Traveling with medication

Bathing suit? Check. Plane tickets? Check. Medicine? Err…that’s where preparing for your trip can become complicated. While most travelers might not think twice about tossing aspirin and routine prescription medications into their bags, traveling with medication should take some thought and pre-planning.

Unbeknownst to you, your prescription medicines and even some over-the-counter medications might be illegal where you are headed. From how to pack your medication to what to do if you run out of medication while abroad, these tips for traveling internationally with medication will help before and during your travels, wherever they may be.

PRE-TRAVEL: What’s up doc?

• Prior to your trip, consult with your physician to identify your healthcare needs at your destination.
• It’s a great idea to research the environmental conditions like altitude, air pollution and humidity at your destination that may contribute to your specific health concerns.
• Be sure to check the availability and standards of care in the city and country you are headed to, advises a State Department official.

PRE-TRAVEL: Be prepared for anything

• Leave emergency contact information and copies of your passport biographic data page and prescriptions with family and trusted friends. Take two copies with you, one in your carry on and one in your checked luggage.
• Carry emergency contact information for your family with you when you travel. Be sure to also pencil this information in the emergency contact information section of your passport too.
• Learn the contact information for the nearest U.S. embassy or consulate, available on the State Department’s Country Specific Information page for each country and on each embassy or consulate’s website. Provide this information to your family and friends in case of an emergency.
• If you have allergies to certain medications, foods, insect bites, or other unique medical problems, consider wearing a “medical alert” bracelet and carrying a letter from your doctor explaining required treatment if you become ill.

PRE-TRAVEL: Know before you go

• Your prescription medication may be illegal in some countries. Which medications are allowed varies country by country. For example, in Japan, you can bring up to a two-month supply of allowable over-the-counter medications and up to a two-month supply of allowable vitamins into Japan duty-free. However, it is illegal to bring into Japan some over-the-counter medicines commonly used in the U.S., including inhalers and some allergy and sinus medications. Specifically, over-the-counter products that contain stimulants (medicines that contain pseudoephedrine, such as Actifed, Sudafed, and Vicks inhalers) or codeine are prohibited. You can generally bring up to a one-month’s supply of allowable prescription medicine into Japan. You must bring a copy of your doctor’s prescription as well as a letter stating the purpose of the drug. However, some U.S. prescription medications, such as Adderall, cannot be imported into Japan, even when accompanied by a customs declaration and a copy of the prescription. Do not mail prescription medicines, including insulin and injectors, without obtaining an import certification called Yakkan-Syoumei from the Ministry of Health, Labor, and Welfare, advises a State Department official.
• Review the State Department’s Country Specific Information for your destination and contact the embassy or consulate of the country you plan to visit to ensure that your medications are not considered illegal substances under local laws. For more specifics regarding your destination, read the Traveler’s Health information available on the Center for Disease Control website. The United Nations Office on Drugs and Crimes has prepared Guidelines for National Regulations Concerning Travelers under Treatment with Internationally Controlled Drugs.
• Before traveling, review the Common Travel Health Topics on the Centers for Disease Control website which provides guidance for travelers based on topic and types of travel.

PACKING: What to Pack

The Centers for Disease Control and Prevention has made a Pack Smart list, which includes routine and special prescription medicines, over-the-counter medicines, supplies to prevent illness or injury and first aid supplies. The list includes:

• Prescription medicines you usually take.
• If you have a severe allergy and your doctor has prescribed epinephrine, bring your Epinephrine auto-injector (for example, an EpiPen).
• Depending on the destination, special prescriptions for the trip like medicines to prevent malaria, antibiotic prescribed by your doctor for self-treatment of moderate to severe diarrhea and medicine to prevent altitude sickness.
• Over-the-counter medicines like antidiarrheal medication (for example, bismuth subsalicylate and loperamide), antihistamine, decongestant, cough suppressant/expectorant, medicine for pain or fever (such as acetaminophen, aspirin, or ibuprofen), mild laxative, mild sedative or other sleep aid, cough drops, antacid, antifungal and antibacterial ointments or creams and 1 percent hydrocortisone cream
• Insect repellent containing DEET (30 percent to 50 percent) or picaridin (up to 15 percent)
• Sunscreen (preferably SPF 15 or greater) that has both UVA and UVB protection
• Antibacterial hand wipes or alcohol-based hand sanitizer containing at least 60 percent alcohol
• Lubricating eye drops
• First-aid supplies, including a first aid quick reference card, bandages, gauze, Ace bandage, antiseptic, tweezers, scissors and cotton-tipped applicators)
• Moleskin for blisters
• Aloe gel for sunburns
• Digital thermometer
• Oral rehydration solution packets
• Health insurance card (either your regular plan or supplemental travel health insurance plan) and copies of claim forms. NOTE: Medicare does not provide coverage outside the U.S.
• Water purification tablets
• Commercial suture/syringe kits to be used by local health-care provider. (These items will also require a letter on letterhead stationery from the prescribing physician.)
• Latex condoms

PACKING: Handle with care

• If you routinely take prescription medication, be sure to include a sufficient supply for your trip and carry enough for brief unforeseen delays or emergency situations, advises a State Department official.
• Pack your prescription medications in your carry-on luggage in case your checked luggage is delayed or lost. Packing medicines in your carry-on means you will also have immediate access to it.
• Medicines needing to be refrigerated can be carried in an insulated medication bag, travel cooler or even insulated lunch bag.
• Carry a letter from your doctor describing your medical conditions and the medication you require. Be sure to ask your physician and pharmacist for the generic or chemical name of your medication.  Drug names differ in many countries, and pharmacists and physicians abroad are more likely to be familiar with this name.
• Pack a note on letterhead stationery from the prescribing physician for controlled substances such as painkillers, stimulants and injectable medications.
• To avoid questions or delays at customs or immigration, keep medications in their original, labeled containers, advises a State Department official.
• Bring extras of any medical necessities you need, like contact lenses or glasses. You might want to pack a pair in both your carry-on bag and your checked luggage, just to be safe, advises a State Department official.
• Travelers should check with the airlines for specific recommendations on traveling with medications and where to put them inflight, advises a State Department official.
• Before your travels, read the Pack Smart information on the Center for Disease Control website, advises a State Department official.
• Contact TSA Cares, a telephone help line to assist travelers with disabilities and medical conditions. The TSA recommends that passengers call 72 hours ahead of travel for information about what to expect during screening and questions about screening policies and procedures. Call TSA Cares toll free at 1-855-787-2227. Help line hours are 8 a.m. to 11 p.m. (EST), Monday through Friday and 9 a.m. to 8 p.m. (EST), weekends and holidays.

AT THE AIRPORT: Swift security screening

The following tips from TSA will ensure you and your medication make it through TSA screenings without a hitch for flights departing from the U.S.

• You can bring your medication in pill or solid form in unlimited amounts as long as it is screened.
• Medication in liquid form is allowed in carry-on bags in excess of 3.4 ounces in reasonable quantities for the flight. It is not necessary to place medically required liquids in a zip-top bag. However, you must tell the officer that you have medically necessary liquids at the start of the screening checkpoint process. Medically required liquids will be subjected to additional screening that could include being asked to open the container.
• Medication is usually screened by X-ray; however, if a traveler does not want a medication X-rayed, he or she may ask for an inspection instead. This request must be made before any items are sent through the X-ray tunnel.
• For medication needing refrigeration, accessories such as freezer packs or frozen gel packs are also permitted through the screening checkpoint, as are supplies that are associated with medically necessary liquids, such as IV bags, pumps and syringes. These items are exempt from the 3-1-1 Rule, but may be subject to additional screening.
• TSA does not require passengers to have medications in prescription bottles, but jurisdictions have individual laws regarding the labeling of prescription medication with which passengers need to comply. TSA recommends travelers become familiar with the medication-related laws in the jurisdiction(s) they are traveling to and from. Just because medications are allowed on the plane when departing the U.S. doesn’t necessarily mean they will be allowable in the country where you are traveling.

TRAVELING: Stick to a schedule

• Remember to adjust your medication schedule accordingly as you cross time zones, advises a State Department official.
• If your medication is lost, damaged or you run out while traveling or it is confiscated crossing borders, contact the nearest U.S. Embassy or Consulate. Each U.S Embassy has a list of doctors and pharmacies that may be able to provide assistance.

TRAVELING: Call for Help

• For help with a medical emergency, here is how to find a doctor abroad.
• You can read more about what the Department of State can and can’t do for you in an emergency.
• Make sure you have the contact information for the nearest U.S. Embassy or Consulate where you are going. Consular duty personnel are available for emergency assistance 24 hours a day, 7 days a week at U.S. embassies, consulates and consular agencies overseas. Contact information for U.S. embassies, consulates and consular agencies overseas may be found in the State Department’s Country Specific Information pages.
• If your family needs to reach you because of an emergency at home or if they are worried about your welfare, they should call the Office of Overseas Citizens Services in Washington, D.C. at 1-888-407-4747 (during business hours) or 202-647-5225 (after hours). The State Department will relay the message to the consular officers in the country where you are. The consular officers will then try to locate you, pass on any urgent messages, and, if you wish, report back to your family on your welfare.