Medication Management on Long Trips If you’re going to be away from the US for more than three months, you’ll have to give some thought to how you’re going to get your maintenance meds refilled. What doesn’t occur to you until you get sick overseas is the need to give some thought to your usual OTC remedies.
Together, Linda and I take four maintenance medications, and I managed to get them synced up so that the refills all occur at about the same time. Generally, with mail order pharmacies, you can ask for a refill two-thirds of the way through the prescribed quantities (e.g. after 60 days for a 90-day refill).
Mail order pharmacies won’t ship overseas, so you’ll need a stateside helper for this. For some plans that permit it, it might be easier to get 90-day refills at a local pharmacy rather than the mail order one. This will reduce wait times by a few days.
Once your helper has the meds, they can be repackaged in a small box or envelope if necessary. We sent the four prescriptions to Europe (once to Ireland and twice to the UK) for $13.50 each time, and it took 5 to 9 calendar days to be delivered. On the customs declaration, we put “prescription refills” and a value of $25, and there were no problems, at least in these countries.
Because of the shipping delay, you will need to identify a place where you can receive the item, and where it might arrive before you do. I asked our pet-sitting hosts for their postal address and permission to do this, and it all worked out well.
By the way, lens.com will send contact lenses overseas for $30, and without having to check with your eye doctor. They have a UK branch so it might be quicker to get them that way, or even to pop into a local optical shop. But they might not have your brand in another country.
What about OTC items?
We were planning a trip of seven months, and that meant about 400 multivitamin tablets, 400 fish oil capsules, and 200 glucosamine tabs. I brought a full bottle of Sam’s Club vitamins (350, I think), the 200-count bottle of fish oil with almost 1000 mg of omega-whatevers, and the remainder of my big bottle of glucosamine. These are fairly big bottles. In Europe, you will not find huge bottles of any medication, and I did not find fish oil with much over 400 gm of the omega oils. I knew I could get these at Boots, though, and decided to settle for those. Sending refills of these in separate shipments would be more expensive, and because of the quantities might not be permitted. By the way, everything should be sent in its original labeled container.
But wait: what if you get sick? What do you use? Most of it is hard to find in Europe, where they customarily use different medicines. You might want to think about:
• Acetominophen (Tylenol): it’s called paracetamol in Europe, and is available only in small quantities (30-60) at a wide variety of prices.
• Ibuprofen (Advil): it’s called ibuprofen or a variation of that, and also available in 30-60 packs at more than you’d expect to pay.
• Decongestant: we use pseudoephedrine (Sudafed) which (in the US) you now have to buy from the pharmacist and give your name, etc. This is to prevent its diversion to the manufacture of meth. In Europe, they don’t sell the pure form, it’s already blended with paracetamol or ibuprofen and usually liquid.
• Antihistamine: they have generic Zyrtec, which goes by a variety of names, and is inexpensive.
• Cough suppressant: There’s no pint bottle of Robitussin like we buy at Costco. I have found tablet dextromethorphine (DM). There are syrups but the taste will not be familiar, to say the least, and the active ingredient is something else. I don’t like to experiment when I’m not feeling well. Bring some DM.
• Expectorant: In the US, this is guiafenesin, which is the main ingredient in Robitussin and Mucinex. Not generally available, although they knew what it was. They offered a tablet equivalent, called ambroxol, which we found just as effective and it’s a much smaller pill.
• Low-dose aspirin: Remarkably, aspirin is a prescription drug a lot of places. There is controversy about whether a daily aspirin is a good idea or not. Bring the 250-count bottle from Costco if your doctor has you on these.
• Melatonin: I’ve seen it, but not with the dosage varieties we have in the US. I’d bring it.
• “Advil PM” or “Tylenol PM”: these sleep aids are either acetaminophen or ibuprofen with Benadryl, whose generic name is diphenhydramine. Not available, although straight diphenhydramine is.
Pharmacies in Europe
On the continent, anything that goes into your body and isn’t food has to be bought at a pharmacy. These vary from tiny to medium, but there is nothing approaching a Walgreens. In cities, there will be at least one pharmacy open at all times, usually on a rotating schedule, and in some countries, like Italy, there will be a sign in the window of the closed pharmacy telling you where the nearest open one is.
In the UK, you will find some OTC meds in larger grocery stores, but any of the ones mentioned above will still need to be bought from a pharmacy. The biggest one is Boots, and they are even in very small villages.
We have always found the pharmacists to be very well qualified. They are permitted to give a little more medical advice than US pharmacists, and some can even prescribe. Almost all spoke enough English, whatever the country. Take the package from whatever you need more of.
Bring your pill-cutter if you have one.