approved eVisa (check here!). VoAs cost $50 USD for a single entry – Note, US Citizens are required to get a Multi-Entry visa which costs $100 USD. (View visa prices here)
If transiting through Kenya (a lot of people fly via Nairobi), you’ll need a Kenyan visa too. Visa’s cost $20 for a 3 day transit visa and $50 for a toursit visa
(By the way, on both my interactions with the imigration officers in kenya they tried to scam me, so know what your obliged to pay and BRING THE EXACT CASH for the visa!)
💉Do I need any vaccinations for Tanzania?
YES! Make sure you are up-to-date with all your vaccines. Common travel vaccines include Hep A/B + Typhoid, and Diphtheria + Tetanus.
A yellow fever vaccination isn’t a requirment to visit Kilimanjaro but is for neighbouring areas in East Africa. In reality, you will might not be allowed back into your home country on your return (I was asked for proof of vaccination upon returning to Australia) so getting this jab prior made for good peace of mind.
Rabies is an issue in Tanzania but the vaccine is expensive and ineffective as a preventative measure (it only lasts a few years and you’ll need to get them again if you require treatment). If bitten by a stray dog seek immediate medical attention!
As always, talk to your GP or specialised travel doctor a few weeks BEFORE you leave.
🏩 What’s the best Kilimanjaro Tour operators?
Your only realy two options here are Kumano Travel and Booking.com. Its a complicated process so I wrote this guide here on the best kumano kodo accomodation options
If you don’t want to figure it all out (it’s meant to be a holiday after all) you can book a package tour. Here are my recommendations for both guided and self-guided.
💸How do you pay for things in Tanzania?
Cash is king in Tanzania, so you’ll want to get some folding tender out from an ATM when you land. Larger businesses and hotels will take Debit / Credit Card but most resturants, and street vendors want cash. I even had to pay for my Kili trip in cash!
I personally use a Wise debit card for all my international money needs as they only convert the funds when you make payment, plus they offer a much better spread (margin on the true exhange rate) than the banks do. They work in all the Tanzanian ATMs I tried.
🚌 What’s the public transport like in Tanzania?
There is a good basic network of local and inter-city busses in Tanzania and travel this way is very cheap. Domestic flight are also very affordable and a far more comfortable option. Checkout Busbora for booking bus tickets online.
📲 How do I get internet/data/wifi in Tanzania and on the mountain?
This one needs a whole nother article, but the short version is prepaid SIM cards are cheap and availible to tourists and locals alike (You don’t need a pricey tourst SIM!)
Your cheapest option is buying a physical sim card on the street corner once landed and getting the shop assistant to help you set it up. I went with Vodacom and had generally good coverage, even up on Kili!
Another option is the Saily eSIM. This is a little more expensive but works from the moment you land is is SOOOOO much easier. It also gives you connectivity across 14 neighbouring African Countries and connectivity the moment you step off the plane!
TIP: I used to use Airalo but now find Saily a much better product – you can get 5% off with code SPECIAL5
✈️ What’s the best site to buy flights to Tanzania?
For finding cheap flights, I recommend Skyscanner. Once you find the flight you’re looking for, I’d then suggest booking directly with the carrier (even if it costs a few $$ more than with one of the agreggators/agencies).
💧Can you drink the water in Tanzania?
Safest not to — tap water in Tanzania may be OK (the locals drink it) but is generally untreated and not reccommended for tourists. Purchase bottled water for drinking and teeth brushing.
🏔️💧Can you drink the water on Mount Kilimanjaro?
Yes — Your tour company with ensure the water provided to you is safe to drink by either carrying in bottled water, or by treating stream water with purification tablets or by boiling it. If you want to drink water from the rivers and streams you generally can but should do so at your own risk. ALWAYS follow best practice and drink from fast flowing water as far up stream as possible. I’d also recommend a Brita Water Bottle for rehydrating on the trail safely.
