Keep the evidence boundary beside acetazolamide dose advice

Agreement: I Agree Body: Dear Editor, Adhikari and colleagues recommend acetazolamide 125 mg every 12 hours for moderate-risk ascent and retain the conditional wording “consider doubling” to 250 mg every 12 hours for high-risk ascent.[1] We suggest that the evidence boundary for this higher-dose option should appear at the same prescribing decision point. The 2024 Wilderness Medical Society (WMS) guideline recommends 125 mg every 12 hours as the adult prophylactic dose and states that 250 mg eve