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This pharmacological combination regimen consists of epoetin alfa (a recombinant human erythropoietin) and acetazolamide, currently being evaluated in a Phase 4 clinical trial by the United States Army Research Institute of Environmental Medicine (USARIEM). Epoetin alfa is a biologic that acts as an erythropoietin receptor agonist to stimulate erythropoiesis, thereby increasing red blood cell mass and improving oxygen delivery to tissues at high altitudes. Acetazolamide is a small molecule carbonic anhydrase inhibitor that facilitates altitude acclimatization by inducing metabolic acidosis and stimulating ventilation. The combination is intended to mitigate altitude-induced decrements in physical performance and reduce the incidence of acute mountain sickness (AMS) in individuals exposed to moderate (3,000 m) and high (4,300 m) altitudes.
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