13 Feb 2015
Medicines abroadCarrying medication abroad and counterfeit medication
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Travellers who take regular medication should plan well ahead. A general check-up prior to travel to ensure medication is optimal and sufficient supplies are available is sensible.
Travellers should carry all medication in its original pharmacy packaging, along with copies of prescriptions, in their hand luggage. A letter from the GP or prescriber detailing the medicines is also advised. Having an extra supply of medication in the hold luggage is sensible.
Some countries may not allow the entry of certain types of medicines, and others may have regulations requiring specific permission for a medication to be brought in. These rules can also apply to medicines available over the counter in the UK.
Certain medicines are ‘controlled’ in the UK and travellers are required to obtain an export licence prior to transporting a certain quantity (usually three months or more supply) of these drugs out of or into the country. A letter from the prescriber detailing the medicines is advised for travelling with smaller supplies.
Travellers should be aware that the legal status of their medication may be different outside the UK. Rules for the different countries can be checked with the foreign embassy in the UK.
Counterfeit (fake) drugs are more common in certain regions and can be a significant health risk.
Travellers who need to carry medication with them should be aware that its legal status in other countries may be different than in the UK. Legal requirements for carrying personal medicines across international borders are highly variable and often not consistently enforced. This applies to over-the counter medication as well as prescription drugs. Some countries may not allow the entry of certain types of medicines, and others may have blanket regulations requiring specific permission for a medication. The regulations regarding whether a traveller needs to carry a doctors letter describing the medications also varies widely.
Counterfeit medications are drugs that have been produced by unauthorised manufacturers, but are presented to the consumer as authorised products. Very often both the packaging and the medication appear virtually identical to the authentic medication. Counterfeit medications may contain inactive substances or toxic ingredients, resulting in treatment failure and/or serious harm. Worldwide estimates of drug counterfeiting range from 1 percent of sales in industrialised countries to over 10 percent in developing countries. In parts of Africa, Asia and Latin America, the proportion of counterfeit medication may be over 30 percent .
Malaria prevention drugs are also counterfeited and this is recognised as a contributing factor in malaria treatment failures and drug resistance [2, 3].
Risks for travellers
Medications for legitimate health conditions may come under intense scrutiny by foreign officials at border controls. This may result in delays, disruption or medicines being confiscated if the correct paperwork and permissions have not been arranged. On rare occasions, travellers who have been found to have drugs that are illegal at the destination or transit country have been imprisoned .
According to the World Health Organisation, counterfeit medicines are rarely effective . The use of these medicines can prolong necessary treatment time, which may exacerbate (worsen) the condition being treated. Treatment with ineffective counterfeit drugs such as antibiotics can also lead to the emergence of drug resistant organisms [5-7]. In extreme cases, counterfeit drugs may even cause serious harm or death .
Travellers who need to travel with medication should plan well ahead. A general check-up prior to travel to ensure medication is optimal and sufficient supplies are available (including cover for possible travel delays) is sensible.
Travellers should check their destination’s regulations on importing or transporting medicines by contacting the relevant embassy/high commission or checking the Foreign and Commonwealth Office (FCO) country advice.
Travellers who are taking certain ‘controlled drugs’ may be required to obtain an export licence prior to transporting set quantities (usually three months’ or more supply) into or out of the UK. The application should be made at least 10 days prior to travel. Some examples of controlled drugs include: Diamorphine, Diazepam, Codeine, Fentanyl, Methadone, Morphine, Pethidine, Ritalin and Temazepam. Further information on the drugs which will require an export license and application forms can be found on the Gov.uk website. Those carrying controlled drugs and other prescription drugs on shorter trips are advised by the Home Office to obtain and carry a letter from the GP or prescriber detailing the medicines.
Wherever possible, travellers should avoid the risk of purchasing counterfeit medication, by obtaining all the medication they will need prior to travel.
Travellers should also be advised to:
- Carry medicines (including those bought over the counter) in their correctly labelled container, as issued by the pharmacist in the hand luggage. Airline regulations should be checked, particularly for injectable medications or liquids as restrictions apply to the quantity that can be carried in hand luggage).
- Passengers needing to fly with oxygen, insulin or other injectable medicines should contact their airline in advance to make appropriate arrangements.
- Consider packing a spare supply of medication in the hold luggage in case of loss of hand luggage.
- Storage requirements for medication must be checked in advance. Arrangements for control of temperature during transit with certain medications maybe needed.
- Carry a copy of all prescriptions.
- A letter from the prescriber detailing the medicines with the generic names for the medications can be helpful for border control checks and in case medicines have to be replaced or medical help is required.
- Carry a note from the prescribing physician on letterhead stationary for controlled substances and injection medications.
- Take out an appropriate level of travel health insurance including repatriation and specific cover for any pre-existing illnesses.
Travellers who need to obtain extra medication should be aware of the risks from counterfeit medicines. They should carry copies of prescriptions of regular medications and consult a recognised pharmacy or health care provider. Medicines should not be purchased from open markets or street vendors.
The International Association for Medical Assistance to Travellers (IAMAT) and the International Society of Travel Medicine (ISTM) global clinic directory can provide contact details of medical practitioners overseas.
Travellers who have received medication acquired abroad and are unwell after travelling should seek advice from their GP or pharmacist.
- British Thoracic Society: Air Travel Recommendations
- Civil Aviation Authority: Carriage of medication
- Civil Aviation Authority: FAQ Diabetes
- Diabetes UK: Travel and Diabetes
- European Medicines Agency: Falsified medicines
- Gov.UK: List of foreign embassies in the UK
- Home Office: Travelling with controlled drugs.
- Medicines and Healthcare Regulatory Authority: Recommendations on the control and monitoring of storage and transportation temperatures of medicinal products
- NHS Choices: Can I take my medicine abroad
First Published : 13 Feb 2015
Last Updated :  12 Oct 2016
- Green MD. Perspectives: Pharmaceutical Quality & Counterfeit Drugs. In: Centers for Disease Control and Prevention (CDC). Health information for international travel 2016. Atlanta, CDC. [Accessed 21 September 2016].
- Newton PN, Green MD, Fernández FM et al. Counterfeit and anti-infective drugs. Lancet Inf Dis. 6, 602-13, 2006.
- Tabernero P, Fernández FM, Green M et al. Mind the gaps – the epidemiology of poor-quality anti-malarials in the malarious world – analysis of the WorldWide Antimalarial Resistance Network database. Malaria J. 8 April 2014. 13:139. [Accessed 13 February 2015].
- Emirates, Banned substances in the UAE. [Accessed 13 February 2015].
- World Health Organization, General information on counterfeit medicines. [Accessed 13 February 2015].
- Delepierre, A. Gayot, A. Carpentier A. Update on counterfeit antibiotics worldwide; public health risks. Med Mal Infect. 2012 Jun; 42(6):247-55. [Accessed 13 February 2015].
- Ndihokubwayo, R. B. Yahaya A. A. Desta, A.T. et al World Health Organization, Regional office for Africa, Antimicrobial resistance in the African Region: Issues, challenges and actions proposed. African Health Monitor, March 2013. [Accessed 13 February 2015].
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