Travel & Altitude Medications

Travel & Altitude Medications


Whether traveling to a foreign country for vacation or just going camping here in the US there are various scenarios you might encounter where you will benefit from being prepared with various medications.  Many of these medications are over the counter, but some will require a prescription from your doctor.  Most family doctors are likely to be pretty reasonable if you go to them and explain why you need a small quantity of several medications.  The same goes for preppers as long as you aren’t stockpiling Percocet and Xanax. 🙂

Something unique to foreign travel is that many of the medications that are prescription only in the United States are over the counter in other countries.

General Issues

Routine dental and medical care should be updated before the trip.  Be sure to have an adequate supply of your regular medications. Know what your travel and medical insurance will cover while you are out of town or abroad including the need to be evacuated.  Being evacuated off the lower portions of Mt. Everest can cost around $8000.   Consider updating your immunizations such as hepatitis. tetanus, influenza, and then any region specific immunizations you might need.  You can check the CDC Travel website for specific recommendations.

Traveler’s Diarrhea

One of the most common travel related illnesses is traveler’s diarrhea.  Your gastrointestinal tract isn’t accustomed to the bacteria it will encounter in some foreign countries.  Most countries in Europe are generally safe.  More high-risk destinations include the developing countries of Latin America, Africa, the Middle East, and Asia.  The diarrhea can range from a minor brief annoyance to a debilitating prolonged misery.  Most cases are related to Escherichia coli.

Common symptoms include:

  • Abrupt onset
  • Increased frequency, volume, and weight of stool
  • Altered stool consistency
  • Nausea and/or vomiting may be associated
  • Abdominal cramping, bloating, flatus
  • Fever
  • Malaise

Although effective, prophylactic antibiotics are generally not recommended as it can increase your risk of adverse reaction to the medication as well as to infections with resistant organisms.  Antibiotics are also not effective against viral or parasitic pathogens and can cause you to have a false sense of security with what you are putting in your mouth.  Its better to just observe strict preventative measures.  The mainstay of treatment is oral rehydration.  You can use Pepto Bismol for symptomatic relief.  Use of antidiarrheal medications could also be considered, however use caution if your have bloody diarrhea as it could signify a more serious illness and you don’t want to lock that inside of your GI tract.  If you develop 3 or more loose stools in an 8-hour period with associated nausea, vomiting, abdominal cramps, fever, or bloody stools, you may benefit from antibiotics.  The mainstay of treatment recently has become Zithromax 500mg daily for 1-3 days.

General Medications

Lets look at some specific medications you might want to include aside from your regular daily meds.  I carry mine in the Plano fishing tackle container in the picture above.  In the past I believe your medications had to be in a labeled pill bottle, but the TSA no longer requires this.  These medications are in addition to the items in my IFAK.  Medications will be in the form Brand name/generic name and will be in Red so you can pick them out.

NSAIDs (Non-Steroidal Anti-Inflammatory Drugs):  Advil/Motrin/ibuprofen, Aleve/naprosyn/naproxen, and aspirin. Available in brand name or generics.  NSAIDS treat pain, fever and inflammation.  Its generally safe, but use caution if you have stomach issues like ulcers or a history of kidney problems.  Prescription doses of these medications are generally higher than the suggested doses on the bottles from the store.  Healthy adults can take Motrin 800mg every 8h OR Naprosyn 500mg every 12h.  Take one or the other, but not both.

Tylenol/acetaminophen:  Tylenol treats pain and fever, but not inflammation.  Because it works differently it can be taken along with NSAIDS.  For instance, you can take Motrin 800mg every 8 hours and Tylenol 1g every 6h.  This works great when you are sick in general to help treat fever and muscle aches.

Vitamins:  Multi-vitamins or any additional specific ones you might want to include.  They are great to take every day in general, but depending on where you are going and for how long you might not have a good source of some nutrients with the foods you will eat.

Antibiotics:  Finding the antibiotics that will cover the most conditions is ideal.  Fluoroquinolones (Levaquin, Avelox, Cipro) are an ideal choice for this.  Cipro tends to not have as much lung coverage for things like pneumonia so Levaquin or Avelox might be a better choice.  Last I knew, the US military has Avelox in their IFAKS.  In general these have good antibacterial coverage for pneumonia, urinary tract infections, upper respiratory infections, gastrointestinal infections and skin infections.  Bactrim or Doxycycline would be other reasonable choices.  Recently Zithromax/azithromycin has become the treatment of choice for traveler’s diarrhea once you get more severe symptoms like fevers, body aches, stomach ache, etc.

Anti-nausea medication:  If you end up with a severe GI illness which also involves nausea and vomiting its going to be hard to stay hydrated.  Nausea can also occur at high altitudes.  Phenergan/promethazine is a common choice, although it can make you quite drowsy.  A better choice might be Zofran/ondansetron which doesn’t cause drowsiness and also comes in a ODT (oral dissolving tablet) form that just dissolves on your tongue.  The nausea medicine doesn’t do much for you if you can’t keep it down so one that dissolves on your tongue is ideal.

Anti-diarrhea:  There is a decent chance you will experience some degree of travelers diarrhea.  As I mentioned, most cases are brief and sell limited, but they can have a protracted course.  As long as you don’t have any of the more concerning symptoms like bloody stool as I mention above you should be safe to use an anti-diarrhea medicine like Imodium/Loperamide.

Allergy medications:  Any of a variety of antihistamines such as Benadryl/diphenhydramine can be helpful for helping with itchy rashes or other allergic reactions.  I also include an anti-histamine/decongestant like Claritin D or Allegra D since they don’t make you drowsy like benadryl and can help dry up secretions.

Medications for High Altitude

When ascending to high altitudes, generally over 10,000ft/3048M, it may be beneficial to take one or several medications to help prevent Acute Mountain Sickness (AMS), High Altitude Cerebral Edema (HACE).  Everyone is affected differently by altitude and some people may be affected on one trip and not another.  There doesn’t seem to be any great pattern to who it affects.  So far I’ve been up to 12,000ft, not had any problems and taken no medication other than vitamins and Motrin.  One of the keys is to ascend slowly so your body has a chance to acclimatize.

  • Motrin/Ibuprofen can help treat AMS symptoms such as headache.
    • Dose – 800mg every 8 hours.  600mg every 8h if you are <100lbs
  • Diamox/acetazolamide is used to prevent and reduce the symptoms of altitude sickness. It can help with headache, tiredness, nausea, dizziness and shortness of breath that can occur when you ascend quickly to high altitudes.  Start taking one or two days before and continuing for three days once the highest altitude is reached.
    • Dose
      • AMS, HACE prevention – 125 mg twice a day; 250 mg twice a day if >100 kg.
      • AMS treatment – 250 mg twice a day
  • Decadron/Dexamethasone is a steroid that decreases brain and other swelling, decreasing the effects of AMS.
    • Dose
      • AMS, HACE prevention – 2 mg every 6 h or 4 mg every 12 h
      • AMS treatment – 4 mg every 6 h
      • HACE treatment: 8 mg once, then 4 mg every 6 h
  • Procardia/Nifedipine is used to treat high blood pressure. For altitude purposes it works  to improve oxygen transfer in the lung and can therefore be used to treat High Altitude Pulmonary Edema (HAPE), though its not nearly as effective as dexamethasone.  It can lower your blood pressure so use caution until you know how it will affect you.
    • Dose
      • HAPE prevention – 30 mg SR every 12 h, or 20 mg SR every 8 h
      • HAPE treatment – 30 mg SR every 12 h, or 20 mg SR every 8 h
  • Cialis/Tadalafil, Viagra/Sildenafil are well known for treating sexual dysfunction.  It works by relaxing blood vessels allowing more blood to flow through them allowing more oxygen to be delivered to tissues.
    • Dose
      • Cialis – HAPE prevention – 10mg twice daily
      • Viagra – HAPE Prevention – 50mg every 8h