As the holiday season approaches, travelers may be tempted to purchase medications over-the-counter abroad that require a prescription in their home countries. Experts advise that these self-prescribed foreign medications can pose serious health risks, ranging from exacerbating existing conditions to potentially fatal outcomes.
Weight-Loss Injections
Injectable medications for obesity and type 2 diabetes, such as Ozempic and Wegovy, which mimic the GLP-1 hormone, are available without a prescription in countries like Thailand, Mexico, and India. These drugs, which regulate blood sugar and increase satiety, require medical supervision in the UK. Incorrect dosages, which are more likely without a prescription, can lead to side effects including nausea, vomiting, diarrhea, and dehydration. More serious complications like pancreatitis or gallbladder problems can also occur. Unsupervised use increases the risk of using the wrong dose or overlooking underlying health issues.
Sleep Aids and Pain Relievers
Melatonin, a hormone that regulates sleep cycles, is readily available as a dietary supplement in the U.S., Canada, and parts of Asia. However, its classification as a food product means it is subject to less stringent testing. Studies have found that over-the-counter melatonin can contain significantly different amounts than stated on the label. High doses or inappropriate use can cause stomach pain, depression, and vivid nightmares, potentially disrupting the natural sleep-wake cycle. Melatonin can also interact with other medications, including blood thinners and diabetes drugs.
Oral diclofenac, a non-steroidal anti-inflammatory drug (NSAID) used to treat inflammation, swelling, and stiffness, is available over-the-counter in some European countries, parts of Asia, and Latin America. In the UK, oral diclofenac is prescription-only due to an increased risk of cardiovascular side effects, including heart attack and stroke, even with short-term use. The drug can shift the body's natural balance of chemicals controlling blood flow and clotting, making blood vessels prone to clots. Studies indicate a higher likelihood of heart attacks in individuals starting diclofenac compared to those not taking it or using other painkillers. Gastrointestinal bleeding and ulceration are also serious risks, particularly for individuals with pre-existing heart conditions or high blood pressure.
Skin Treatments and Corticosteroids
Tretinoin, a synthetic form of vitamin A used to treat acne and sun-damaged skin, is prescription-only in the UK but available over-the-counter in countries such as Mexico, Thailand, and parts of Southern and Eastern Europe. Incorrect use, such as choosing the wrong strength or applying too frequently, can lead to skin damage, redness, peeling, and inflammation. Tretinoin also increases sun sensitivity and should not be used during pregnancy due to potential birth defects.
Corticosteroids, used to reduce inflammation for conditions like asthma and eczema, are prescription-only in the UK. However, they can be purchased without a prescription in South-East Asia, the Middle East, Africa, and Latin America. Incorrect long-term use can suppress natural hormone production, weaken bones, and lead to decreased bone density and an increased risk of fractures. Other side effects include elevated blood sugar, mood changes, and weight gain. Suppressing the immune system can increase the risk of severe infections. Abruptly stopping corticosteroids after long-term use can trigger a potentially life-threatening adrenal crisis.
Antibiotics and Potentially Fatal Medications
Oral antibiotics are prescription-only in the UK but widely available without one in parts of South-East Asia, the Middle East, Africa, and Latin America. Overuse and misuse of antibiotics contribute to antibiotic resistance, a major global health concern. Using antibiotics for viral infections, which they cannot treat, or taking the wrong dose or duration, not only fails to improve symptoms but also diminishes the effectiveness of antibiotics for serious bacterial infections. Improper use can also disrupt gut microbes, leading to severe diarrhea or sepsis.
Metamizole, a drug used to treat severe pain and fever, is banned in the UK due to its risk of causing agranulocytosis, a sudden collapse of the immune system. Despite this, it is available over-the-counter in some Eastern European countries. The early signs of agranulocytosis, such as a sore throat or fever, can be mistaken for a common virus, potentially delaying diagnosis and treatment when the condition can become fatal.