How to: Altitude Sickness Prevention in Cusco, Peru

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Written by Ashley Lopez

This post will be dedicated to sharing my experience managing the high altitude of 3,400 meters above sea level in Cusco, Peru.

Hi everyone, welcome to Ashley Spills. Ashley, here. You can check out my other posts here. Altitude sickness, or Soroche, is a discomfort that usually occurs when visiting a new place with a higher altitude. Some symptoms include nausea and vomiting, dizziness, headaches, difficulty breathing, and loss of appetite.

As some of you may know, my family is from Lima, Peru and I have had the privilege to travel to Peru when I was one year old (1996), in 2005, 2015, and 2017. Collectively, I have visited and traveled from Lima to Cusco four times. Cusco is a popular city to travel to in Peru because it gives you accessibility to Machu Picchu and many more beautiful places to visit. Today, I will discuss how the altitude impacted my body during each trip. Most of my trips have consisted of flying to Cusco, but the altitude hit me differently each time.

Preparing for a trip to Cusco

Preparing for a trip to Cusco is not something to take lightly if your body is used to being at or below sea level. I will dive into altitude sickness prevention, and please know that the trip is definitely worth it. Cusco gives travelers access to many tours and the ability to book with various travel agencies. There are so many options to choose from. It can feel hectic at times, but of course the most popular tour is Machu Picchu – can’t wait to tell you about my trips there! Each experience was different.

To be clear, shortness of breath, feeling light headed every now and then, and dry nostrils are things I experienced in all of my trips, regardless of the outcome (good or bad). Going upstairs, walking on ascending roads and just walking too fast in general caused this (besides the dry nostrils, that was because of the dry air) due to the lack of oxygen. When this occurred, I drank a lot of water, stopped what I was doing, and took deep breaths. These feelings were only momentarily for the most part but were felt at least three to six times a day during each trip.

The methods of travel I’ve experienced

  • 2005: Lima to Cusco by plane
  • 2015: Lima to Cusco by bus
  • 2017 – Trip 1: Lima to Cusco by plane
  • 2017 – Trip 2: Lima to Cusco by plane

2005 trip

I was ten years old at the time and didn’t know what to expect from Cusco because I didn’t know much about altitude nor how it would affect my body. I remember the short one-hour plane ride from Lima to Cusco. This was the only trip out of the four that I felt nauseous and threw up multiple times. My symptoms weren’t immediate, rather a few hours after landing due to jumping right into tourist-y activities right away instead of resting. I vomited a lot, felt dizzy, and had terrible headaches.

After a day or two of feeling so queasy, a local gave me some tea and she rubbed some leaves on my forehead. I instantly felt better. At the time I didn’t know what the hell this woman gave me. Now I understand it was mate de coca (coca tea) and coca leaves. Coca leaves are cultivated and legal in Peru as natives use it to relieve hunger, fatigue, and to enhance physical performance. Yes, coca leaves are the main active ingredient in cocaine; but the leaves themselves have been used medicinally in Peru for several generations.

Pros:

  • It was my first time in Cusco – woo, I made it!
  • The coca tea and leaves made me feel better almost instantly

Cons:

  • Getting sick because I jumped right into being a tourist
  • I did not do anything for altitude sickness prevention
  • Experienced shortness of breath, light headedness, and dry nostrils

2015 trip (Incorporated altitude sickness prevention)

In 2015, I took a bus from Lima to Cusco. At the time, I was 20 years old and not at all prepared for such a long journey. The bus ride was about 26 hours long and it was absolutely brutal. I am not exaggerating (speaking for myself of course). If you have vertigo, a weak stomach, are scared of heights, cannot sleep on a bus, or cannot stay still: do NOT take the bus.

If you enjoy long rides and sharp turns on a two-story bus, then go for it. The bus drove through mountains with extremely narrow and curvy roads. I was terrified the bus would flip over during each turn because that’s what it felt like on the second floor of the bus. I was holding onto my seat for dear life. There were a ton of people throwing up and using the restroom because everyone was slowly adjusting to the altitude; it smelled awful. Did I mention that none of the roads had barriers or dividers?

The highlight of this trip was that I was able to prepare a little better by taking medicine that I bought from a pharmacy in Lima (will provide names and pictures below) to help my body adapt to the altitude. I was able to keep everything in my stomach in place and did not feel nauseous or dizzy once I got to Cusco.

Pros:

  • My body slowly acclimated to the altitude since the bus was gradually going higher and higher
  • Saw beautiful views that I wouldn’t have seen on a plane – but keep in mind that you cannot enjoy the scenery the whole time since the trip runs overnight
  • Economically friendly if you’re booking a trip to Cusco last minute (like I did – the only reason I took the bus in the first place) – I booked with Movil Bus for a price of about $50
  • Incorporated altitude sickness prevention

Cons:

  • The bus ride was way too long
  • Eight hours of the ride consisted of the what felt like, deadly and sharp turns every three to five minutes
  • Again, experienced shortness of breath, light headedness, and dry nostrils

2017 – Trip 1 (Incorporated altitude sickness prevention)

My first trip to Cusco in 2017 was on a plane. At this time, I was 22 years old. Before my flight, I got medicine from a pharmacy in Lima as well. Arriving to Cusco via plane after 12 years of not doing so felt bizarre. As soon as I stepped foot on the platform that led me off the plane, I felt super heavy and completely imbalanced. Luckily, the airport had coca leaves as soon as I entered so I was able to chew on these until I arrived at the Airbnb.

I took it slow my first day. Although I didn’t get actively sick (didn’t throw up, no dizziness, and no headaches), my stomach was all over the place this particular trip. I believe the altitude messed with my digestion this time because I was using the restroom… a lot. Sorry for the unwanted info, but seriously, it was a minimum of four times a day!

2017 – Trip 2 (Incorporated altitude sickness prevention)

My second trip to Cusco in 2017 was similar to the first with regards to transportation, taking medicine beforehand, and chewing on coca leaves at the airport. I would say this was my most successful trip to Cusco because I didn’t get sick, I wasn’t continuously using the restroom, and I let myself rest more. Here’s a quick fun fact: my boyfriend and I did… umm adult activities while in Cusco and were completely breathless and exceptionally lightheaded afterwards… just a heads up!

Disclaimer – I went two times this year because I had two people visit me while I was in Peru and the both of them desired to go to Cusco

Combining my pros and cons list for both 2017 trips below—

Pros:

  • No nausea, no dizziness, and no headaches
  • Chewed on coca leaves immediately at the airport
  • The commute was a lot better than riding the bus
  • Incorporated altitude sickness prevention

Cons:

  • My stomach was all over the place during my first 2017 trip
  • And of course, experienced shortness of breath, light headedness, and dry nostrils

Altitude sickness prevention

In 2015 I consumed the medicine called Sorojchi Pill every eight hours. This pill contains aspirin, acetaminosalol, and caffeine.

altitude sickness prevention
Sorojchi Pills

In both of my 2017 trips I took ALTI Vital every four to six hours. This pill contains coca leaf, ginger, guarana, muña (an Andean medicinal plant), as well as caffeine.

altitude sickness prevention
ALTI Vital

Depending if you prefer a more natural substance, ALTIA Vital is the way to go! But both pills positively aided my body immensely. I purchased both at Inka Farma and Mi Farma (Peruvian pharmacies). During my last three trips, I drank lots of water, ate light, consumed mate de coca, and chewed on coca leaves throughout each day to support my body in feeling balanced. I bought the mate de coca and coca leaves at the Mercado Central de San Pedro located near downtown Cusco off Calle Santa Clara and Cascaparo, but can likely be found in other markets.

altitude sickness prevention
Personal picture: from my experience, coca leaves are usually sold in plastic bags. Please excuse all the cash money or Soles 🙂

In the end, make sure to plan your trip to Cusco accordingly.