The average American gets nearly 10 prescriptions filled a year, and those with a chronic illness may take even more medications. For most people, taking medicine exactly as it is prescribed is difficult, even at home with pills in plain view.
Factor in a long trip, a laid-back vacation mind-set and multiple time zones, and it's easy to understand why travelers have an even more difficult time taking their medications properly.
Being on the road can also present such problems as running out of a needed prescription or losing medicines.
Most of these troubles can be resolved, pharmacists say, by planning and following some simple suggestions.
To keep on schedule, you could continue taking medicines as if you were still in your home time zone, says Steve Clement, a Belleville, Ill., pharmacist and spokesperson for the American Pharmaceutical Assn. To help with scheduling, set a watch to your home time, perhaps programming the alarm to beep when it's time for a dose. A drawback to this approach: You may be getting up in the wee hours to take a pill.
Alternatively, you could note the interval between doses and keep that interval the same whatever time zone you're in, suggests Daniel Albrant, a pharmacist consultant in Arlington, Va., and a spokesperson for the American Pharmaceutical Assn. But this plan may disturb your sleep as well.
Another option, Clement suggests, is to ask your doctor if you can skip a dose and begin anew the next morning, resetting the schedule for the destination's time zone.
It's more crucial to stick to an exact schedule with some medicines than with others, Albrant and Clement agree.
In general, they say, it's vital to follow a precise dosing schedule for medicines that control chronic conditions, including high blood pressure, seizures, diabetes and heart rhythm disturbances.
Birth control pills are also important to take on a set schedule. In recent years, Clement says, he has noticed that physicians write "Take every 24 hours" on birth control prescription orders rather than the traditional "Take daily." The same advice is given in package inserts, says a spokeswoman for Ortho-McNeil Pharmaceutical, which manufactures several oral contraceptives.
You can't expect to be fully protected against pregnancy if you skip more than one dose per cycle, Albrant says, unless that missed dose happens to be one of the "dummy" pills without hormones that some birth control packets include. If you skip just one hormone-containing tablet, it's a good idea to use a backup contraceptive method.
Among medicines that usually don't have to be taken on such a rigid schedule are antibiotics and analgesics, Albrant says.
To be sure your medicine arrives, carry all medications with you rather than in checked baggage, the two pharmacists agree, even if you don't need to take a dose until well after arrival.
Having the original containers can also help you move through customs more quickly. The U.S. Customs Service advises travelers who need potentially addictive drugs, stimulants or narcotics, such as some cough medicines, tranquilizers, sleeping pills and antidepressants, to take these steps: Keep those drugs in their original packaging, carry only the quantity that a person with the specific condition would typically carry and take along a prescription or written statement from the prescribing doctor explaining what the drug is for and the dose.
Carrying an extra prescription can also help if you run out of medicine. Be sure your doctor's handwriting is legible. Ask for the drug's brand and generic names; brand names can vary from country to country.
The American Pharmaceutical Assn. adds these suggestions for long-distance travelers:
* Take a list of each prescription and over-the-counter medicine you use regularly, why you take it, and what dose you take. Note any drug allergies.
* Don't buy over-the-counter drugs at foreign pharmacies without asking the advice of a pharmacist or physician. Overseas, some over-the-counter products have ingredients that are available only by prescription in the U.S. Such products may not have labels to warn you about the drug's potential side effects and possible drug interactions.
Healthy Traveler appears twice a month.