Altitude sickness: All you need to know and how to avoid it

Posted by Oliver Eberlein on

Cities: Cusco, Huaraz, Puno, Arequipa // Category: Tips to travel in Peru // Reading time: 7 min  


The altitude sickness is a topic that worries many travelers before arriving to elevated cities, such as Cusco (11,154 ft. / 3400 m) or Puno (12,555 ft. / 3827 m). Especially when reading reviews and comments online you can find many experiences of people laying in bed with nausea or having severe headaches.

That’s probably the last thing you want when thinking about the beautiful spots you can visit in the Peruvian mountains, such as Palccoyo, Vinicunca or Humantay.


Vinicunca snow-capped Rainbow Mountain Cusco


In order to help you understand the altitude sickness and its syndromes better, we did some research, talked to our travelers and also gathered information from locals living at high altitude.

This article will help you understand what the altitude sickness is, what the typical symptoms are and what to do to avoid it.


What is the altitude sickness?

The altitude sickness is a physical discomfort that usually occurs when visiting a place located at a higher altitude. In Peru, destinations at higher altitudes are Cusco, Arequipa’s Colca Canyon, Huaraz or Puno.


Couple walking on the alternative rainbow mountain palccoyo

  The Alternative Rainbow Mountain Palccoyo in Cusco at 4900 m. (16,076 feet)


Most travelers who are affected by the altitude sickness are those traveling by plane, coming from a place with higher temperatures and lower altitude. This is due to the abrupt changes in altitude and climate as the air is thinner and the weather is colder.


What are the symptoms?

The majority of people usually get the altitude sickness between 6 and 24 hours after having reached altitudes of more than 3000 m.

Some of the typical symptoms of altitude sickness are:

  • headaches
  • nausea and vomiting
  • tiredness
  • breathing difficulties/shortness of breath
  • loss of appetite

That doesn't sound like great holidays, does it? The average duration of the altitude sickness is around two to three days. This is normal as the acclimatization time for a traveler in Peru is approximately two days.

But don't worry, there is always a solution. In this case, proper preparation is key.

There are certain tips to avoid the altitude sickness. These tips are recommendations from locals and past travelers who enjoyed a great (or not so great) time in the Peruvian highlands.


Girl hands up in front of Humantay Lake and snow-capped mountains in background

Exploorer at the Humantay Lake at 4200 m (13,779 feet).


Avoiding the altitude sickness and its symptoms

Take medicine

Some of the most common pills to prevent and to treat altitude sickness and its symptoms are the following:

  • Acetazolamide (sold under the name of Diamox) to prevent and treat high altitude sickness
  • Soroche pills (a very popular pill among Peruvians)
  • Ibuprofen and paracetamol to treat headaches
  • Gravol or Promethazine to treat nausea

You should take Diamox or Soroche pills to prevent the altitude sickness 1-2 days before going up in altitude. However, you should still be careful and go up in altitude gradually without rushing it.

If you feel like you are getting the symptoms mentioned above even though having taken medicine, it’s recommended to rest or go down until feeling better. The pills are available at every pharmacy and most likely the staff at your hotel/hostel will also be able to help you out.

We recommend getting them before traveling to high altitudes so that you can prevent the symptoms as much as possible. And of course, talk to your doctor before traveling so he can give you personal recommendations and read all the instructions thoroughly.


Drink coca tea or chew coca leaves

The coca tea (mate de coca) is the most popular tea in the Peruvian highlands. If you want to prepare a coca tea yourself, all you have to do is put some coca leaves into hot water, wait a few minutes and add some sweetener if you want.

Important note: Avoid drinking coca tea if you have to take job related drug tests. It is possible that a drug test might turn out positive, even if the leaves only contain a very small amount of cocaine.

Among locals, chewing coca leaves is very common. It’s part of their culture and they say it allows them to focus better. We have done it during several hikes, such as the Rainbow Mountain Vinicunca hike or the 5-Day Salkantay Trek to Machu Picchu and it definitely helped us.

You can also find the coca leaves in the form of cookies or sweets in every tourist shop. They are the perfect "on-the-go" snack.


Get used to the altitude step by step

Your body normally needs a couple of days to get used to the new altitude. That’s why you should take 2-3 days to get used to it. When arriving to Cusco, it’s a good idea to visit the Sacred Valley and Machu Picchu first, before doing hiking tours, such as to the Rainbow Mountains or to the Humantay Lake, as they are located lower. A tour that offers all of that is our Best of Cusco in 4 Days Tour.

As a general rule of thumb you should avoid climbing more than 300-500 m a day and have a rest day every 600 - 900 m you go up, or every 3-4 days.


Coca tea with Peruvian mountains in the back

Enjoying a coca tea in the Peruvian highlands.


Drink plenty of water

As a general rule of thumb, you can add 1.5l to your normal usage. It’s very important to keep your body hydrated.


Avoid alcohol and sports

It’s best to avoid alcohol, smoking and any kind of exhausting physical exercise until getting used to the altitude after a couple of days.


Eat low-fat dishes and avoid fatty meals

Soups, rice, pasta, potatoes, bread, fruit and chicken are great low-fat dishes and give your body the energy it needs. High-carb diets have shown to increase the mood but make sure to mix it up and also to include some lean protein, such as chicken, and some healthy fats, such as avocado, nuts etc.

Carbohydrates are good because they require less oxygen for your metabolism than fat and protein.

Try to avoid eating anything creamy or salty because your body will need more time to digest this kind of food. Salty meals, for example, will cause a faster dehydration of your body.

Important noteMany travelers have a lack of appetite after arriving due to the altitude. As a result, they consume up to 40% less calories than usual. That’s why it’s important that you eat enough food when arriving to your destination, even if you don’t feel hungry.  


Get Agua de Florida

Agua de Florida is a small bottle of yellow cologne made of different herbs. Inhaling it is supposed to help when having difficulties with the altitude, headaches and breathing problems.

It’s a famous medicine among locals. You can find it in pharmacies, small shops and in markets.


Buy Oxishot

Oxishot is a small dischargeable that contains up to 8 l of oxygen. It will help you reduce headaches, fatigue and also when you have breathing problems. You can buy it in pharmacies or small shops in Cusco for around S/ 45 (around $14).


Exploor Peru Guide Carlos at Maras Salt Mines Cusco

Our guide Carlos explaining more about the Maras Salt Mines.


Considering all of this and making use of the recommendations, the altitude sickness will hopefully not be a problem for your while you are in Peru.

It's crucial that you prepare yourself properly and that you take the altitude sickness seriously as it can potentially end up being the deciding factor whether your vacations turn out incredible or incredibly bad.

In case you have another recommendation or experience related to the altitude sickness, we would be happy to read about it in the comments below.

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Created on , posted by Jakob

Diese Tipps waren soooo hilfreich. Ich sitze gerade am Flughafen von Cusco, bevor es in Richtung Zürich geht und ich wollte mich für eure Hilfe bedanken. Gut das ich diese Tipps angewendet habe, ansonsten hätte ich meine Zeit in Peru im Bett verbracht. Danke Exploor!

Created on , posted by Jonathan

Thanks for sending us the helpful article, Erik. This is really useful as I am a pilot and I can’t afford to have problems with “coca” in my urine for the regular drug tests and I also don’t want to spend 4 days sick in bed when I’m in Cusco lol. Take care and see you soon in Cusco!

Created on , posted by Brock McIntosh

In 2012, researchers began studying the use of ibuprofen as prevention and treatment for high altitude sickness. In 2017, a meta-analysis of those studies was conducted ( It found that taking a dose of 600 mg of ibuprofen 3 times daily significantly reduced the chances of getting high altitude and the severity of the sickness for those who did get sick while taking the ibuprofen. It’s cheaper and more readily available than some of the other high altitude pills out there, and its side effects aren’t as bad. And as always, drink lots of water!

Created on , posted by Erik at exploor

Thank you, Manuel. Glad that I could help and I’m sure it will make your time in Cusco easier! Have a great time over there!

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