How long does altitude sickness last in Cusco?

Most people feel better within 2-3 days. Complete acclimatization takes 1-2 weeks, but you'll feel functional much sooner.

Can I take the train from Cusco to Machu Picchu if I have altitude sickness?

Yes, the train descends to Aguas Calientes at 6,700 feet, which often helps symptoms. Machu Picchu itself is at 7,900 feet, lower than Cusco.

Should I avoid the Inca Trail if I'm sensitive to altitude?

The Inca Trail reaches 13,800 feet at Dead Woman's Pass. If you struggle in Cusco, consider the train option instead. Acclimatize in Cusco for at least 4 days before attempting the trail.

What if I can't get Diamox before my trip?

You can buy acetazolamide in Lima or Cusco pharmacies without a prescription. It costs about $10-15 locally.

How to handle altitude sickness in Cusco and Machu Picchu

Arrive in Cusco 2-3 days early to acclimatize before visiting Machu Picchu. Take altitude sickness medication, stay hydrated, and avoid alcohol. If symptoms worsen beyond mild headaches, descend immediately to lower altitude.

Take preventive medication before arrival. Start taking acetazolamide (Diamox) 125mg twice daily 1-2 days before arriving in Cusco. Consult your doctor first. This helps your body adjust to lower oxygen levels.
Plan a gradual ascent. Fly into Lima first, then Cusco (11,200 feet). Spend 2-3 full days in Cusco before attempting Machu Picchu. This gives your body time to produce more red blood cells.
Hydrate aggressively on arrival. Drink 3-4 liters of water daily. Avoid alcohol completely for the first 48 hours. Alcohol worsens dehydration and altitude symptoms.
Rest on your first day. Keep activities light for 24-48 hours. Walk slowly, take frequent breaks, and avoid strenuous exercise until you feel normal.
Recognize warning symptoms. Mild headaches, nausea, and fatigue are normal. Seek immediate medical help for severe headaches, vomiting, confusion, or difficulty breathing. These signal serious altitude sickness.
Use coca tea and oxygen if needed. Drink coca tea (legal in Peru) to ease mild symptoms. Many Cusco hotels provide oxygen tanks. Use for 10-15 minutes if feeling lightheaded.
Descend if symptoms persist. If you feel worse after 2-3 days, or develop severe symptoms, descend to lower altitude immediately. Return to Lima or seek medical attention.

How long does altitude sickness last in Cusco?: Most people feel better within 2-3 days. Complete acclimatization takes 1-2 weeks, but you'll feel functional much sooner.
Can I take the train from Cusco to Machu Picchu if I have altitude sickness?: Yes, the train descends to Aguas Calientes at 6,700 feet, which often helps symptoms. Machu Picchu itself is at 7,900 feet, lower than Cusco.
Should I avoid the Inca Trail if I'm sensitive to altitude?: The Inca Trail reaches 13,800 feet at Dead Woman's Pass. If you struggle in Cusco, consider the train option instead. Acclimatize in Cusco for at least 4 days before attempting the trail.
What if I can't get Diamox before my trip?: You can buy acetazolamide in Lima or Cusco pharmacies without a prescription. It costs about $10-15 locally.