Counterfeit Medications

  There has been some concern that many people travel abroad to stock up on foreign medications, as they are already finding them cheaper then available at home. There are many worries that what you buy may not be what you think it is. In many cases it is easier for a supplier to cut out the active ingredient of a pill and replace it with an adulterant- a substance that mimics the appearance of the active ingredient. This is done much the same in Canada with the underground anabolic steroid market. Sometimes adulterants may also be harmful and not just inert fillers.

  Recently on a trip to Mexico I noticed one pharmacy still selling Vioxx- the anti-inflammatory drug that was pulled off shelves worldwide by its manufacturer. While I have heard of patients hoarding their stock it has been over three years since Vioxx had been legally manufactured. This pill and package looked identical to the original product but was clearly a fake. A colleague in Odessa Ukraine had remarked that her patients had responded more than expected to some ibuprofen samples I had given the clinic. She believed the amount of active ingredient was low or non-existent in many of the drugs available in Ukraine!

  Most recently counterfeit anti-malarials were exposed in China. Many travelers buy their anti-malarials locally instead of in Canada, but what most travelers don't know is that anti-malaria medication should be started in advance of actual exposure to malaria so going cheap is not the most beneficial way. Ideally travelers should receive medication through a licensed practitioner (i.e. doctors, nurses or pharmacist) and be sure that any medication purchased is not expired and has been stored correctly. This is not always easy to do or to verify.

I suggest bringing between 2-3 times the amount of regular medication needed from Canada to ensure that you have enough and storing it carefully in checked luggage. Dividing medication in a safe place at your destination helps in case something is lost or stolen.

Lastly, when traveling through poor countries it is discouraged to give medications directly to people. This often does more harm than good. It is better to give any extra medication to a recognized heath charity (if they can legally use it) or better yet, give them cash so they can determine how best to use their “health dollars”.

Tourists can, through inadvertent action undermine legitimate health infrastructure and make things worse. Supporting an existing health care system helps make them more efficient and also benefits us when unexpectedly we need their help.