Have meds, will travel: 8 questions you need to ask your patients before they hit the skies

Canadians are trotting the globe again, making almost 2.6 million trips in June alone, according to Statistics Canada. That’s nearly seven times the total in June 2021, though still about 40% short of the numbers in June 2019, before the pandemic hit. In addition to packing their walking shoes and—if the destination calls for it—their favourite sunscreen, many Canadians are also stashing prescription and over-the-counter medications in their luggage. This could raise red flags at the border, depending on what and how much medication a patient is traveling with, and which country the meds are entering. If you know patients with passports at the ready and plane tickets booked, do them a favour and have a chat about travelling with meds. First things first: Do they really need all those refills? In its fall newsletter, the College of Physicians and Surgeons of Saskatchewan reminded prescribers to consider asking to see a patient’s trip itinerary before authorizing a large quantity of medications. Pavithra Ravinatarajan, a Kitchener, Ont., pharmacist and CEO of Pavithra Consulting Inc., said this is also something pharmacists may want to do to help patients plan for an upcoming trip, which might also require particular immunizations. “So you can ensure any OTCs they need are the right quality, how many vaccines to order in depending on how many people are going,” she explained. Read: What does the role of the pharmacist look like during the future of travel? Have they done their destination due diligence? Is your patient on Adderall going to Japan—and taking more than 60 days’ worth of prescription daily-wear contact lenses? Both of these items are likely to cause a problem at passport control, even when they’re accompanied by a prescription. Even over-the-counter meds can get travellers to Japan in trouble if these contain prohibited ingredients such as pseudoephedrine or codeine. Whether they’re going to Japan, Curacao or the Netherlands, patients should be advised to check with their destinations’ consulate or official website to see what’s allowed and prohibited, and how many days’ worth of medications they can bring in. For example, in the U.S., travellers are allowed 90 days’ worth of most meds but only 30 days’ worth of narcotics. In certain cases, patients may need to get some type of authorization for their meds and should allow for enough time to get this processed. Global Affairs Canada also recommends that travellers check the Canadian government’s travel advice and advisories webpage, which lists restrictions and alerts by country. Have they gotten their list—and checked it twice? That pharmacist-generated list of prescription medications is as critical to travelling patients as their passports. Remind patients to get an up-to-date list to pack along with their meds, and to keep a copy either in another bag or with their travelling companion. If a patient gets prescriptions filled at more than one pharmacy, it may be necessary to get a list from each pharmacy if the province or territory where the patient lives does not have a centralized drug information system. While a prescription meds list is usually enough, in some cases—such as when a patient is travelling with narcotics or other controlled substances—it may be good idea to also ask the pharmacist for a copy of the prescription, suggested Ravinatarajan. Could these all get lost in translation? That list of meds from the pharmacist, and that very thorough doctor’s note explaining why the meds are needed—they would all be meaningless if the border agents at your patient’s destination country can’t understand English or French. Remind your patient to check if translated documents are necessary, and if these translations need to be completed or notarized by certain parties. What happens if or when their supplies run out? If your patients are out-vacationing their supply of medications—whether that’s due to local restrictions on how much meds they can bring in or because they’re staying longer than originally planned—do they know where they can refills and what documents they need to show either a doctor or pharmacist, or both? Urge your patients to make arrangements well ahead of their trip with the appropriate providers in their destination country. In addition to ensuring their needs will be looked after, this will also spare you the stress of having to respond to an urgent out-of-country request from your travelling patient. Read: Will more Canadians resort to medical tourism? Check-in or carry-on? Let’s pack it up The government of Canada advises travellers to pack all medications in their original labelled containers, in carry-on baggage. The two-bag limit for carry on does not apply to medical supplies, so your patients can rest assured than an extra bagful of meds won’t force them to cull their travel shoe collection. Those looking to streamline their packing by mixing up all their pills in one handy vial should know that’s not a good idea. If they’re travelling with liquid meds, these should be presented separately to the screening officer at the airport. And how should they pack their cannabis? It’s illegal to transport cannabis across the Canadian border, even if it’s medical cannabis backed by a prescription and regardless of whether you’re going out or coming into the country. For any patients thinking of mailing their cannabis or narcotics to their destination ahead of their arrival, the best advice you can give is: Don’t do it. Customs and border control screening technologies in many countries have become so sophisticated there’s a high likelihood they will get caught. So just say no. Do they know what they need to know about bringing meds back to Canada Under Health Canada rules, Canadians returning home from travel may be allowed to bring back a personal quantity—of either a single course of treatment or a 90-day supply—of prescription medications that were prescribed and filled in Canada, or that were initiated while they were abroad. Similar rules apply for over-the-counter medications. Patients who are bringing back meds should know that these meds will need to be in their original hospital- or pharmacy-dispensed packaging, or have the original label still attached indicating what the meds are and what they’re for. For more information, direct your patients to the Health Canada website detailing guidelines for bringing health products into Canada for personal use. Read: Just trying to help: Doctor slammed after he 'worked around the rules' so a patient could get meds

Have meds, will travel: 8 questions you need to ask your patients before they hit the skies

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