Medications for Traveling Abroad

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What to do regarding taking medication abroad:
We recommend following these steps to ensure that you have your prescription for
the duration of your holiday:

  • Contact us 2 months before your flight to let us know what medication you
    may need and how long you are going away for. You may need a letter
    signed by the GP stating what medication you are on and why you need it.
    This may come with a charge.
  • You will need a copy of your prescription stating the generic name of your
    medication. This is due to medications having different brand names and
    therefore you will need to know the name that is carried across all countries.
  • NHS guidelines advice that you carry the majority of your medication in your
    hand luggage and then some spare in your suitcase in case of loss or
    damages.
  • If you have liquid medicines over 100mls, contact the airline and airports you
    are travelling through. This also includes medications such as inhalers. You
    may need a document to prove the liquid form of the medication is necessary.
    Carrying over 100mls can sometimes mean this medication needs to be
    screened separately to your luggage. Inform security before your X-Ray that
    you have liquid medication with you.
  • If you need to travel with needles or syringes you will need to carry the
    relevant medication alongside the equipment.
  • Get advice from the pharmacy on how to store your medication if travelling to
    a hot country or see the NHS website’s advice for storing your medications.
  • Check the country you are travelling to as they may have restrictions on the
    medications that they allow into the country. If any medications, you are
    taking are controlled drugs then you will need to contact the relevant
    embassy before you travel.

Taking medications for flying


Diazepam in the UK is a Class C IV controlled drug. The following outlines the issues
surrounding its use with regards to flying and why the surgery no longer prescribes
such medications for this purpose.


Diazepam is a sedative, which means it makes you sleepy and more relaxed. There
are several very good reasons why prescribing this drug is not recommended.


According to the prescribing guidelines Diazepam is contraindicated (not allowed) for
treating phobias (fears). It also states that “the use of benzodiazepines to treat
short-term ‘mild’ anxiety is inappropriate.” Your doctor would be taking a significant
legal risk by prescribing against these guidelines. They are only licensed short term
for a crisis in generalised anxiety. If this is the case, you should be getting proper
care and support for your mental health and not going on a flight. Fear of flying in
isolation is not a generalised anxiety disorder.


There are concerns about reduced awareness and reaction times for patients taking
Diazepam which could pose a significant risk to themselves and others due to not
being able to react in a manner which could save their life in the event of an
emergency on board necessitating evacuation.


The use of such sedative drugs can make you fall asleep, however when you do
sleep it is an unnatural non-REM sleep. This means you won’t move around as much
as during natural sleep. This can cause you to be at an increased risk of developing
a blood clot (Deep Vein Thrombosis – DVT) in the leg or even the lungs. Blood clots
are very dangerous and can even prove fatal. This risk is even greater if your flight
is greater than 4 hours, the amount of time which has been shown to increase the
risk of developing DVT whether in an aeroplane or elsewhere.


Whilst most people find Diazepam sedating, a small number have paradoxical
agitation and aggression. They can also cause disinhibition and lead you to behave
in a way that you would not normally which can pose a risk on the plane. This could
impact on your safety as well as that of other passengers and could also get you into
trouble with the law. A similar effect can be seen with alcohol, which has led to
people being removed from flights.


Diazepam and similar controlled drugs are illegal in several countries. They may be
confiscated, or you may find yourself in trouble with the police. The passenger may
also need to use a different strategy for the homeward bound journey and/or other
legs of the journey.


It is important to declare all medical conditions and medications you take to your
travel insurer. If not, there is a risk of nullifying any insurance policy you may have.
Given the above we will no longer be providing Diazepam or similar drugs for flight
anxiety and instead suggest the below aviation industry recommended flight anxiety
courses.


Flight anxiety does not come under the remit of General Medical Services as defined
in the GP contract and so we are not obliged to prescribe for this. Patients who still
wish to take benzodiazepines for flight anxiety are advised to consult with a private
GP.