Travel Prescriptions: Which Medications Should You Take with You?

October 23, 2020

After planning and spending money on a trip, you want to count on having an enjoyable time, and few things can ruin a vacation faster than getting sick. Consider the following list of medications to ensure a happy, healthy trip:

  1. Malarone (Atovaquone / Proguanil), Chloroquine, primaquine, and tafenoquine are medications taken to prevent malaria in countries in which mosquitoes carry the disease. The Center for Disease Control and Prevention (CDC) in Atlanta keeps a list of countries and regions in which prophylaxis is recommended. Chloroquine should be started 1 to 2 weeks prior to travel, at a dose of 500 mg per week. Primaquine should be taken at a dose of 30 mg per day, starting a day or two before the trip, during the trip, and for two weeks after return. Tafenoquine should be started 3 days before travel, at a dose of 200 mg per day, and continued at 200 mg per week during travel, followed by 200 mg a week after travel. Malarone should be started one or two days before and continued at least for a week after leaving the malaria area.
  2. High altitude sickness occurs when climbers ascend too rapidly above 2500 meters, or about 8,000 feet. Climbing slowly and taking it easy the first two days, while staying hydrated, can prevent illness. When that is not possible, Diamox, (acetazolamide) can prevent headache, shortness of breath, dizziness, tiredness, loss of appetite, nausea, and vomiting.  Acetazolamide should be taken at a dose of 125 mg every 12 hours, beginning the day before the ascent.
  3. Motion sickness, either at sea or on land, can make the trip less than fun. Scopace (scopolamine) is an excellent treatment to prevent nausea, vomiting, and generalised sick feeling. It can be worn as a patch behind the ear or taken intranasally. The patch should be applied to the skin 4 hours before the trip begins. Unlike the patch, intranasal spray will not cause drowsiness, because it goes directly to the brain, allowing an effective lower dose to be used. It was developed for astronauts who need to stay alert in space. Certain 1st generation H1 antihistamines are also effective: Dramamine (dimenhydrinate) should be taken orally at a dose of 50 to 100 mg every 4 to 6 hours, beginning 1 hour before travel. Meclizine works very similarly, and a 25 mg tablet is taken up to every six to eight hours. Both are the preferred medications during pregnancy (pregnant patients are especially prone to motion sickness).
  4. Nausea Medications: The most effective medication against nausea is Zofran (ondansetron). Usually 4 mg are taken every 6 hours as needed for nausea and vomiting. They exist as regular tablets (the cheapest form), as dissolvable tablets, as liquid or as films.
  5. Traveler’s diarrhea is a problem for about 35% of tourists to developing countries. It should be treated with rehydration (bottled or canned water) and antibiotics. The most common antibiotic to treat or prevent it is ciprofloxacin. One 500 mg tablet is usually taken twice a day for several days–but one time regimen exist. Another common antibiotic is Azithromycin (“Z-pack”) which is often used for travelers in areas in which the water is contaminated with E. coli and other fecal bacteria. A single dose of 500 mg is recommended, followed by another 500 mg 12 hours later if needed. Flagyl (metronidazole) is used to prevent and treat traveler’s diarrhea caused by invasive species of amoeba. The medication may be taken at a dose of 4 tablets at once or ½ tablet per day for 4 to 7 days. Plenty of water should be taken along with the medication, and alcohol should be avoided.

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Planning a trip? Did you know that our doctors can counsel you and prescribe you the appropriate travel prescriptions online, which you can then pick up an any pharmacy right after your consultation. Bon voyage!

October 23, 2020

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