There's no way to know how many travelers returning home from abroad tuck a few blister packs of prescription pills into their bags. Souvenirs of a visit to a local pharmacy, many drugs are often available without a prescription for just pennies a pill. And even if prescriptions are ostensibly required, travelers often find that local druggists are willing to bend the rules. Taking a chance is tempting. A 90-day supply of 20-milligram Lipitor tablets can be had for just $190 in Canada compared with $336 here, for example. With high drug costs eating into people's budgets at home, the siren call of a cut-rate diuretic or anti-inflammatory may be hard to resist.
But—and you knew this was coming—buying drugs overseas can be risky, especially in developing countries where drug counterfeiting may be common and manufacturing and storage practices may be suspect. And even if you're in a European country and get a prescription from a doctor there, you need to be careful: Dosages and drug names may be different from what you're familiar with in the United States. If you're thinking of buying prescription drugs overseas for any reason, keep these pointers in mind:
You say tomato. There are dozens of drugs whose names or spellings are similar—or even identical—to those of drugs in the United States but have completely different active ingredients and indications for use overseas. For example, in the States, people take Ambien to help them sleep, but in the United Kingdom, Ambyen is used to treat abnormal heart rhythms, according to a public health advisory about confusing drug names put out by the Food and Drug Administration in 2006. Likewise, travelers to Denmark who ran out of their prescription Prozac might find their spirits—and their blood pressure—plummeting if they accidentally took Prazac, a Danish hypertension drug.
The key is to know the active ingredient in the brand-name drugs that you take. This is the same as the drug's generic name. Since many people take the generic versions of brand-name drugs, this is already familiar. You'd ask for fluoxetine rather than Prozac, and zolpidem instead of Ambien.
Size matters. Overseas drugs often come in different dosages from their U.S. counterparts. If you normally take two 20-milligram tablets daily in the United States, you might have to take four 10-mg pills elsewhere to get the same dose. And remember, if a drug overseas says "retard" after the name, don't get all adolescent and snicker. "That's how they describe 'slow release' in Europe," says Paul Doering, pharmacy professor at the University of Florida College of Pharmacy and codirector of the drug information service center there for health professionals.
Just say no. Even though you can buy amoxicillin over the counter, that doesn't mean you should. "I felt like I was getting away with something" is how Doering described the feeling when a druggist in Brazil offered to sell him heart medication without a prescription. Apart from the uncertainty about whether you're actually getting the proper medicine at the proper dose, think twice about casually picking up a drug that may have serious side effects or that typically requires a doctor's exam or a lab test to determine whether it's appropriate for you. Temptation is a drug, but you don't have to succumb.