It is normal for travelers to carry medicine with them. Most would have something for colds and allergies. Some might even carry antibiotics for diarrhea and throat problems.
People visiting relatives often carry medicines for chronic conditions such as diabetes, because most pharmaceutical products are cheaper abroad.
Guidelines for Bringing Pharmaceuticals into the U.S.
There are guidelines put in place by U.S. Customs and Border Protection (CBP) and the Food and Drug Administration (FDA).
The former is on the lookout for illegal drugs (recreational and performance-enhancing) and not routine pharmaceutical products. But a substantial quantity of controlled substances would surely attract their attention. It might be hard to explain why you have 90 tablets of 1 mg alprazolam in your purse to two grim-looking interrogators.
It is best to prepare yourself in every possible way.
1. You must carry a valid prescription. It is necessary you renew your prescription a week or two before departure. Ensure that the prescription carries the doctor’s name, qualifications, and registration number, and the phone number of the hospital or his or her practice.
2. Carry the medication in its original packaging. Do not tear off blister strips and put them in a plastic medicine bottle or box from Amazon. A label containing information about the chemical element, date of manufacture, date of expiry, and medication strength is essential. Pharmacies in many countries do not use plastic bottles with printed labels. In that case, carry a hard copy of the invoice from your pharmacy. You must be able to prove legal provenance at all times.
3. You can carry 90 days’ worth of medication. If your prescription asks you to consume 2 tablets of clonazepam daily, then you can carry at most 180 tablets.
4. Medical devices such as a pulse oximeter, blood pressure monitor, or compressor nebulizer require a prescription.
5. Suppose you are carrying needles (for example, an EpiPen for anaphylactic shock). In that case, you need to not only carry a prescription but also disclose it during baggage check to avoid hassles with the Transportation Security Administration. You do not want to be part of any activity that places you on a No-Fly list. It would spoil your visit entirely.
6. For drugs that double as narcotics—for example, opioid-based painkillers such as Fentanyl—you need to disclose your possession voluntarily to CBP personnel.
Commonly Available Formulations Banned in the U.S.
There are thousands of drugs on the market. They might have been allowed, licensed for manufacture and sales, and then had their permit revoked.
It might be that a drug made by an American company was later disallowed in the U.S. but is commonly available in many countries. The most well-known and prescribed among these are described below.
- Nimesulide: It is a cheap, fast-acting, nonsteroidal anti-inflammatory drug (NSAID) that is commonly used for treating aches and pains that accompany a flu.
- Rofecoxib: Made by Merck, it is also an NSAID for arthritis and chronic pain management. It is not technically banned, but the manufacturer has withdrawn it from U.S. markets.
- Phenylpropanolamine: PPA is a cheap decongestant. It is not banned in the U.S., but sales are disallowed by FDA following cases of strokes. Further, PPA is a chemical used for meth manufacturing. Hence, it is one drug you do not want to carry through U.S. Customs.
- Metamizole: Known as Novalgin to billions around the world, Metamizole is an effective painkiller. It is banned in the U.S. due to cases of serious side effects.
- Cisapride: If you have been an ulcer patient, chances are you were prescribed Cisapride. It is meant for increasing gastrointestinal motility and relieving constipation. In some patients, it causes serious nausea and headache.
- Furazolidone: A constant favorite of doctors in the developing world, Furazolidone is sold as Dependal-M for treating gastrointestinal disorders. Its metabolites are carcinogenic, and the drug is banned in the U.S.
- Nitrofurazone: It is a broad-spectrum antibiotic sold as Furacin ointment and used topically. It has been banned in the U.S. due to its carcinogenic properties.
- It might be that you are carrying a medicine made by a U.S. company (e.g., Prepulsid, a Cisapride brand, made by Johnson and Johnson in Asia), but that does not make it legal in the U.S.
- A medication may not be technically banned, but the FDA might have issued an advisory against its consumption. That is as good as a ban, since any manufacturer promptly withdraws the medication from the market thereafter. The drug might be used for veterinary purposes in the U.S., and a total ban would disrupt the process.
- The list of banned medications is huge and updated frequently. You need to check your formulations for possible banned/prohibited substances. Most disallowed medications have a safer alternative, such as Etoricoxib in place of Rofecoxib.
Herbal and Traditional Medicines: Are They Allowed Through Customs?
This is a tricky question to answer with two aspects to it.
First, some supplements (such as kratom) are banned in few states like Alabama, Florida, and Tennessee, but they are not banned at the federal level. This means you won’t be stopped at the airport if you have kratom tablets, but you could be prosecuted for possession of a banned substance when you are in Miami.
It gets even more complex with ephedra. Some ephedra products are allowed, but those containing the main ingredient ephedrine are banned. Ephedra is otherwise known as Ma Huang, an extremely popular herbal extract in large parts of Asia, and is used for weight loss.
Second, ayurvedic medicines often contain dangerous amounts of lead and mercury. They are banned for sale but not for personal consumption. Therefore, you could carry it but not transact.
If you ask for our advice, we would say that for your duration of stay in the U.S., do not use herbal supplements unless they are accepted globally, such as spirulina, turmeric, ginseng, etc.
Traveling with Medications? Ensure You Follow the Law
The distribution of medication in the U.S. is highly controlled. It is quite impossible to walk into a drug store and ask for azithromycin (the Z-Pack is used for upper respiratory tract infections, such as a sore throat and accompanying fever). There is a demarcation between over-the-counter (OTC) and prescription medication.
There are strict rules in place about what you can carry into the U.S., and you have to take them seriously; otherwise, your experience at customs may not be a pleasant one.
Above all, do not enter into a protracted argument about the merits of carrying 100 tablets of diazepam in your carry-on luggage.
If necessary, surrender the medication after a due apology, and then visit a physician with an appointment and get a fresh prescription that you can fill legally in the U.S.
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