August is the time of year when many students prepare for a semester or year studying abroad. During the pretravel encounter, questions often arise about medications- how much to bring? any issues crossing borders? storage during transit and at destination? etc. In this TravelByte we offer some general guidelines and two good resources for counseling students- and all international travelers- about traveling with medications.
- Travel health nurses (THNs) should advise travelers to bring at least one to two weeks of extra medications in the event of trip delays. Ideally these medications should be kept in their original containers. Bring copies of any Rx prescriptions, including the generic names for medicines. Per CDC, leave prescription copies at home with a friend or relative in case the traveler loses a copy or needs an emergency refill.
- Medications should only be kept in carry-on luggage, never in packed luggage. Emergency drugs such as epinephrine auto-injectors, inhalers, and the like should be kept on the person, not stored in overhead bins during transit. Research will be necessary to ensure that medications requiring refrigeration can be safely maintained during travel and at the destination.
- When traveling to hot, humid destinations, it is especially important to store medications in cool, dark areas.
- Questions about crossing borders? THNs can help travelers research and review all questions and regulations pertaining to the importation of medications into a destination. Is a particular medication allowed? What are maximum quantities that may be imported? Know that some medications- most notably narcotic agents, HIV drugs, and injectable hormones, but also OTCs such as cold medicines- may be considered controlled substances and not allowed into certain countries. Bringing these banned medicines into a destination could result in criminal prosecution. The International Narcotics Control Board maintains a website with regulations about medications containing controlled substances for some, but not all countries at https://www.incb.org/incb/en/travellers/country-regulations.html Another approach to answer these questions is to directly contact U.S. embassy personnel in the destination country to learn about any medication prohibitions. Contacting a foreign embassy may or not be helpful.
- All the cannabis products that are approved in some states here often are not approved abroad and should not be taken out of the U.S.
- It might be advisable for oral contraception users to switch to a LARC method – either an IUD and implant before traveling, especially if staying for a lengthy period, as pills and other products can be easily misplaced, are vulnerable to temperature changes, and may not provide protection in the event of traveler’s diarrhea or vomiting. See the March edition of Educational Resource for full details on this topic.
- If a student needs to take a medication into a country where that drug is banned, the clinician can help the student to either 1) identify an alternative medication that is allowed or 2) identify a medical provider in the destination country that perhaps can prescribe the drug. If time allows, a provider may be able to switch a student’s medication prior to departure.
- Students should be admonished to never try to “sneak in” medications and never to purchase medications abroad unless the source is a reliable, vetted one and the packaging is original. Medications obtained abroad may be counterfeit, adulterated, or lack the same active ingredient as a U.S. product.
- It is not advisable to have family or friends mail medications to a student as these packages are routinely delayed at Customs and rarely arrive intact or in a timely fashion.
- Individuals traveling for several months or longer may be challenged to bring a sufficient medication supply to last the trip duration. A letter explaining the quantity of medication brought into the country may be helpful when going through customs. This letter should be written on letterhead by the prescribing provider and translated into the local language. This approach is also recommended for any injectable medications such as auto-injectors and insulin.
- If a traveler is using health insurance to secure more than a 30 day- supply of prescriptive medications, the prescribing provider should request a “vacation override” or equivalent from the insurance company at least several weeks before departure. Alert the traveler that often these overrides only permit purchases several days just before the departure date.
- Anyone leaving in less than two weeks may be challenged to acquire needed medications. For more guidance refer to The Last Minute Traveler section of the CDC Yellow Book.
- If a traveler must acquire a new medication or renew or replace a prescription during a trip, it is advisable to contact their travel assistance insurance or the administration of their local program (study abroad, mission group, etc.) for guidance.
- It is never advisable to send a traveler with vaccine doses to complete an immunization series. Cold chain storage must be preserved to ensure vaccine efficacy.
CDC provides a good overview of this topic with additional specific recommendations and resources on their Traveling Abroad with Medicine website @ https://wwwnc.cdc.gov/travel/page/travel-abroad-with-medicine#
IAMAT in 2019 published one of the best resources on this topic: Travelling with Medications: A Guide. It provides many excellent recommendations, goes into considerable detail, and includes a handy checklist. It is available @ file:///C:/Users/shers/Downloads/IAMAT_Travelling_with_medications.pdf
July 2022 GR
ATHNA 