8
Gertsch et al Results
14%
12%
35%
34%
NNT 4
GB/AZ
AZ
GB
Placebo
Ginkgo to prevent AMS?
· Repeat Pike's Peak study
3 day preload instead of 5, different product
· No benefit, while AZ 250/day worked
· Chow et al, 2002
N=55, 3800m, 5 days, 2x120 mg/day
· No benefit, while AZ 250/day worked
· Moraga et al, 2002
N=32, 3700m, 1 day, 2X80 mg/day
· 40% reduction in AMS
So What to Make of All This?
· Studies are inconclusive because of
differences in dose, timing, ascent profiles
· Ginkgo is a complicated plant extract;
preparations vary considerably
· Ginkgo is harmless
· Definitive studies will identify the active
ingredients, mechanism and efficacy
· Until then...
What to Advise?
· Gingko (some preparations) work for many
folks; not as good as acetazolamide
· It's cheap and non-Rx, it's safe
· So why not offer it as an alternative or
addition to AZ?
· 100 mg bid, 60 mg tid, starting ? days prior
to ascent
Drugs for HAPE
· Beta-agonists
· PDE-5 inhibitors
· acetazolamide
Sartori et al
, NEJM
346: 1631-1636, 2002
