Buying medicines on your travels

Research by the godfather of travel medicine, Professor Robert Steffen, states that of Europeans travelling to a resource-poor destination and staying for a month, more than half will develop some kind of illness. Many of these illnesses will be trivial but travellers will often shop locally for soothers, cures or treatments. Here are some points to consider when buying medicines overseas.

Before setting out on any trip, think about what has made you ill in the past. Are you susceptible to chest infections or cystitis? Do you know which treatments work best for you? Does a particular antibiotic cause you spectacular diarrhoea? Have any medicines triggered a rash or wheeze? Do you know how to identify these treatments when away?

Most prescribed antibiotics will be labelled with their trade name, which will be completely different to the UK name, even in another English-speaking country. You need to know the longer generic name of any medicine you might need to take. It is also important to know the generic name and dose of any regular medication you take. For example, you’ll have trouble replenishing supplies of your asthma medication if you know it simply as the blue, purple or brown inhaler. And what does your inhaler dispense? Is it 50μg or 200μg per squirt? Gen up before you travel.

NHS rules state that GPs should prescribe no more than a two-month supply of regular medicines (or, in the case of the contraceptive pill, usually six months). People travelling longer term might need to ask their GP for a private prescription.

Similarly, if you want a prescription for an antibiotic to take in case you get an infection while abroad, that would need to be provided on a private prescription. Private prescriptions for simple broad-spectrum antibiotics shouldn’t be especially expensive although it is worth shopping around. Older antibiotics are much cheaper than newer ones. Ciprofloxacin, for example, might cost £12-20 for a short course.

Large quantities of the combined oral contraceptive, however, will be pricy. For this reason, as well as for reasons of efficacy, women taking extended trips might consider arranging a long-acting method of contraception. IUDs and implants can’t get lost, don’t increase the risk of DVT and don’t stop working if you have a stomach upset, but require being organised well before travel.

Most inexperienced travellers pack far too much into their first-aid kit. The important items are palatable soluble paracetamol, decent dressings, a good drying antiseptic, some throat lozenges and – for tropical trips – a thermometer.

Assuming that you are not going to an extremely remote village, anything else you might need should be available at your destination. If you choose to travel with prescribed painkillers or sleeping tablets, it’d be wise to carry a doctor’s letter confirming that they’ve been prescribed. Some Middle Eastern countries and other destinations (including Thailand) have very strict penalties for carrying powerful medicines.

Except for trivial ailments such as sore throats and colds, it is challenging to be your own doctor. It’s not a great idea to self-diagnose and treat yourself with whatever you can buy over the counter locally. It’s usually worth tracking down a clinic (your insurance should have a helpline to make some suggestions), where a clinician can work out what the problem is and maybe arrange a stool check. Generally the medicines sold by such clinics will be of good quality.

Buying over the counter probably increases your risk of taking counterfeit medicines, all-too-common in many parts of Asia and Africa. Have a good look at any medicines you buy. If you notice spelling mistakes on the packet then buy them elsewhere. You are less likely to be given counterfeit medicines if you source tablets through a reputable clinic. Most counterfeits are harmless, but have no beneficial effects either. However, some travellers choose to buy such items abroad in order to save money. If the remedy you’re buying is important to your health, it’s worth paying a little more at an international clinic.

In some countries – Indonesia and Egypt are two culprits – there is a vogue for combining cocktails of medicines in one tablet. This isn’t considered good practice among Western-trained physicians. While one drug cocktail might be expected to be a cure-all, taking combinations of medicines increases the very real risk of significant side effects. It is better to try to seek a diagnosis to find out what single treatment is most likely to cure the problem.

Some people seek natural or herbal remedies when illness strikes; indeed, in many destinations there is a thriving trade in such cures. China is perhaps one of the most renowned for this and a visit to a traditional pharmacy is worth it if only for the sport of trying to identify the dried relicts on off er. Be alert, though, to the risk of condoning trade in endangered species if you do buy anything. Herbal cures and teas are often excellent if symptoms are gastrointestinal. Senna, ispaghula and castor oil, for example, are natural laxatives; hot drinks help stimulate a sluggish bowel. However, it is best to research before swallowing any unidentified substance. And beware – I have heard numerous stories about ‘constipation’ and ‘diarrhoea’ getting muddled in translation.

50% plus felt ill or took medication
30% plus experienced travellers’ diarrhoea
8% Consulted a doctor abroad or back home
2% Incapable of work a er return
1% plus had fever and respiratory symptoms
0.001% died abroad
*Travellers from Switzerland staying in a resource-poor country for a month

Last month, a good friend went into a pharmacy in Beijing in search of painkillers. He was looking for something reasonably strong such as Solpadeine. When the pharmacist recognised this as containing codeine, a derivative of opium, he said, “We went to war with the British over stopping people like you using this stuff!”

It can be difficult to obtain potentially addictive medicines in many destinations. It is probably best to attend a clinic – such as those run by SOS (www.internationalsos.com) – if you need powerful painkillers.

Dr Jane Wilson-Howarth knows how to say ‘diarrhoea’ in a dozen languages; her blog is at troglopedetes.blogspot.co.uk