How to Prevent Altitude Sickness in Cusco (The Ultimate Guide for 2025)

A must-stop for any traveler heading around Peru, Cusco has a perfect mix of ancient history, colonial architecture and epic Andean landscapes. 

However, given this city is located within the mountains, the high altitude here tends to cause problems for those who aren’t used to these conditions.

In this comprehensive guide we’ll explore everything you need to know about altitude sickness in Cusco. This includes how to prevent it, why it occurs as well as what typical symptoms look like. 

Table of Contents

How to Prevent Altitude Sickness in Cusco 

Quick Answer: The key to preventing altitude sickness is to take it slow in order to allow your body to naturally adapt to the higher altitudes.

Cusco is located up at an altitude of 3399m, which means your body will find it harder to operate at its usual capacity. 

It takes on average 48 hours for our bodies to acclimate to these higher altitudes, so we strongly recommend keeping your first two days light so your body can adapt quicker and easier. 

What Is Altitude Sickness?

Altitude sickness is a condition where your body reacts negatively when exposed to increases in altitude. This usually occurs at altitudes of around 2500m, although for some it won’t cause any noticeable effects until they are at even higher altitudes.

Essentially what happens is that due to less available oxygen in the air within higher altitudes, the body has to work harder to get its usual needs met. Depending on the individual, some may have more trouble adapting which can lead to the onset of altitude sickness symptoms.

Fascinatingly, it’s still not understood exactly why some individuals get altitude sickness and others don’t. This is why it’s important to prepare regardless of your physical fitness, as this doesn’t guarantee you’ll have no issues.

how to prevent altitude sickness

Recognising The Symptoms Of Altitude Sickness

Getting altitude sickness in Cusco for the first time isn’t the most pleasant experience. However, knowing what could happen before you arrive will help you to relax, and will also help you identify what stage you are at (and how to manage it). 

It’s important to mention that we are not medical professionals, and the following information should be treated as such. We recommend doing your own extra research on symptoms and what to do in the event of an emergency related to altitude sickness.

Stage One: Minor Symptoms

Given Cusco is nestled up at 3399m, the majority of travelers heading here will experience at least some minor symptoms. These usually include headaches, nausea and shortness of breath (when walking for long periods), however they usually disappear by themselves after 2 days once your body has fully adjusted. If you are experiencing any of these symptoms, then we recommend drinking Coca Leaf tea, and also going slow during your first couple of days.

Stage Two: Moderate Symptoms 

These usually occur when heading on higher altitude day trips and treks from Cusco such as on the Salkantay Trek, and especially so when exceeding 4000m. Some may also experience them in Cusco with little physical activity, and again it’s different for every individual. Common symptoms here include sickness, dizziness, difficulty sleeping as well as a loss of appetite. If you are heading on a high altitude trek soon (or are currently experiencing any of these symptoms), then we recommend taking Soroche Tablets, which are essentially pills for altitude sickness. You’ll also want to keep yourself well hydrated and to move slowly. 

Stage Three: Major Symptoms 

When heading on high altitude treks, it is possible to develop potentially life-threatening conditions. These include High-Altitude Pulmonary Edema (HAPE) and High-Altitude Cerebral Edema (HACE), which involve the build-up of fluid in the lungs or brain. These are usually caused by rapid ascension in altitudes with no time spent acclimating. Symptoms include confusion, shortness of breath when resting as well as coughing up a white or pink substance. If you get any of these symptoms then immediately tell your trek leader who can arrange medical help for you.

How Likely Is It That I Will Get Altitude Sickness In Cusco?

As we’ve already mentioned, the majority of travelers heading to Cusco will probably experience some minor symptoms during their first couple of days. Again it’s possible to prevent these from happening in the first place with different methods, which we’ll explore later in this guide.

In terms of knowing to what extent altitude sickness will affect you as an individual, it’s still very difficult to guess. Scientists have still been unable to draw a strong conclusion as to why some get it worse than others, and physical ability doesn’t seem to be a considerable factor. 

It’s a common saying that marathon runners can head up to 4000m and have various altitude sickness symptoms, whilst those who are sedentary and highly overweight experience zero symptoms whatsoever at the same altitude.

qoricancha church

The Different Methods To Prevent Altitude Sickness In Cusco

In this section, we’ll take a look at some of the best ways to prevent you from getting altitude sickness in Cusco. Some of these you can use once you are already in the city (such as before heading on high altitude treks), whilst other strategies can be used several days before arriving into the region.

Gradually Increase Your Altitude Before Arriving In Cusco

This is one of the most reliable ways of preventing altitude sickness in Cusco before you arrive. Essentially, the body needs time to acclimate to higher altitudes, and especially so if making an elevation gain of over 1000m. This is the case for the majority of travelers who head directly from Lima to Cusco, who if taking the plane, will climb over 3000m in just a 2 hour flight! If you have the time available, then we suggest making stops at Nazca and Arequipa along the way, so your body gradually adapts to higher altitudes.

Drink Coca Leaf Tea

One of the true tried and tested methods for preventing altitude sickness, Coca Leaves have been used by locals throughout the Sacred Valley for thousands of years. These leaves have several perks including increasing energy, however the most useful benefit is the easier absorption of oxygen at higher altitudes. You can either munch on Coca Leaves (and then spit them out), or drink an infused tea which provides all of the same benefits. Most accommodations in Cusco will provide these, and you can also buy them in markets and stores to bring with you on a trek.

Head To Machu Picchu First

Surprisingly enough, this is actually another effective way of getting acclimated before staying longer in Cusco. Machu Picchu is located at a lower altitude of 2430m, so you can head here as soon as you arrive into the region. You can base yourself in the mountainous town of Aguascalientes for a few days, visiting the ancient ruins as well as relaxing in the natural hot springs. We suggest heading on an overnight tour to Machu Picchu as soon as you arrive, which will allow you to acclimate with less issues.

Use Soroche Pills

One of the most efficient ways of preventing altitude sickness is by using altitude sickness medication. Known locally in Peru as Soroche Pills, this powerful medication contains a mix of ingredients including caffeine and aspirin which all help to keep potential symptoms at bay. It’s more powerful than Coca Leaves alone, and usually provides relief for around 8 hours. You can buy Soroche Pills in any Inkafarma or other pharmacy within Cusco. Again we are not medical professionals, so please talk to a doctor or the pharmacy staff before using altitude sickness medications for directions and advice. Although rare, it has been known to cause certain side effects, so again please do your own research before taking them.

What To Do During Your First Two Days In Cusco

As we’ve already mentioned, your body needs 48 hours to properly acclimate to a higher altitude. This means that when arriving in Cusco, you’ll want to keep your first two days light with no physically demanding activities (unless coming from destinations at similar altitudes such as Lake Titicaca).

Whilst this may not sound great for the eager hikers out there currently reading, we actually find it’s the perfect time to really explore Cusco and get to know all of its hidden secrets and gems. This includes walking around the Plaza de Armas and the winding white streets of San Blas, as well as feasting on Andean dishes within the Mercado San Pedro.

You can also head on some gentle walks and trails, which will also help you to acclimate faster. This includes walking up to the Cristo Blanco statue, which takes around 40 minutes and gives impressive views over Cusco. You can also head into the surrounding Sacred Valley, where you can visit the towns of Pisac, Ollantaytambo and Chinchero (which all have their own local markets and ancient ruins to explore).

If you’re planning on heading on the Inca Trail during your time in Cusco, then the above options are great for altitude preparation since they are located at similar altitudes. You can learn more about how to prepare for the Inca Trail here.

cristo blanco cusco

Treating Altitude Sickness In Cusco

Perhaps you’ve found this guide after having gotten altitude sickness yourself, or are wondering what to do if you also get ill with this condition.

It’s first important that you relax, and understand that your body is reacting naturally to the different changes in altitude (this is common for all humans). If you have light symptoms and can still walk fine, then you can head to a local pharmacy and take Soroche Pills to relieve your symptoms. It’s important to also stay well hydrated and avoid excessive walking where possible.

If your symptoms are more serious, such as difficulty walking, breathing or have tight chest pains, then you’ll want to immediately contact emergency services or make your way to a local hospital. Here you’ll get the right treatment and can relax knowing you are in good hands.

Remember that it is extremely rare to get more serious symptoms within the city of Cusco itself, although it can sometimes occur if you have pre-existing medical conditions. More likely, the more serious conditions would happen on much higher altitude hikes, and in this event your tour guide will know how to handle the situation. 

Here at ABExpeditions, all of our tour guides are trained to deal with any altitude-related emergencies, either providing you quick relief in the moment (Coca Leaf Tea or Alcohol Spray), or getting you to the closest hospital if necessary.

How Long Does It Take To Get Over Altitude Sickness?

This really depends on the individual and the scenario, however below we’ll cover some common examples.

If you’ve just arrived in Cusco and have a light headache or nausea, then naturally (without assistance) you should start feeling better in 2-3 days. If you take Soroche Pills or drink Coca Leaf Tea upon arriving, then you’ll start feeling better in around 1 hour.

Another common situation is getting altitude sickness on a higher altitude hike (such as to Rainbow Mountain or Lake Humantay). In this instance you can use an alcohol spray which your tour provider will have, which has immediate effects. If on a day trip, then the severity of symptoms usually reduce as you start your decline in altitude back to Cusco. 

When heading on a longer multi-day trek (such as around Ausangate National Park), the amount of time to get over altitude sickness can really vary. If you’ve prepared properly and are trying different methods such as eating potassium-rich foods and using Soroche Pills, then symptoms should usually clear up in a day. However this is not a guarantee, and some may have symptoms during the whole trek until they finally return to lower altitude after completing the trek. We always recommend bringing a variety of methods with you which will all help to relieve symptoms as much as possible.

how to prevent altitude sickness in cusco

Altitude Sickness In Cusco FAQ

Here we’ll now answer some of the most frequent questions we get about altitude sickness in Cusco and how to treat it.

How Long Does It Take To Acclimate To The Altitude in Cusco?

Usually your body will need around 2 Days to adjust to the lower level of oxygen present in Cusco (and the surrounding Sacred Valley). This can be somewhat sped-up by using Coca Leaves and Soroche Pills, although it’s best to let your body naturally adjust on its own and avoid demanding hikes during this initial period. It’s important to note that some travelers may need more days to get fully acclimated, whilst others are fine from the moment they arrive!

Is Ibuprofen Better Than Diamox For Altitude Sickness?

It really depends on your specific circumstances, which we’ll now explore. If you’re heading to Cusco from a much lower altitude (such as Lima), and will start hikes as soon as you arrive, then Ibuprofen would be your best choice. Diamox is a better alternative if you plan to stay in Cusco for a longer time, and is worth taking if you still have symptoms after several days.

What Helps With Altitude Sickness Naturally?

Perhaps you don’t want to take medications, or are looking for extra help whilst taking a course of altitude sickness tablets. Drinking plenty of water is always essential at higher altitudes, and eating certain foods such as Chocolate, Fruits and Potato-based dishes also help as they will replenish you with much needed Potassium. Coca Leaves are another natural remedy which are used daily by locals, as well as using an alcohol spray for quick relief when feeling unwell at higher altitudes.

How to Prevent Altitude Sickness in Cusco 

And that’s all for this comprehensive guide on how to prevent altitude sickness in Cusco.

Whilst this beautiful city and surrounding Sacred Valley region have lots of unique and memorable attractions to visit, unfortunately altitude sickness remains a common issue here for visitors.

Symptoms can really vary between individuals, and some may not get any during their whole time here. However it’s important to prepare properly the best you can before arriving, and know how to manage any symptoms in case you get them here in Cusco.

Are you thinking of heading on the Inca Trail when in Cusco? Read our Ultimate Inca Trail Guide which lists everything you need to know about hiking this legendary ancient route.

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