Travelling with Prescription Medications

This year Canadians will make close to 20 million trips out of the country. Many will have one or more prescriptions or over-the-counter (OTC) medications in their bags. An overseas trip, whether for vacation or business, can take a lot of planning, and sometimes medication needs are overlooked. Since travel-related diseases are common in many destinations popular with Canadians, it is always a good idea to visit a travel health clinic a month or more before you leave to find out what vaccines (and precautions) are recommended. Unpleasant surprises are the last thing a stressed traveller needs. If you are travelling with medications it is important to take along enough for the length of the trip, along with the appropriate documentation, and to transport them the right way. In some countries, drugs that are legal and readily available in Canada are considered illegal or require a prescription, so do your research before you leave. BEFORE YOU LEAVE When travelling with prescription medication outside of Canada, always carry proof of need, to ensure you are considered in legal possession of the drug. Proof includes proper identification on the pharmacy label indicating the contents, dosage and a Drug Identification Number (DIN) and possibly a note of explanation from your doctor. If you have special medical conditions, such as diabetes or epilepsy. discuss your travel plans with your doctor or pharmacist before leaving. Depending on your medical condition, itinerary and length of travel outside Canada, consider carrying a statement from your doctor that indicates your major health problems and dosage of medications. This statement should be signed and dated and will provide important information for medical authorities in case of emergency. Don't forget your medical alert bracelet and a list of allergies to medications. Some medications (e.g. pain killers or cough syrups containing codeine), even though legally prescribed in Canada, could result in problems in other countries. If you are unsure about travelling with a prescription or OTC product, consult your pharmacist, doctor or the foreign embassy, and carry it in the original container. Some nonprescription drugs available in Canada are not recognized as nonprescription drugs in other countries. For example, some allergy medications are prescription drugs in the US. You will not be able to purchase such medications abroad without first seeing a doctor. If you might need to purchase a less common medication while travelling, check to ensure it is readily available in the country you are visiting. If you have private health insurance or are covered under a provincial drug plan, check what is covered outside Canada. It is always a good idea to purchase travel insurance that covers any health care you may need during your trip. It should also include an evacuation clause so that you can be transported to safety in the event of a medical emergency or natural disaster.

PACKING YOUR SUITCASE

Bring enough medication for the duration of the trip, plus a few extra days' supply in case of a delayed return home. Take only medication for personal use.
Pack all medications in your carry-on bag, not your suitcase which could potentially be lost.

Leave all medications in the original, labelled container, not in purchased pill boxes, to avoid potential problems with customs officials. Don't try to save luggage space by combining medications into a single container.

Remember to follow the storage information shown on the prescription label. Insulin that will not be used within one month or any medication that requires refrigeration can be kept cool in a wide mouth thermos. Fill the thermos with cold water and then pour it out before inserting the medication. Refrigerate the medication when you have arrived at your destination.

If you need syringes for a medical condition, such as diabetes, carry a supply to last your entire trip, along with a medical certificate that states that they are for medical use. In countries where illicit drug trafficking is a problem, syringes may prompt suspicion from the police or border security agencies if a traveller does not have this documentation. Syringes may be prohibited in carry-on luggage due to security concerns, so contact your airline before departure to make arrangements if you might need to use them during a long flight.

If you wear glasses or contact lenses, pack an extra pair along with the prescription in case you need to replace them.

If your medication might get some rough handling (e.g. during backpacking), blister packs can prevent breakage as can cotton balls inserted in the vial.

Pack a first-aid kit for small emergencies. Items to include are painkillers such as ASA, ibuprofen or acetaminophen; antidiarrheals such as PeptoBismol or Imodium; antacids for heartburn; sea sickness drugs or patches; bandages; adhesive tape; topical antibiotic ointment; sunscreen; an antiseptic; alcohol swabs; waterless hand sanitizer; eye drops; a laxative; insect repellent; a decongestant and an antihistamine. (Consult your pharmacist or physician first to see if these medications are appropriate for you.) Put scissors, safety pins and tweezers in your suitcase, not a carry-on bag, so they're not confiscated at the airport. You can also buy general medical kits from sporting goods stores and pharmacies.

DURING YOUR TRAVELS
If you are changing time zones, consult your pharmacist about how to adjust your dosing schedule to avoid missed doses. The adjustment will vary according to the type of medication.

Some medications that require a prescription in Canada are easily accessible in other countries without one. However, the quality of these drugs may not meet Canadian manufacturing standards and cannot be guaranteed safe or noncounterfeit.

If you or a travel companion require an injection overseas, it is important to verify that the needle and syringe have never been used and, ideally, are disposable. If you are unsure, weigh the health risks of an injection you might need in an emergency situation against the risk of developing a transmittable illness through a potentially dirty needle.

Travellers have sometimes been arrested for possessing prescription drugs (particularly tranquilizers and amphetamines) that they purchased legally in one country and then brought to another country where they are illegal. Others have been arrested for purchasing prescription drugs abroad in quantities that local authorities suspected were for commercial use. If in doubt about foreign drug laws, ask local authorities or the nearest Canadian embassy or consulate. Be cautious, not sorry.

RETURNING TO CANADA

If you are prescribed a drug while abroad, only a maximum 90-day supply for personal use can be brought back into Canada. If the drug is a narcotic or controlled substance, only the lesser of a 30-day supply or one course can enter Canada, and it must be declared at the border. The drug must be in its original container along with evidence that you have been under a physician's care.

RESOURCES

Dept.of Foreign Affairs; Travel Assistance

Health Canada; Travel Medicine Program

List of Travel Health Clinics

Travel Health Advisories

Centers for Disease Control and Prevention; Travelers' Health
(www.cdc.gov/travel).

International Association for Medical Assistance to Travellers

World Health Organization; International Travel & Health

Travel Health Online

Patient Self Care, Canadian Pharmacists Association, 2002

The above information is from the Canadian Pharmacists Association, 1785 Alta Vista Drive, Ottawa, Canada ON K1G 3Y6 (613) 523-7877 (800) 917-9489