As a pharmacist, I often come across patients with all sorts of medication problems just before or during their travel. Forgotten medicines, missed doses, lost medicines, damaged medicines, exhausted supplies, and last-minute scrambles for refills are all familiar cases that we handle at the pharmacy counter during the travel season.
Patients who take regular medications to manage a chronic condition need to plan properly so that their treatment is not interrupted during travel. Proper planning and preparation go a long way in ensuring you stay safe and healthy while on a trip.
Here is a guide to help you manage your medicines while travelling:
1. Plan ahead
It is essential to begin preparations 2 to 3 weeks in advance. One common mistake to avoid is last-minute rushed packing. Before you travel:
- List all medications that you will need to carry, including supplements and any Over-The-Counter products. Write down generic names because of the variation in brand names across countries.
- Pack enough medicine for the entire duration of your trip and some extra doses (3 to 7 days) in case of changes or delays in your travel plans.
- Check that the medicines are not expired. You do not want to discover that you carried expired medicines while on your trip.
- For chronic conditions, avoid last-minute refills.
- Never assume that you will easily find your medicines at your travel destination, especially if your medicine is usually hard to find.
- Note down emergency contacts for local hospitals and pharmacies at the travel destination.
- Where possible, do not start a new medicine just before you travel.
2. Carry medicines in your hand luggage
Never carry medicine in checked bags or in the trunk of a car. If you are on essential medications such as inhalers, insulin, heart medicines, epilepsy medicines, allergy and pain medications, you might need to access your medicines during the journey.
Checked bags in flights and cars are prone to temperature changes, which predispose medicines to damage. The cargo compartments in planes usually experience extreme temperature fluctuations that may degrade medications and even freeze liquid medicines, including insulin. There is also the risk of checked bags getting mishandled, delayed or even lost.
3. Carry your prescriptions and any necessary medical documents
For international travel, always carry a copy of your prescription and a doctor’s letter, especially if you are carrying controlled drugs, certain injections and large quantities of medicines. Having the necessary documents with you eases airport clearance, helps you get refills when necessary and is crucial in case of a medical emergency while abroad.
Some drugs, such as opioids and ADHD drugs, are illegal in certain countries. If you must carry these types of drugs, have a letter from your doctor on the official letterhead, stating the diagnosis and the need for the medicines. Carrying controlled drugs without proper documentation may subject you to legal issues.
4. Know the medication regulations of your destination
Different countries have different rules when it comes to prescription medications. Before you travel internationally, check that your medication is allowed in the country, and if there are any limits on the quantity you can carry.
While some medicines may be legal in one country, they may be restricted in another country. e.g., certain sedatives and painkillers. If you are travelling with a controlled substance, declare it upfront during security checks.
Also note that certain drugs may be sold over the counter in one country but not in another. You can get this information from your pharmacist or by checking the embassy website of the country you are travelling to. The International Narcotics Control Board Website can also offer you guidance on what to expect.
You must never carry pills that are not labelled. Carrying the original pharmacy labelled containers will save you the hassle with customs officers. While you might have your daily doses in a pill organiser, have the original pack of the medicine. Do not combine different medicines in one container, as this may raise suspicion.
For liquid medicines, the volume restriction does not apply if you are carrying medically necessary medicines such as cough syrups and insulin. However, you must declare these during security checks if you have large volumes of these medicines.
5. Consider time zone changes
The difference in time zones when travelling across continents can affect the timing of your doses. Your pharmacist can guide you on how to adjust your doses efficiently so that you stay on track. This is especially important for crucial medications such as insulin, birth control and antiepileptic medicines.
Simple, once daily dosages should be taken at the usual time based on the destination. If you are taking multiple doses per day, the doses should be gradually adjusted. Do not double up doses without guidance from your pharmacist or doctor.
If the time shift is under two hours, just take your doses at the new local time. For large time shifts (over 6 hours), gradual dosing adjustments are required. Keep your watch on home time for the first day so that you don’t miss a window, then slowly shift by 2 hours daily until you match the local time.
6. Ensure proper storage
The general rule of thumb when it comes to storing medicines is to ensure you keep them away from direct heat and light. Leaving medicines in hot cars can lead to degradation, which makes them less effective.
For temperature-sensitive medicines like insulin and other classes of drugs that require cold chain storage, ice packs and insulated pouches are recommended while in transit. You must take caution not to freeze them by placing them directly against the ice packs.
7. Be prepared for minor illnesses
It is common to experience some minor illnesses such as diarrhoea, upset stomach and allergies, during travel. Having this in mind can save you from inconveniences during your trip, especially if you are travelling to remote areas where access to a pharmacy might be a challenge.
Carrying a small medication kit is therefore essential. Crucial items to carry in your emergency medication kit include antihistamines, pain relievers, antidiarrheal medicines, oral rehydration tablets, antacids, motion sickness tablets, insect repellents and a hand sanitiser.
8. Verify your insurance coverage
Always check with your insurance provider on whether they provide cover abroad and what the emergency procedures are. It is important that you have travel insurance and ensure that you understand its policies. Some travel insurances do not cover certain pre-existing conditions.
What if your medicines get lost?
In the unfortunate event that you lose your medicine while travelling, contact a local pharmacy or hospital. If you need assistance to find medical care, contact the nearest embassy. If needed, you can also contact your doctor back at home.
It is important to travel with physical copies of your prescriptions and also have photos of the prescriptions on your phone. Even if a local pharmacy won’t fill the prescription, it will help a doctor to rewrite it. You must also know the generic names of the medicines because brand names vary by country and regions, e.g. Panadol in the UK vs Tylenol in the US.
Final dose of clarity
Forgotten doses, improper storage and airport issues can result in a lot of stress and interruption of travel plans. Travelling while on medication does not have to be stressful. Proper planning will help you to stay on track with your doses and enjoy your trip.
If you are unsure about how to go about it, talk to your doctor or pharmacist for guidance.
Safe travels and stay healthy!
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