Altitude Sickness — Detailed
Altitude sickness (Soroche) is the most important health issue for travelers to Peru. Here is a detailed guide:
Altitude Profiles of Main Destinations
| Location | Altitude | Risk |
|---|---|---|
| Lima | 0 m | None |
| Machu Picchu | 2,430 m | Low |
| Sacred Valley | 2,800 m | Low–Medium |
| Cusco | 3,400 m | Medium |
| Arequipa | 2,335 m | Low |
| Colca Canyon (Chivay) | 3,640 m | Medium |
| Puno/Lake Titicaca | 3,827 m | Medium–High |
| La Raya Pass | 4,335 m | High (transit only) |
| Patapampa Pass (Colca) | 4,910 m | High (transit only) |
| Inca Trail (Dead Woman's Pass) | 4,215 m | High |
Optimal Acclimatization Strategy
- Day 1–2: Lima (0 m) — Arrive, overcome jet lag
- Day 3: Flight to Cusco (3,400 m) — REST DAY! Only light activity, coca tea, drink plenty, go to bed early
- Day 4: Sacred Valley (2,800 m) — Descend to the Sacred Valley — sleeping there is more comfortable than in Cusco
- Day 5+: Activities — After 48 hours of acclimatization in Cusco/Sacred Valley, you are ready for most activities
Alternative (better, but more time-consuming): Fly to Cusco, immediately continue to the Sacred Valley (2,800 m) for 2 nights, then to Cusco (3,400 m).
Medications
- Acetazolamide (Diamox): Prescription required in Germany, but available over-the-counter in Peruvian pharmacies. 125–250 mg twice daily, starting 1–2 days before ascent. Speeds up acclimatization. Side effects: tingling in fingers/toes, frequent urination, metallic taste with carbonation.
- Ibuprofen/Paracetamol: Effective against headaches. Always have on hand.
- Coca leaves/coca tea: The traditional remedy. Proven effective for mild symptoms. Available everywhere in the highlands.
- Sorojchi Pills: Peruvian combination preparation (aspirin + caffeine) for mild symptoms. Available in every pharmacy.
Achtung
DO NOT fly directly from Lima to Puno or Lake Titicaca (3,827 m) without prior acclimatization! The jump from 0 to almost 4,000 m without a stopover is dangerous. Acclimatize first for 2–3 days in Cusco (3,400 m) or Arequipa (2,335 m).
