Landing in Cusco at 11,200 ft (3,400 m) can feel thrilling, then a little dizzy. The Sacred Valley sits lower at about 9,200 ft (2,800 m), Machu Picchu rests at 7,970 ft (2,430 m), and Puno on Lake Titicaca climbs to 12,500 ft (3,812 m). You might hear locals call it soroche, and you may wonder how your body will react.
Here is the good news. Most cases of altitude sickness are mild and improve in 1 to 3 days with rest. You can prevent most problems with a smart plan, a calm pace and the right habits from day one. Fitness does not protect you, so even marathoners need a strategy. This guide lays out clear steps so you can explore with confidence and enjoy every view.
Ready to start planning with experts who care about your comfort? Contact us to talk to a Peru travel expert and get a free quote tailored to your pace.
Altitude sickness happens when your body does not get enough oxygen at higher elevations. Air pressure is lower, so each breath brings fewer oxygen molecules into your lungs. That shortfall can trigger a headache, nausea, or worse if you climb too fast.
Mild Acute Mountain Sickness (AMS) is the most common form. It often feels like a hangover. More serious forms are rare but dangerous. High Altitude Cerebral Edema (HACE) is swelling in the brain. High Altitude Pulmonary Edema (HAPE) is fluid in the lungs. These need urgent care and, most of all, a quick descent.
Symptoms usually begin 4 to 36 hours after you arrive at a higher altitude. Many people feel better within 24 to 72 hours if they stay at the same height and rest. Fast ascent from sea level raises your risk. A past history of AMS, dehydration, poor sleep or a cold also make symptoms more likely.
Let’s clear up a few myths. Being very fit does not prevent AMS. Age or gender do not decide who gets sick. Warm weather does not mean more oxygen is in the air. The key is a slow pace and smart choices, not gym strength.
For more on prevention and care, check the CDC’s overview on Travel to High Altitudes and the medical guidance in the CDC Yellow Book chapter on high-altitude travel.
You might also notice mild swelling in your hands or face. Most people improve with rest, fluids and time. Keep your plans easy and let your body catch up.
Even strong runners and hikers can get AMS. Your body still needs time to adapt. You will breathe faster, your heart will work a bit harder and over days your body will make more red blood cells. That process cannot be rushed by fitness alone.
Watch for warning signs of HACE and HAPE:
If any of these appear, stop ascending, go to a lower altitude at once and get medical help.
Mild AMS often improves in 24 to 72 hours at the same altitude. Many travelers feel better after two nights in Cusco, or after spending the first nights in the Sacred Valley or near Machu Picchu. Going lower speeds recovery. Once you feel normal, you can step up your activity.
You can set yourself up for a smooth trip with a simple four-step plan outlined below. Keep choices easy. Give your body time. Eat light. Drink often. Sleep earlier than usual on the first nights.
For a doctor-reviewed checklist, see the CDC’s guidance on high-altitude travel and prevention.
Need a hand timing your activities around acclimatization? Contact us to talk to a Peru travel expert about a custom, slow-first itinerary so you avoid altitude sickness.
If you had AMS before or you plan a quick ascent, ask your doctor about acetazolamide (Diamox). A common prevention dose is 125 to 250 mg every 12 hours, starting 24 hours before you reach altitude, then continue for 2 to 3 days at altitude. People with a sulfa allergy or who are pregnant should discuss risks and options with their doctor.
Common side effects include tingling fingers, more urination and a change in taste for soda. Do not self-medicate without medical advice.
If you fly into Cusco, consider sleeping in the Sacred Valley for the first nights. The lower altitude helps your body adapt gently.
Plan gentle tours, quiet walks and free time. Avoid hard hikes or long runs. Keep alcohol to zero the first 48 hours. Carry warm layers, sunscreen, and a refillable bottle.
Coca tea (mate de coca) is a popular local drink. Some travelers find it eases mild symptoms like headache or fatigue.
Soroche Pills in Peru may include aspirin, caffeine and sometimes acetazolamide. Read labels and ask a pharmacist what is inside. If you have heart or stomach issues, talk to a doctor first.
Many hotels in Cusco keep oxygen on hand, which can ease symptoms for a short time. Oxygen helps you feel better but does not replace acclimatization.
Stay calm, slow down and listen to your body. Mild AMS often improves with rest and fluids at the same altitude. If symptoms worsen or do not improve after 24 to 48 hours, go to a lower place. Red flags mean you should descend at once and seek care. Especially when doing treks such as the Inca Trail.
Travel clinics and pharmacies in Cusco and the Sacred Valley are used to helping travelers. Keep your travel insurance details and medication list handy.
Seek help if you have:
Ask your hotel to call a doctor or guide you to a nearby clinic. Bring your insurance info and a list of your medicines and allergies.
Going lower is the most effective treatment for moderate to severe symptoms. Practical steps include:
Tell your guide early. Transport can be arranged. Your health comes first. Tours can be adjusted and rescheduled when you feel stronger.
Want itineraries designed with smart acclimatization in mind? Get in touch with us for a free quote and let a Peru travel expert time your route for comfort.
Give your body a gentle start. If you can, fly into Lima first. Rest one night before flying to Cusco. Sleep the first nights in the Sacred Valley, which is lower than Cusco. Do the Machu Picchu day tour next, then enjoy Cusco’s city sites after you feel better. Save the highest stop, Puno, for last. That’s how we plan our customized Peru tours to ensure an impeccable experience.
A light pace builds confidence and keeps your energy high for the experiences you came for.
Here is a quick look at the main stops and their elevations.
| Place | Elevation ft | Elevation m |
|---|---|---|
| Lima | Sea level | Sea level |
| Sacred Valley | ~9,200 | ~2,800 |
| Cusco | 11,200 | 3,400 |
| Machu Picchu | 7,970 | 2,430 |
| Puno/Titicaca | 12,500 | 3,812 |
Both versions lower your risk by sleeping lower first, then stepping up to Cusco once you feel better. For more inspiration, have a look at our Peru tours.
For a complete overview, have a look at our Peru packing list.
Sleeping lower first is the single best itinerary choice. Plan gentle Sacred Valley activities on day 1 and 2. Visit Machu Picchu on day 2 or 3. Explore Cusco’s museums, markets, and historic sites after your body has adjusted. Save longer hikes, like Rainbow Mountain or Humantay Lake, for day 3 or later, when you feel steady.
Slow your ascent, drink water, eat light and skip alcohol at first. Consider acetazolamide if your doctor agrees. Rest when your body asks. Most altitude sickness Peru cases are mild and pass with time, especially with a well-paced plan. Give yourself the gift of a smooth start and the Andes will reward you with clear views and calm energy.
Altitude sickness, also called acute mountain sickness, is a reaction to lower oxygen levels at high altitude. In Peru, cities such as Cusco (about 3,400 meters), Puno (about 3,800 meters), and high Andean passes put extra stress on the body. When you gain height faster than your body can adjust, you may develop symptoms like headache, nausea, and fatigue as your body tries to adapt to the thinner air.
Most travelers start to feel altitude sickness above 2,500 meters, which is around 8,200 feet. Many popular Peruvian destinations are above this level, such as Cusco, Puno, and the Sacred Valley. Risk rises when you fly directly from sea level, like Lima, to these high cities without time to adapt. A slower approach with one or two nights at a lower point in the Sacred Valley or similar areas can reduce the risk.
Common symptoms of altitude sickness in Peru include pounding or persistent headache, nausea or vomiting, loss of appetite, dizziness, shortness of breath with light effort, unusual tiredness, and poor sleep. Symptoms usually start within 6 to 24 hours after arriving at altitude. Mild symptoms often improve with rest, fluids, and time. If symptoms get worse instead of better, you should seek medical help.
To reduce the risk of altitude sickness, plan your route so you gain height in stages. If possible, spend a night or two in a mid-altitude area like the Sacred Valley before staying in higher cities like Cusco. Drink plenty of water, eat light meals, avoid alcohol and heavy exercise on arrival, and rest on your first day. Some travelers use altitude medication such as acetazolamide, but this should be discussed with a doctor before the trip. Local remedies, such as coca tea, may help some people feel better, but they do not replace medical treatment if symptoms are serious.
You should seek medical help if symptoms are strong, do not improve with rest, or get worse over time. Red flags include severe or worsening headache, trouble breathing at rest, chest pain, confusion, trouble walking in a straight line, or feeling very weak. These can be signs of serious forms of altitude illness that need quick treatment and often descent to a lower altitude. Many tourist areas in Peru have clinics or doctors familiar with altitude problems, so ask your hotel or tour operator for help right away.
Ana14 July, 2024 at 8:42 am
Tenemos planeado ir a Peru en noviembre. Mi esposo padece de muchas condiciones incluyendo cirugías de corazón y presión arterial alta. Su neuro cirujano, que es peruano, nos dijo que él sí podía viajar a Peru, mi pregunta es ¿Si compro una máquina de oxígeno portable, estaría reduciendo los síntomas de mal de altura? ¿Le servirá?
Oliver from Exploor14 July, 2024 at 9:55 am
¡Hola Ana!
Es genial que estén planeando un viaje a Perú en noviembre. En cuanto a tu pregunta sobre el mal de altura, una máquina de oxígeno portátil puede ayudar a reducir los síntomas del mal de altura al proporcionar oxígeno adicional cuando sea necesario. Esto puede ser especialmente útil en lugares de gran altitud como Cusco y Machu Picchu.
Sin embargo, es importante consultar con su médico antes de viajar para asegurarse de que este enfoque sea adecuado para las condiciones de salud específicas de tu esposo. Además, es recomendable planificar una aclimatación gradual, hidratarse bien y evitar el esfuerzo físico excesivo al llegar a altitudes elevadas.
Si tienen más preguntas, no duden en enviarnos un correo a [email protected].
Vane14 February, 2024 at 8:53 pm
Un niño de 9 años con 40kg de peso, qué puede tomar para el soroche? aparte de hidratarse y tomar mate de coca? …en nuestro caso, viajamos a Cuzco y de los 4 días, 3 días estuvo mal! ya sea caminando, con frio, calor. Su primer día estuvo muy bien. En la noche del 2do día le dio soroche, luego en la tarde del 3er día y en la mañana del 4to día. Tomando siempre mate de coca pero sin medicarlo.
Oliver from Exploor15 February, 2024 at 10:51 am
Hola Vane! Recomendamos hablar con un doctor en estos casos, nosotros no estamos calificados para dar consejos médicos sobre la salud de tu hijo. Que se mejore pronto!
Saludos!
Maximiliano3 September, 2023 at 2:10 pm
Es normal sentir como los efectos después de descender ??
Llevo 5 días aprox desde que baje y me eh sentido así como un poco mariado y como con falta de concentración , esto me pasó desde que subí a 4600 en mi trabajo
Oliver from Exploor4 September, 2023 at 3:26 pm
Hola Maximiliano, gracias por tu comentario. Recomendamos que saques cita con un médico para que te pueda ayudar con el tema, ya que nosotros no estamos capacitado para hacer ese tipo de evaluación.
Saludos,
Oliver
Dame28 August, 2023 at 7:18 am
Tengo artritis y voy a viajar y visitar desaguadero Bolivia por tierra.. que tanto me afectara la altura por mi condición de salud ? que debo hacer o qué medidas debo tomar ? Es mi duda.. gracias
Oliver from Exploor30 August, 2023 at 11:37 am
Hola Dame, recomendamos que antes de viajar consultes con tu médico. Es importante acostumbrarse a la altura poco a poco, siempre tomando las medidas necesarias como tomar mucha agua, comer comida ligera y tomar pastillas como el Soroche.
Saludos,
Oliver
Ilda Méndez12 July, 2023 at 10:48 am
Puede ir a Machu Picchu una persona con cirugía de corazón. Toma medicamento para la presión con bien control
Oliver from Exploor14 July, 2023 at 11:53 am
Hola Ilda, cómo estás? Recomendamos que primero hables con tu doctor antes de planear tu visita a Machu Picchu para evitar cualquier inconveniente potencial. Nosotros somos expertos en el tema de viajes, pero no somos doctores para darte una recomendación personalizada en cuanto a temas de salud. Esperamos que nos puedas visitar pronto. 🙂
Muchas gracias y saludos,
Oliver
No sé supone que los aviones están preparados para no sentir mal por la altura ???18 August, 2022 at 8:43 pm
No sé supone que los aviones están preparados para los pasajeros para contrarestar el mal de altura??
Daniel3 March, 2023 at 6:48 am
Los aviones tienen cabina presurizada, el problema es AL DESCENDER DEL AVIÓN.
cecilia30 May, 2022 at 4:59 pm
Yo les recomiendo las capsulas naturales
ALTIVITAL son hechas con hojas de coca, de muña, guaraná y jengibre. son efectivas si tomas dos en la mañana y dos en la tarde solo los 3 primeros dias en altura. no tiene contraindicaciones, no hacen daño y las pueden tomar niños y ancianos.
Oliver from Exploor31 May, 2022 at 8:24 am
Hola Cecilia, gracias por tu recomendación! La próxima vez que viajemos a Cusco lo vamos a tener en cuenta.
Saludos 🙂
Isabel7 October, 2023 at 10:20 am
Si viajo con mi bebé de año y Medio como le puede afectar la altura? Y en tal caso que si se le podría dar algo?
Oliver from Exploor8 October, 2023 at 12:09 pm
Hola Isabel, gracias por tu comentario. Recomendamos consultar ese tema con tu médico de confianza.
Saludos
Oliver
Donde se compran ? Me toca viaje del 24 de noviembre al 3 de diciembre24 October, 2022 at 12:47 pm
A mi el jengibre me sube presión será que estas cápsulas no me hagan daño?
Jutta21 May, 2022 at 9:35 am
Gracias por todos las muy buenas sugerencias. Cada experiencia puede ser muy diferente a la de otros pero al final lo que más preocupa es de que manera la salud puede ser afectada.
Pensamos hacer nuestro viaje a Cusco para agosto Machu Picchu etc, en particular, tengo artritis en rodillas y varices, también me preocupa si la altura podría afectar la parte vascular….
Oliver from Exploor21 May, 2022 at 11:03 am
Hola Jutta, muchas gracias por tu comentario. Es muy cierto lo que dices, cada experiencia puede ser muy diferente a la de otros. Por eso y muy importante seguir las recomendaciones generales para evitar cualquier tipo de inconveniente. En cuanto a tu caso particular recomendaría que hables con un médico para que te pueda dar una opinión profesional.
Ojalá puedan viajar a Cusco pronto! 🙂 Saludos.
Ed14 May, 2022 at 10:11 am
Hello! Thanks a lot for the information!
I’m planning to go next month in June to Cusco for 4 days, however, just have a question if a women probably is pregnant for one month could still get any medication or local remedy? Definetly in that case we wil ask her doctor in advance.
Oliver from Exploor15 May, 2022 at 6:52 pm
Hey Ed, thank you for your message! This is a very good question and we’d rather not give any recommendation as we are no experts in this field. As you say, best would be to talk to your doctor in advance so you can prepare properly. Let us know if you need anything else. 🙂
Mike12 May, 2022 at 2:16 pm
Awesome article! I’m traveling with my family to Peru next month and we are very excited. Have you heard how children do with the altitude? I’m curious if they will need to medicine or will be fine on their own.
Oliver from Exploor15 May, 2022 at 6:44 pm
Hey Mike, glad the article helped. Thank you for your kind words! 🙂
Regarding your question, we’ve never had any problems so far with the children that travelled with us. Best would probably to double check with your doc and see what recommendations they give. From past travelers we know that they gave Soroche pills to their kids when they were having issues with the altitude apart from the other recommendations, e.g. rest, drink lots of water and coca tea etc. Let us know if you have any other questions.
Saludos, Oliver
Doug Perrington21 February, 2022 at 12:09 pm
Very cool and thanks for sharing this. Is Palccoyo still the “hidden” gem or can we expect in April more travellers there than at Vinicunca?
Konsti from Exploor Peru21 February, 2022 at 1:17 pm
Hello Doug, thanks a lot for your positive words. April is the start of the dry season and for that reason you’ll face more travellers in Peru than the months before. However, at Palccoyo you won’t face as many travellers as at Vinicunca and you will embrace the beautiful landscapes. For more information about the two rainbow mountains have a look at our blog post: differences between Palccoyo and Vinicunca rainbow mountain. Best, team exploor
Ángela Tescari6 December, 2021 at 10:41 pm
Hola quisiera me ayuden con esta gran duda que tengo; si una persona que está acostumbrada a viajar en avión o sea ha viajado en avión varías veces Y no ha sentido ningún síntoma de mal de altura. Será que por tierra al visitar desaguadero y bolivia que son zonas altas puede sentir síntomas porque de verdad que en avión no los ha sentido por eso mi duda .. porque acá en el documental dice que lo sufren mucho las personas que viajan en avión ?? Gracias si pueden aclararme las dudas muy agradecida bendiciones
Jose12 October, 2022 at 7:07 am
El avión tiene cabina presurizada es como estar a cero metros sobre el nivel del mar, mientras que si te trasladas por tierra tu cuerpo se tiene que adaptar a los 3000 o 4000 mts sobre el nivel del mar totalmente diferente e incomparable
Gabriel27 October, 2022 at 4:13 am
No es cero es 14.7 al nivel del mar
P3t322 November, 2021 at 1:29 pm
Great info! Is it really not possible going to the gym or doing an exercises in Cusco? And where can I get the pills?
Konsti from Exploor Peru22 November, 2021 at 1:39 pm
Hello P3t3,
it’s very important that you are getting used to the altitude in Cusco. For that reason we highly recommend avoiding sport in the first 24-48 hours. Besides that, you’ll get the altitude pills such as sorojche already at the airports in Lima/Cusco or at every pharmacy in Peru. Let us know if you have any further questions.
Blake M.13 September, 2021 at 10:09 pm
Dear Exploor team, I really appreciate the free tips on your blog! If I have 3 days in Cusco which tours would you recommend, also considering the altitude? I heard many people got sick at Rainbow Mountain. Cheers Blake
Exploor Peru15 September, 2021 at 8:29 am
Hey Blake, thank you for your comment. We’d recommend visiting the Sacred Valley, Machu Picchu and either Rainbow Mountain or Humantay Lake (in the same order as the former destinations are at a lower altitude than the latter). People that get sick at Rainbow Mountain mainly because they didn’t give their body enough time to get used to the altitude. This is very important to consider! If you have any other questions just let us know 🙂
Brenda O'Neil26 August, 2021 at 1:20 pm
Thanks for this info! Quick follow up question; which altitude sickness medicine would you recommend we should buy when in Peru?
Oliver from Exploor26 August, 2021 at 8:33 pm
Glad it was helpful! I’d recommend Sorojchi Pills, you can get them at every pharmacy in Peru.
N.G11 April, 2023 at 6:30 am
Hi, thank you for the information!
I wanted to understand, when arriving in Cusco I should rest a few days before going on any hike?
Thank you!
Oliver from Exploor11 April, 2023 at 9:30 am
Hey Brenda, how are you doing? Glad the article is helpful!
We definitely recommend resting 24-48 hours before going on a high-altitude hike, such as Rainbow Mountain, Humantay Lake or Salkantay Trek. This way you allow your body to get used to the altitude. Hope this helps, let us know if you have any additional questions.
Saludos,
Oliver