Meds - general info

GENERAL MEDS FOR TRAVELERS:

CONTACT YOUR DOCTOR OR VISIT PASSPORT HEALTH AS SOON AS TRIP IS CONFIRMED

                                            MEDICATIONS FOR TRAVEL

When traveling out of the country, it is wise to raid the drugstore prior to departure to make sure that you have supplies in case of injury or illness.  Those marked with asterisk (*) require a prescription.

Antibiotics:   

1.     CIPRO*250 mgs taken twice a day for 3 days will be useful for diarrheal, urinary tract, and some upper respiratory infections.  Dose may be doubled for severe infections.

2.     Amoxicillin* 250mgs taken three times a day for 5 days can be used for ear, urinary tract, skin and diarrheal infections.  Dose may be doubled for severe infections.  Must not take if allergic to penicillin.

Note:   these can be taken in sunlight and are not diminished by alcohol.

Antimalarial:

                  Malarone* (antimalarial prophylaxis): combination of Atovaquone 250mg and proguanil 100mg.  This pill is taken once daily starting 2 days before reaching endemic area, throughout the time in the endemic area, and for 7 days afterwards.  This should not be taken with tetracycline drugs and should be taken right after eating food.

General Medications and Supplies:

1.     Lomotil*(diphenoxylate HCl/atropine sulfate), Imodium, Pepto-Bismol for diarrhea (Lomotil stronger than Imodium, but may cause dry mouth and drowsiness).  Note that Pepto-Bismol, a substance like aspirin, should not be taken by those allergic to aspirin.

2.     Eye drops:

a.      Naphcon A, or Vasocon A: antihistamine drops for allergy

b.     Tears as lubricant,  important for very dry or dusty climates

c.     Tobrex*(tobramycin) antibiotic drops for infection (red eye, crusting): 2 drops 4 times a day for 4 days in affected eye

3.     Sunblock: use a lotion that is at least 15 SPF and a lip balm with SPF of 15 or more

4.     Lotrisone*(betamethasone and clotrimazole) cream for (fungal) rashes

5.     Bandaids, thermometer, antibacterial wipes(e.g. “Wet Ones”), alcohol wipes and needle for splinters

6.     Elastic stockings for long flights: this truly helps to prevent the swelling that often occurs after sitting on a long flight.  It is good for the circulation as well.  (usually can be bought at surgical supply stores).

7.     Ambien*(zolpidem tartrate) 5 mgs (1-2 at bedtime) as sleeping aid for  long flights

8.     Insect repellant: the repellant must contain DEET in a concentration of at least 30-35% (for adults) to be effective against mosquitoes that transmit the malaria parasite.  Deep Woods “Off” meets this requirement.  “Ben’s”is a high concentration repellant for serious wilderness trips (95% DEET).

9.     Westcort*(hydrocortisone valerate)  cream (corticosteroid) for itchy insect bites

10.   Advil, Tylenol, or aspirin for pain, headache.

11.   Antihistamine: Clarinex* 5 mgs (non sedating)for sneezing, runny nose)1/day

Travel Medications and Advice (continued):

12.   Decongestants(use ½ hour before take-off and landing) if you have any symptoms of congestion in the ears, nose, head::

a.     Sudafed for blocked ears, for flying to prevent perforated ear drums

b.     Afrin nasal spray (short-acting) before taking off and on landing

13.   Anti motion sickness: meclizine or dramamine

14.   Indigestion: Mylanta antacid/antigas tablets

Immunizations: CONTACT YOUR LOCAL DOCTOR OR VISIT PASSPORT HEALTH The hepatitis vaccinations, ideally, are given over a span of 6 months (although accelerated schedules are available).

Up-to-date reports are available to determine what is needed from the CDC (Centers for Disease Prevention and Control) and their web site is very informative (www.CDC.gov).  Hepatitis A vaccine:  useful for any country where the water is questionable (most places outside of the US, Canada, and Western Europe) given as a series of two injections 6 months apart. We recommend the hepatitis B vaccine for frequent world travelers. Other routine vaccinations should be up to date (tetanus-diphtheria, polio, typhoid).  The Yellow Fever vaccine must be given no less than 10 days prior to departure and is required in some parts of the world for entry into the country.

JOIN SOS (1-800-523-8662 or  www.internationalsos.com/buymembership):

International SOS is the premier medical assistance company in the world, in the event you need to talk to a Western trained physician in virtually any place in the world. Remember, no medical question is stupid, so CALL SOS when in doubt as to what to do medically.  It is better to be prepared than to be left alone and without medical support away from home.  Also, you do not have to be in a “third world” country to need this kind of assistance. 

Altitude sickness prevention: Diamox*(acetazolamide) Applicable when going to altitudes above 2000-3000 feet. Some people even get symptoms (e.g. headache) in Denver, CO which is the “mile high” city.  There is no need to suffer in silence: Diamox helps!  But one must take it BEFORE leaving for the high altitude area.

Diamox*(acetazolamide): 125 mgs twice daily, starting 1 day prior to arrival in high altitude area and for the first 3 days at altitude.  Common side effects are frequent urination early on (it is a diuretic), diarrhea, and sometimes tingling in the tips of the fingers, toes and even nose. This tingling is nothing to be alarmed about and is better than suffering from altitude sickness (nausea, vomiting, headache, shortness of breath).  Carbonated beverages sometimes taste bad while on this medication. Some individuals need the higher dose of 250 mgs twice daily (based on previous experience or symptoms while at altitude): one can also supplement the 125 mgs twice daily  with a midday dose (e.g. if you feel queasy or have a headache).  In summary, take the medicine 1 day before going to altitude, and for the first 3 days at altitude, and a fourth day if any symptoms exist and feel free to take the higher dose if necessary.

FINALLY, after raiding the drug store, PLEASE TAKE ALL OF THE ABOVE WITH YOU

IN YOUR CARRY-ON BAGS BOTH TO AND FROM: MANY A WEARY TRAVELLER HAS HAD THE ONSET OF TRAVELLER’S DIARRHEA IN THE AIRPORT OR IN-FLIGHT WHEN RETURNING HOME.                                                                            January 2, 2007