Ready for vacation? Don’t forget your travel medicine

BY STACY COVITZ

From vaccines to your traveling pharmacy, it’s best to be prepared

Travel is one of my passions, and one of my favorite trips had me hiking, zip lining, and repelling my way through parts of Argentina, Uruguay and Chile.

I like to think of myself as a seasoned international traveler; lucky enough to hit several new countries each year. I’m comfortable communicating even when I don’t speak the language, know dining etiquette across the world, and can fit everything I need for one month in a backpack.

But I felt like a real novice when, the night before going from Buenos Ares to Iguazu Falls, a fellow traveler asked me which malaria medications I had taken and brought with me. I gave her a blank stare and said, “I mean, I have bug spray…” So, there I was, about to hike through a humid, subtropical climate, with all kinds of strange bugs, animals and creatures, armed only with some basic bug spray and the tetanus shot I’d received as a routine vaccination the year before.

Luckily, travelers – especially single, female travelers – take care of each other. Since we were both staying at the only hotel inside Argentina’s side of Iguazu, she left some DEET at the front desk for me and gave me her contact information in case I needed to take some of her prescription.

The good news – I didn’t get malaria, yellow fever, or any other food, water or critter-related illness, and the DEET didn’t eat through my clothes. (DEET is no joke, people, follow directions carefully.)

It was a good lesson, though, one that I acted on the following year when I went to Costa Rica.

As you plan your vacations, make sure to talk with your doctor about what vaccines you need and where you need to go to get them. Some of the vaccines need to be taken in advance – for example, for Costa Rica, I needed the Hepatitis A vaccine, which is given in two doses, six months apart. (You’re safe to travel after the first dose, but so much the better to have them both out of the way.) The Centers for Disease Control and Prevention also recommends protection from typhoid. The typhoid pill series lasts longer than the shot, takes a week to complete and needs to be completed one week before travel.

Matt Crotty, PharmD, BCIDP, infectious diseases pharmacist at Methodist Dallas Medical Center, advises looking on the CDC’s website to learn which vaccines are recommended, then discussing those risks with your doctor. “For example, CDC may recommend malaria prophylaxis, but for a short trip to urban areas, is that still necessary? It’s a risk / benefit discussion you can have with your doctor and decide together.” Crotty points out that most primary care physicians don’t offer vaccines needed for exotic travel, but they can refer you to a travel medicine clinic.

Most places you travel, you’re much less likely to get yellow fever and more likely to catch a common cold or get an upset tummy. Your resistance is low because you’re tired, you were just on a germy airplane, you’re staying at a germy hotel, and (hopefully) eating some adventurous food. Even if you’re packing light, I’ve learned it’s important to bring one week’s worth of general medications. Other than my every day prescriptions, here’s what’s in my carry-on:

• Antihistamine/decongestant (I like to bring the “behind the pharmacy counter” pseudoephedrine)
• Saline nasal spray, which helps me with dryness after long plane trips
• Mix of acetaminophen and ibuprofen, for headaches, fevers, sunburns, regular overall pain
• Multi-use stomach medicine for indigestion, nausea or worse (I hate chewing antacids, so I opt for the generic version of swallowable pepto capsules)
• Hydrocortisone for itchy skin or rashes
• Band aids
• First aid cream like Neosporin
• Cough drops
• Non-drowsy motion sickness pills
• Sunscreen and aloe gel
• Bug spray
• Tissues

This is what works for me – I’m someone who gets motion sickness and has upper respiratory / allergy issues. One of my favorite travel companions gets stomach problems, so she packs a broader variety of pills for tummy troubles, but leaves the nasal spray and decongestants at home. Some things to talk with your doctor about:

• Sleep aids
• Antibiotics
• EpiPen (if you have a severe allergy)
• Medicine to prevent altitude sickness

Crotty suggests talking to your doctor about Diamox for that altitude sickness. He says Zofran or scopolamine patches worn behind the ear can help fight sea sickness.

The scopolamine patch worked wonders for me on a choppy cruise ship once. But learn from my mistake – don’t take the patch off right away; leave it on while you re-adjust to the ground. This is especially important if you’re going to go on rides at the Harry Potter theme park the same day you dock.

Crotty says many pharmacists and physicians have moved away from the recommendation to pack antibiotics before overseas travel. Though the meds could decrease the length of traveler’s diarrhea by a day, talk to your doctor about the side effects taking antibiotics could bring. You may decide the drugs aren’t worth it. Crotty suggests simply practicing good hand hygiene, like washing your hands with soap and water when possible and carrying alcohol-based hand sanitizer, as well as taking non-antibiotic drugs, like the pepto I mentioned earlier.

Here’s one other rookie mistake I made – drinking Coke Zero with ice in Costa Rica. I made a big effort to avoid the water, but it didn’t occur to me that ice is made of water. DUH, right? I paid for it later, but luckily, my little travel pharmacy had me prepared.

I’m skilled at packing light, and having a traveling pharmacy doesn’t take up much room. And believe me, it’s such a relief to have the meds when you need them. Once in Prague and once in Florence, I had to mime big sneezes with an exaggerated “Achoo!” to get cold medicine because the pharmacist didn’t speak any English.

Here’s one more tip for international travel. Normally, I don’t take the pill bottles or boxes with me because they take up too much room. However, when traveling to New Zealand, you’re required to show proof of prescription. It’s not always enforced, but one security agent in Auckland recently took away my saline spray!

I suggest packing a mini-pharmacy when you’re traveling domestically, too. Stressing out about finding a drug store can really put a damper on your vacation, and if you’re at a resort, you may end up paying a lot more for some ibuprofen.

And of course, it seems like once you’re prepared, you don’t need the drugs you pack.

So…get out there and have a great adventure!

Looking to talk travel with a physician? Find one here!