Cusco is located at 3,399 meters above sea level, an altitude that can affect anyone regardless of their physical condition. Altitude sickness, known locally as soroche, is simply the body’s reaction to the lower amount of oxygen available in the air.
The most common symptoms appear within the first 12 to 24 hours after arrival. These include headache, fatigue, shortness of breath when walking, nausea, dizziness, and difficulty sleeping. Some people feel nothing, but most experience at least one or two of these discomforts. There is no way to predict who will be more affected, as it does not depend on age or physical fitness.
The first day in Cusco is key. Upon arrival, the best thing you can do is take it easy. Walk slowly, avoid running up stairs, and give your body time to adjust. Many travelers make the mistake of heading out to explore the city as soon as they drop off their luggage, and they end up feeling worse. A relaxed pace during the first few hours helps a lot.
Drinking plenty of water is essential. Dehydration worsens altitude sickness symptoms, so drink water constantly even if you’re not thirsty. Coca tea, a traditional infusion served in hotels and restaurants, also helps. It’s not a miracle cure, but it eases mild discomfort and is available everywhere.
Avoid alcohol and heavy meals on your first day. Your digestive system works more slowly at high altitude, and alcohol dehydrates you, which intensifies discomfort. It’s also better not to smoke if you are a smoker, as it further reduces the oxygen your body receives.
If the headache is strong, you can take standard pain relievers such as ibuprofen or acetaminophen. Pharmacies in Cusco also sell altitude sickness tablets like Sorojchi Pills or acetazolamide (Diamox), but it’s best to consult a healthcare professional before taking them, especially if you have pre-existing medical conditions.
Gradual acclimatization works better than any pill. If your schedule allows, spend two or three days in Cusco before doing excursions to higher places like Rainbow Mountain (5,200 meters) or Ausangate. If you come from Lima or another sea-level city and go straight to Machu Picchu, consider staying in Aguas Calientes (2,040 meters) first and going up to Cusco afterward, although this is not always practical.
Most people feel better after the second day. Symptoms decrease as the body adapts. If after 48 hours you still have strong discomfort, persistent nausea, or severe difficulty breathing, seek medical attention. There are tourist clinics in downtown Cusco that handle these cases.
Some people use canned oxygen, available in pharmacies and hotels. It can provide temporary relief but does not replace real acclimatization. Hotels with oxygen-equipped rooms can be helpful if you have trouble sleeping during the first few days.
