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Medication and Medical Items

On this page, examples of essential non-prescription liquid, aerosol or gel medications:, how to pack your medication, medical items and assistive devices, mobility aids.

Passengers with medical needs are allowed to bring  prescription and essential non-prescription medications  with them through the security checkpoint as well as any  medically required items and mobility aids .

Prescription and essential non-prescription medications

You may bring prescription and essential non-prescription liquid, gel and aerosol medication in quantities more than 100 ml in your carry-on bag. Medications do not have to be placed in your 1 L plastic bag. See How to Pack your Medications  for more detail.

Solid tablet non-prescription medication (i.e. acetaminophen, ibuprophen, vitamins) is not subject to volume restrictions. Certain powders and granular materials (e.g. mineral-based supplements that are primarily calcium, magnesium or iron) in your carry-on are limited to a total quantity of 350 ml or less.

• Contact lens solution
• Cough syrup
• Decongestant spray

Bringing a day-by-day pill separator is not an issue for security; however, there may be other considerations about travelling with medication, especially when travelling outside of Canada. We recommend finding out more at travel.gc.ca .

Recreational cannabis : Passengers are responsible for knowing the laws and regulations in effect at their destination within Canada. For more information, visit canada.ca website. Liquid and topical forms are subject to liquids, aerosols and gels (LAGs) restrictions in carry-on baggage, and must be placed with other LAGs in a 1-litre clear closed and re-sealable plastic bag. 

Cannabis for medical purposes : The amount of cannabis you carry must be in accordance with the Access to Cannabis for Medical Purposes Regulations . For more information, see Health Canada’s Guide to Understanding the Regulations . Cannabis oil is permitted in carry-on in a quantity of more than 100 ml when used for medicinal purposes, and you will need to remove it from your carry-on and present it to the screening officer at the entry to pre-board screening. However, if the amount of oil is 100 ml or less, it is to be placed in a 1-litre clear bag with other liquids, aerosols and gels.

Please Note: Flying outside of Canada with cannabis is illegal. For more information, visit travel.gc.ca .

• We recommend that you pack all medication in your carry-on baggage and place it in an easy-to-access area.
• We recommend that you carry liquid, gel or aerosol prescription medication in original containers with a pharmacy label identifying the medication.
• Prescription and essential non-prescription medications are exempt from liquid, aerosol and gel restrictions, but you should be ready to present them to the screening officer.

Medical Implants, Mobility Aids and Assistive Devices

Some examples of medical items and mobility aids are listed in the table below.  Note that certain medical devices and passengers with implanted medical devices must be swabbed for explosive trace detection (ETD) testing. See the  Special Needs  page for tips by health condition, disability or medical need. 

• Computer or electrical assistive devices
• Apnea monitors
• Orthopedic shoes
• External medical devices
• Assistive/adaptive equipment
• Augmentation devices
• Ostomy supplies
• Enteral-feeding pumps
• Continuous Positive Airway Pressure (CPAP) machines and respirators (the distilled water used by this device is exempted from the liquid restrictions)
• Bi-level positive airway pressure (BPAP) devices
• Personal oxygen concentrators (POCs) 
• Hearing aids
• Cochlear implants
• Visual aids
• Personal supplemental oxygen*
• CO 2 personal oxygen concentrators*
• Teething rings
• Medications
• All diabetes related medication, equipment & supplies
• Braille note takers
• Communications and cognitive aids/devices (e.g. slate and stylus, automatic page turners, book holders, and adapted pencil grips)
• Any other disability related equipment and associated supplies 
• Syringes, hypodermic needles and biojectors (needle guard must be in place and you must have the medication with you)
• Medical defibrillators*
• One small mercury thermometer (must be in protective case)
• Wheelchairs (and tools for wheelchair disassembly/reassembly)
• Canes  or walking sticks
• Orthotic devices
• Prosthetic devices (and tools for prosthetic devices)
• Artificial and prostheses 
• Sports devices (that enable persons with disabilities to play sports and be physically active)
• Gas cylinders for operating mechanical limbs
• Support braces
• Support appliances
• Service animals

* with airline’s approval

Documentation to support your medical needs or condition is not required; however, if you feel that it would help ease your screening, it should be presented to the screening officer along with your medically necessary items.

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Travel health notices, vaccines and medicines.

• Non-Vaccine-Preventable Diseases

Stay Healthy and Safe

• Packing List

After Your Trip

There are no notices currently in effect for Canada.

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Check the vaccines and medicines list and visit your doctor at least a month before your trip to get vaccines or medicines you may need. If you or your doctor need help finding a location that provides certain vaccines or medicines, visit the Find a Clinic page.

Routine vaccines

Recommendations.

Make sure you are up-to-date on all routine vaccines before every trip. Some of these vaccines include

• Chickenpox (Varicella)
• Diphtheria-Tetanus-Pertussis
• Flu (influenza)
• Measles-Mumps-Rubella (MMR)

Immunization schedules

All eligible travelers should be up to date with their COVID-19 vaccines. Please see  Your COVID-19 Vaccination  for more information. 

COVID-19 vaccine

Hepatitis A

Consider hepatitis A vaccination for most travelers. It is recommended for travelers who will be doing higher risk activities, such as visiting smaller cities, villages, or rural areas where a traveler might get infected through food or water. It is recommended for travelers who plan on eating street food.

Hepatitis A - CDC Yellow Book

Dosing info - Hep A

Hepatitis B

Recommended for unvaccinated travelers younger than 60 years old traveling to Canada. Unvaccinated travelers 60 years and older may get vaccinated before traveling to Canada.

Hepatitis B - CDC Yellow Book

Dosing info - Hep B

Cases of measles are on the rise worldwide. Travelers are at risk of measles if they have not been fully vaccinated at least two weeks prior to departure, or have not had measles in the past, and travel internationally to areas where measles is spreading.

All international travelers should be fully vaccinated against measles with the measles-mumps-rubella (MMR) vaccine, including an early dose for infants 6–11 months, according to  CDC’s measles vaccination recommendations for international travel .

Measles (Rubeola) - CDC Yellow Book

Canada is free of dog rabies. However, rabies may still be present in wildlife species, particularly bats. CDC recommends rabies vaccination before travel only for people working directly with wildlife. These people may include veterinarians, animal handlers, field biologists, or laboratory workers working with specimens from mammalian species.

Rabies - CDC Yellow Book

Learn actions you can take to stay healthy and safe on your trip. Vaccines cannot protect you from many diseases in Canada, so your behaviors are important.

Eat and drink safely

Food and water standards around the world vary based on the destination. Standards may also differ within a country and risk may change depending on activity type (e.g., hiking versus business trip). You can learn more about safe food and drink choices when traveling by accessing the resources below.

• Choose Safe Food and Drinks When Traveling
• Water Treatment Options When Hiking, Camping or Traveling
• Global Water, Sanitation and Hygiene | Healthy Water
• Avoid Contaminated Water During Travel

You can also visit the  Department of State Country Information Pages  for additional information about food and water safety.

Prevent bug bites

Although Canada is an industrialized country, bug bites here can still spread diseases. Just as you would in the United States, try to avoid bug bites while spending time outside or in wooded areas.

What can I do to prevent bug bites?

• Cover exposed skin by wearing long-sleeved shirts, long pants, and hats.
• Use an appropriate insect repellent (see below).
• Consider using permethrin-treated clothing and gear if spending a lot of time outside. Do not use permethrin directly on skin.

What type of insect repellent should I use?

• FOR PROTECTION AGAINST TICKS AND MOSQUITOES: Use a repellent that contains 20% or more DEET for protection that lasts up to several hours.
• Picaridin (also known as KBR 3023, Bayrepel, and icaridin)
• Oil of lemon eucalyptus (OLE) or para-menthane-diol (PMD)
• 2-undecanone
• Always use insect repellent as directed.

What should I do if I am bitten by bugs?

• Avoid scratching bug bites, and apply hydrocortisone cream or calamine lotion to reduce the itching.
• Check your entire body for ticks after outdoor activity. Be sure to remove ticks properly.

What can I do to avoid bed bugs?

Although bed bugs do not carry disease, they are an annoyance. See our information page about avoiding bug bites for some easy tips to avoid them. For more information on bed bugs, see Bed Bugs .

For more detailed information on avoiding bug bites, see Avoid Bug Bites .

Stay safe outdoors

If your travel plans in Canada include outdoor activities, take these steps to stay safe and healthy during your trip:

• Stay alert to changing weather conditions and adjust your plans if conditions become unsafe.
• Prepare for activities by wearing the right clothes and packing protective items, such as bug spray, sunscreen, and a basic first aid kit.
• Consider learning basic first aid and CPR before travel. Bring a travel health kit with items appropriate for your activities.
• If you are outside for many hours in the heat, eat salty snacks and drink water to stay hydrated and replace salt lost through sweating.
• Protect yourself from UV radiation : use sunscreen with an SPF of at least 15, wear protective clothing, and seek shade during the hottest time of day (10 a.m.–4 p.m.).
• Be especially careful during summer months and at high elevation. Because sunlight reflects off snow, sand, and water, sun exposure may be increased during activities like skiing, swimming, and sailing.
• Very cold temperatures can be dangerous. Dress in layers and cover heads, hands, and feet properly if you are visiting a cold location.

Stay safe around water

• Swim only in designated swimming areas. Obey lifeguards and warning flags on beaches.
• Do not dive into shallow water.
• Avoid swallowing water when swimming. Untreated water can carry germs that make you sick.
• Practice safe boating—follow all boating safety laws, do not drink alcohol if you are driving a boat, and always wear a life jacket.

Keep away from animals

Most animals avoid people, but they may attack if they feel threatened, are protecting their young or territory, or if they are injured or ill. Animal bites and scratches can lead to serious diseases such as rabies.

Follow these tips to protect yourself:

• Do not touch or feed any animals you do not know.
• Do not allow animals to lick open wounds, and do not get animal saliva in your eyes or mouth.
• Avoid rodents and their urine and feces.
• Traveling pets should be supervised closely and not allowed to come in contact with local animals.
• If you wake in a room with a bat, seek medical care immediately.  Bat bites may be hard to see.

All animals can pose a threat, but be extra careful around dogs, bats, monkeys, sea animals such as jellyfish, and snakes. If you are bitten or scratched by an animal, immediately:

• Wash the wound with soap and clean water.
• Go to a doctor right away.
• Tell your doctor about your injury when you get back to the United States.

Reduce your exposure to germs

Follow these tips to avoid getting sick or spreading illness to others while traveling:

• Wash your hands often, especially before eating.
• If soap and water aren’t available, clean hands with hand sanitizer (containing at least 60% alcohol).
• Don’t touch your eyes, nose, or mouth. If you need to touch your face, make sure your hands are clean.
• Cover your mouth and nose with a tissue or your sleeve (not your hands) when coughing or sneezing.
• Try to avoid contact with people who are sick.
• If you are sick, stay home or in your hotel room, unless you need medical care.

Avoid sharing body fluids

Diseases can be spread through body fluids, such as saliva, blood, vomit, and semen.

Protect yourself:

• Use latex condoms correctly.
• Do not inject drugs.
• Limit alcohol consumption. People take more risks when intoxicated.
• Do not share needles or any devices that can break the skin. That includes needles for tattoos, piercings, and acupuncture.
• If you receive medical or dental care, make sure the equipment is disinfected or sanitized.

Know how to get medical care while traveling

Plan for how you will get health care during your trip, should the need arise:

• Carry a list of local doctors and hospitals at your destination.
• Review your health insurance plan to determine what medical services it would cover during your trip. Consider purchasing travel health and medical evacuation insurance for things your regular insurance will not cover.
• Carry a card that identifies, in the local language, your blood type, chronic conditions or serious allergies, and the generic names of any medicines you take.
• Bring copies of your prescriptions for medicine and for eye glasses and contact lenses.
• Some prescription drugs may be illegal in other countries. Call Canada’s embassy to verify that all of your prescription(s) are legal to bring with you.
• Bring all the medicines (including over-the-counter medicines) you think you might need during your trip, including extra in case of travel delays. Ask your doctor to help you get prescriptions filled early if you need to.

Many foreign hospitals and clinics are accredited by the Joint Commission International. A list of accredited facilities is available at their website ( www.jointcommissioninternational.org ).

Select safe transportation

Motor vehicle crashes are the #1 killer of healthy US citizens in foreign countries.

Be smart when you are traveling on foot.

• Use sidewalks and marked crosswalks.
• Pay attention to the traffic around you, especially in crowded areas.
• Remember, people on foot do not always have the right of way in other countries.

Riding/Driving

Choose a safe vehicle.

• Choose official taxis or public transportation, such as trains and buses.
• Make sure there are seatbelts.
• Avoid overcrowded, overloaded, top-heavy buses and minivans.
• Avoid riding on motorcycles or motorbikes, especially motorbike taxis. (Many crashes are caused by inexperienced motorbike drivers.)
• Choose newer vehicles—they may have more safety features, such as airbags, and be more reliable.
• Choose larger vehicles, which may provide more protection in crashes.

Think about the driver.

• Do not drive after drinking alcohol or ride with someone who has been drinking.
• Consider hiring a licensed, trained driver familiar with the area.
• Arrange payment before departing.

Follow basic safety tips.

• Wear a seatbelt at all times.
• Sit in the back seat of cars and taxis.
• When on motorbikes or bicycles, always wear a helmet. (Bring a helmet from home, if needed.)
• Do not use a cell phone or text while driving (illegal in many countries).
• Travel during daylight hours only, especially in rural areas.
• If you choose to drive a vehicle in Canada, learn the local traffic laws and have the proper paperwork.
• Get any driving permits and insurance you may need. Get an International Driving Permit (IDP). Carry the IDP and a US-issued driver's license at all times.
• Check with your auto insurance policy's international coverage, and get more coverage if needed. Make sure you have liability insurance.
• Avoid using local, unscheduled aircraft.
• If possible, fly on larger planes (more than 30 seats); larger airplanes are more likely to have regular safety inspections.
• Try to schedule flights during daylight hours and in good weather.

Helpful Resources

Road Safety Overseas (Information from the US Department of State): Includes tips on driving in other countries, International Driving Permits, auto insurance, and other resources.

The Association for International Road Travel has country-specific Road Travel Reports available for most countries for a minimal fee.

Maintain personal security

Use the same common sense traveling overseas that you would at home, and always stay alert and aware of your surroundings.

Before you leave

• Research your destination(s), including local laws, customs, and culture.
• Monitor travel advisories and alerts and read travel tips from the US Department of State.
• Enroll in the Smart Traveler Enrollment Program (STEP) .
• Leave a copy of your itinerary, contact information, credit cards, and passport with someone at home.
• Pack as light as possible, and leave at home any item you could not replace.

While at your destination(s)

• Carry contact information for the nearest US embassy or consulate .
• Carry a photocopy of your passport and entry stamp; leave the actual passport securely in your hotel.
• Follow all local laws and social customs.
• Do not wear expensive clothing or jewelry.
• Always keep hotel doors locked, and store valuables in secure areas.
• If possible, choose hotel rooms between the 2nd and 6th floors.

Healthy Travel Packing List

Use the Healthy Travel Packing List for Canada for a list of health-related items to consider packing for your trip. Talk to your doctor about which items are most important for you.

Why does CDC recommend packing these health-related items?

It’s best to be prepared to prevent and treat common illnesses and injuries. Some supplies and medicines may be difficult to find at your destination, may have different names, or may have different ingredients than what you normally use.

If you are not feeling well after your trip, you may need to see a doctor. If you need help finding a travel medicine specialist, see Find a Clinic . Be sure to tell your doctor about your travel, including where you went and what you did on your trip. Also tell your doctor if you were bitten or scratched by an animal while traveling.

For more information on what to do if you are sick after your trip, see Getting Sick after Travel .

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Travel Tips

How to Make Sure You Travel with Medication Legally

Traveling with medication — even prescription drugs — isn’t as simple as packing it. Here’s how to stay on the right side of the law, anywhere you go.

By Tanya Mohn

Travelers often pack medications when they go abroad, but some popular prescription and over-the-counter ones Americans use for things like pain relief, better sleep, allergies and even the common cold are illegal in some countries.

The United Arab Emirates and Japan, for example, are among the most restrictive nations, but many ban or restrict importing narcotics, sedatives, amphetamines and other common over-the-counter medications.

Most travelers won’t run into problems for carrying small amounts for personal use, said Katherine L. Harmon, who oversees health analysis for iJET International , a travel risk management company. But noncompliance can result in confiscation,(which could, in turn, have severe medical consequences), deportation, jail time, and even the death penalty. “Does it happen a lot? No. Could it? Yes,” Ms. Harmon said. “Consumers need to understand this and how it might adversely impact them before they book that awesome trip to an exotic location.”

She shared a few tips to keep you on the right side of the law, whatever you take and wherever you roam.

Laws vary by country and there is no central, up-to date repository, so Ms. Harmon suggests consulting your physician, travel medical insurance company, or local pharmacist four to six weeks before traveling. “When you inquire about your shots, ask about medications. Odds are they may not know off the top of their head, but they have the resources to find out.”

She also suggests checking with the embassy of your destination country. The State Department website lists foreign embassies in the United States, and their contact information. It also lists insurance providers that offer overseas health coverage. Comparison websites Insure My Trip and SquareMouth can help assess those insurance plans, if they’re necessary.

Label and Pack Your Medication Properly

Carry all of your medication — even vitamins and supplements — in their original, clearly marked containers or packaging in a clear plastic bag in carry on luggage. Make sure the name on the prescription, the medicine container and your passport (or one for the recepient of the medication) all match. If you lost the product information insert, ask the pharmacist to print a new one for you.

Also, check the Transportation Security Administration’s website for up-to-date rules and regulations on packing and carrying your medication when you depart. The standard rules for liquid carry-ons don’t apply to medications in liquid or gel form, but you need to inform the T.S.A. when you pass through security so they don’t confiscate it .

Obtain and Carry Necessary Documentation

Keep copies of your original prescriptions, if you can . Better yet, obtain a letter on official letterhead from your physician that lists the medicines you need and why they were prescribed. Ideally, you would get this translated to the language of your destination country, so it’s easy to read.

For some medication and specialized equipment used to administer them, some countries require documents to be submitted to government officials well in advance of your arrival. Ms. Harmon, for example, was questioned at the Singapore airport once for entering with an EpiPen, but she had prior authorization allowing its transport.

Know the Names and Amounts of Active Ingredients

The documentation you carry should also indicate the generic and chemical names of the active ingredients, which determines permissibility, not brand names.

For example, the active ingredient in Benadryl, diphenhydramine, is banned in Zambia in over-the counter products. In Japan, it is allowed only if the amount in a tablet or injection is limited. However, a typical 25 milligram tablet of Tylenol PM in the United States exceeds the 10 milligram maximum amount in a tablet you can bring into Japan. Some countries restrict the overall total amount of an active ingredient an individual traveler can legally import, which may impact longer stays.

Reduce or Substitute Medication

In countries where a medication is allowed, but its amount is capped, reducing your dosage or switching to another available medication is the best way to stay compliant. Allow enough time beforehand to ensure the smaller dose or new medicine works effectively, and consider making the switch before your trip to give yourself time to adjust.

Some medications can be used for several diagnoses. Hormones used for birth control may also be used to treat excessive menstrual bleeding, Ms. Harmon said. “Doctors need to get creative sometimes. Substitutions can allow authorities to accept the drug as a medical need rather than going against the country’s religious or moral code.”

Reassess Your Travel Plans

Parents with a child doing well on Adderall for attention deficit hyperactivity disorder who prefer not to make adjustments on the fly, or a student with bipolar disorder may want to consider vacation or study abroad locations where the medications they rely on for mental health are not banned or restricted.

“Viewpoints on treatment and diagnoses can vary widely,” Ms. Harmon said. “Western Europe and North America understand that brain chemistry is often at the root of these problems. But some countries, like Russia, do not consider mental health challenges as medical problems and often treat them criminally.”

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Bringing health products into Canada for personal use (GUI-0116)

Table of contents, role of individual, government of canada's role.

• What types of health products are regulated under the Food and Drugs Act ?

What is meant by personal use?

Who can import a health product for personal use, can i bring medical devices into canada, can i bring prescription drugs into canada, are there shipping or packaging requirements, can i bring drugs for food producing animals or animals intended for food (including all horses) into canada.

• Can my doctor/veterinarian access health products that are not available in Canada?

Can I bring/mail health products to a foreign country?

Appendix b - contact us, policies and guidance documents.

The following table shows the two types of icons used in this document, and the way they are intended to be used:

Important: Key or cautionary information for people to know.

Information: Supplementary information like quotes and legal references.

This guidance document describes the rules for bringing health products into Canada for personal human and veterinary use. Health products include prescription drugs; over-the-counter (OTC) medications; natural health products (NHPs); veterinary health products (VHPs); medical devices; blood for transfusion; human cells, tissues, organs for transplantation and semen for assisted conception.

The guidance document:

• describes what health products you can and cannot bring into Canada
• defines personal importation and
• explains the difference between a personal versus commercial import

By following the information in this guidance, you will better understand what is considered a personal use import, the restrictions in place for the importation of prescription drugs and the commercial licensing implications that apply when a shipment is considered to fall outside the conditions of a personal use import.

Shipments that are imported for the purpose of sale in Canada are considered commercial imports and must meet the applicable regulatory requirements as outlined in Importing and exporting health products for commercial use (GUI-0117) . Non-compliant shipments may be seized or refused entry into Canada. Please refer to the Compliance and Enforcement Policy for Health Products (POL-0001) which describes how the Regulatory Operations and Enforcement Branch (ROEB) of Health Canada delivers its national border compliance and enforcement program.

These guidelines apply to you if you:

• live in Canada (resident of Canada)
• are returning to Canada from abroad
• are a visitor to Canada such as a tourist or a visitor with a study or work permit

This guidance document addresses the requirements under the Food and Drugs Act (the Act and its regulations) for health products. Some health products may also have additional restrictions placed on them by other Acts, such as the Controlled Drugs and Substances Act (CDSA) and its regulations and the Convention on International Trade in Endangered Species of Wild Fauna and Flora . Where multiple restrictions/requirements exist, the most restrictive conditions will apply.

Canadians are encouraged to buy licensed health products in Canada that have been assessed to be safe and effective if used according to their directions for use.

If health products are purchased outside the country, individuals need to be aware of the potential health and financial risks (loss of product, purchase/shipping costs) associated with this activity, particularly when buying drugs, natural health products or medical devices online. Health products sold online may be cheaper and easily purchased but riskier because they may be counterfeit (i.e. "fake"), contain the wrong level of an active ingredient, contain toxic substances, or even be past their expiry date.

It can be difficult for Canadians to determine if an internet store is located in Canada, as some sites may appear to be operating in Canada, when in fact they are not. For example, internet stores may have Canada in their name or include a symbol such as a maple leaf that could lead one to assume it is a site operating within Canada. Avoid buying health products from questionable websites. If you have questions about whether an Internet pharmacy is legitimate, contact the licensing body in your province or territory .

Individuals are responsible for knowing if the products being imported contain a prescription drug or a controlled substance as they have distinct import restrictions.

Health Canada is responsible for compliance monitoring and enforcement activities related to health products in order to verify that regulatory requirements are being applied appropriately.

Health Canada works in partnership with the Canada Border Services Agency (CBSA) to assess the compliance of referred health products at the border against the Act and its Regulations, regardless of whether the products are entering by mail/courier or on your person.

CBSA customs officers may detain any health product they suspect does not comply with the Act and its Regulations using their powers as described under section 101 of the Customs Act .

The CBSA may then contact Health Canada to confirm if the product is compliant with the importation requirements found in the Act and its Regulations. Health products found to be non-compliant during the Health Canada inspection will be refused entry or seized. To verify whether the product meets the requirements, Health Canada will assess the product and make an admissibility determination. The assessment may include taking samples of the product for laboratory analysis to confirm the product's composition and that it is not adulterated with an unspecified ingredient (e.g. prescription drug in a health supplement). Health Canada may also contact you for copies of relevant records or documents.

To avoid potential delays at the border, Health Canada recommends that all pertinent information about the product and persons authorized to import (or export) the product be included with the shipment at the time of import.

The Act provides Health Canada with the authority to seize and detain any health product that is believed to be in contravention of the Act or its Regulations. Health Canada also has the authority to order unlawful imported goods to be removed from Canada, or where removal is not possible, order the goods to be destroyed.

Health Canada will notify you and the CBSA in writing of the outcome of the inspection should your product(s) be deemed inadmissible into Canada including any notice of seizure (if applicable) and disposition options, where applicable.

Note: Under section 30.7 (1) of the Act , Health Canada may recover expenses associated with the storage, transport or disposal of seized goods or the removal or destruction of unlawfully imported goods from the owner or importer or the person having possession, care or control of it at the time of the inspection. Furthermore, Health Canada is not responsible for any consequences including financial loss as a result of an admissibility determination made in accordance with its authority under the Act .

What types of health products are regulated under the Food and Drugs Act?

Health products are generally associated with the treatment or diagnosis of a disease, sickness or human/animal condition. They are separate from cosmetics which are regulated under the Act , but not as a drug or a medical device. Cosmetics do not have a therapeutic purpose and are typically used for cleansing, improving or altering the complexion of the skin, hair or teeth, including, deodorants and perfumes. The addition of health claims can make a product that would otherwise appear to be a cosmetic, a health product. The following types of health products are regulated under the Act and its associated Regulations in Canada:

• Prescription drugs for human and animal use (e.g. antibiotics, heartworm medication containing medicinal ingredients on the Prescription Drug List (PDL))
• Over-the-counter drugs for human and animal use (e.g. pain relief tablets and cough medications, oral deworming medication which includes medicinal ingredients not found on the PDL or schedules of the CDSA)
• Natural health products for human use (e.g. vitamins and minerals, herbal remedies, homeopathic medicines)
• Veterinary health products (e.g. veterinary health products for joint support in animals containing active, homeopathic or traditional medicine substances found in List C )
• Medical devices for human use (e.g. thermometers, contact lenses, blood pressure monitors, diabetes test strips, condoms)
• Blood and blood components for human transfusion*
• Human cells, tissues and organs for transplantation*
• Active pharmaceutical ingredients intended for human and animal use

* Only blood, human cells, tissues, and organs for the uses noted above are regulated under the Act . Sperm and ova for the purpose of assisted human reproduction are regulated under the Assisted Human Reproduction Act and the Safety of Sperm and Ova Regulations , and therefore are out of scope of this document. Any use falling outside of this scope may still require permits from either the Public Health Agency of Canada or the Canadian Food Inspection Agency due to their potential to carry human or animal pathogens (see Appendix B - Contact us ). For more information on the requirements for donor sperm and ova, please refer to the Guidance Document – Safety of Sperm and Ova Regulations .

Guidelines for importing health products for personal use

This section describes what you need to know to bring health products into Canada for your personal use.

Personal use means that you are bringing a health product into Canada and the product is:

• for your own use
• for the use of a person or animal who is under your care, or
• for the use of a person or animal with whom you are travelling

Health Canada takes the following factors into consideration in determining whether the import is for a personal use (list is not exhaustive).

• no more than a 90-day supply or a single course of treatment, whichever is less, based on the product's directions for use
• the medical device does not require direct oversight or administration by a trained operator for its use

"Directions for use" refers to:

• the dosage information included on the health product's label or packaging
• the insert or product monograph included with the health product, or
• an official prescription, hospital/pharmacy dispensing instructions, or a doctor's order included with the health product

If the health product does not include directions for use or if the directions for use are in a foreign language or unclear, Health Canada may look at dosage instructions from similar products or recognized sources.

You are a commercial importer if you bring a health product into Canada to:

• sell or give it to someone else that is not under your care
• treat a patient as part of a practitioner/patient relationship
• treat an animal that is not your own
• advertise its sale
• export it out of the country

Each of these activities is considered a sale of a health product, regardless of whether there is an exchange of money. As such, both the individual ( establishment licence or natural health product site licence ) as well as the product requires licensing.

See guidelines for Importing and exporting health products for commercial use (GUI-0117) for a description of the rules commercial importers must follow.

Importation of health products exceeding the personal importation limit of 90-days may be considered a commercial import. For animals, the quantity is based on the number of animals being treated. For medical devices, the quantity of units imported may be taken into consideration.

If you bring the same health products into Canada in multiple shipments and the total amount exceeds a 90-day supply over a 90-day period, you may be considered a commercial importer.

Residents of Canada and visitors are permitted to bring into Canada a personal use quantity (a 90-day supply or single course of treatment) of an OTC medication, NHP, VHP or a medical device for personal use without requiring specific licences for the import.

There are no import restrictions for medical devices for personal use. However, it must be clear that the device can be used directly by the individual without the need for assistance or oversight by a professional. If the device needs the assistance or oversight of a professional, it would be classified as a commercial device.

Specific import restrictions exist for drugs to be used on food producing animals or animals intended for food (including all horses). These drugs must either be market authorized in Canada, be on the list of notified VHP , or a product found on List B: List of Certain Veterinary Drugs Which May Be Imported But Not Sold and be specifically authorized for use on the animal species in question.

Prescription drugs also have specific import requirements and are only permitted to be imported by a practitioner, a drug manufacturer, a wholesale druggist, a registered pharmacist, or a resident of a foreign country while a visitor in Canada . Canadian residents are generally not permitted to import prescription drugs by mail or courier. In certain cases, exemptions exist for Canadian residents to import prescription drugs (see Can I bring prescription drugs into Canada? ).

Be aware that a medication that does not need a prescription in another country could need a prescription in Canada. Check Health Canada's Prescription Drug List (PDL) to see if the health product needs a prescription in Canada.

The PDL is comprised of human drugs in the first part of the list and veterinary drugs in the second part of the list.

Medical devices imported for personal use are not subject to restrictions under the Act or the Medical Devices Regulations; however, it must be clear that the use of such a device would not require the direct oversight of, or administration by, a trained operator, otherwise it would be considered a commercial import. Health Canada maintains a listing of all active licences online. Information accompanying medical devices including the manufacturer's instructions or operator's manual will be used to determine intended uses. The quantity of medical devices imported may also be taken into consideration.

Some health products, particularly prescription drugs, may also contain controlled substances. A health product that is a controlled drug or substance in Canada has its own regulations and rules, including specific import requirements. You are responsible for making sure you meet any rules or conditions that apply to your situation. Find more information on travelling to or from Canada with prescription medications that contain controlled substances .

Residents of Canada

Generally, residents of Canada are not allowed to bring prescription drugs into Canada for people or animals. This includes whether you carry them across the border or have them delivered by mail or courier. Health Canada may permit you to import a personal quantity (a 90-day supply or a single course of treatment) of a prescription drug in the following situations:

• Canadian residents returning to Canada with prescription drugs that were prescribed and filled in Canada for their use or for use on a person/animal for whom they are responsible.
• Canadian residents returning to Canada with prescription drugs for themselves or for an individual or animal under their care and with whom they are travelling, who are continuing a medical treatment that was required to be initiated while abroad.
• Canadian residents and visitors to Canada that belong to a foreign-sponsored clinical trial.
• Recently landed immigrants or refugees seeking continued treatment.

Canadian residents requiring ongoing treatment with a prescription medication that was started abroad should speak with their doctor about accessing a licensed product in Canada. Where a licensed product is not available, the individual may wish to speak with their doctor about Health Canada's Special Access Program (SAP), or to their veterinarian about the Emergency Drug Release program as applicable. For details, see " Can my doctor/veterinarian access health products for me that are not available in Canada? " Prescriptions that are issued abroad may not be filled in Canada; likewise, drugs prescribed in Canada should only be filled in Canada.

Health Canada recognizes the need for continued treatment without interruption of medical conditions that began outside of Canada. If you are a Canadian resident under the long-term care of a doctor from another country, you should contact a Canadian medical practitioner to get the medication within Canada.

Visitors to Canada

Visitors entering Canada may bring a personal quantity of a prescription drug for their own use or for the use of a person or animal under their care and with whom they are travelling.

Visitors staying in Canada for more than three months may bring into Canada an additional 90-day supply of a health product every three months for their own personal use by mail or courier.

Visitors to Canada must be ready to provide evidence of their visitor status. Evidence includes documents such as:

• a copy of your passport
• student or work visa, or
• letter from an employer or university

As a visitor, if the drug is mailed to you, you are encouraged to include a copy of any of the above documentation in the package and indicate on the outside of the shipping package that it is destined to a visitor in Canada.

Health products you bring into Canada for personal use must either:

• be in the package dispensed by the hospital or pharmacy
• be in the original retail package, or
• have the original label attached to it (the label must clearly say what the health product is and what it contains)

When deciding whether a health product meets the amount allowed for personal use, Health Canada will look at the directions for use. It is important that products have proper labelling information.

No person can import a drug for use in/on food-producing animals or animals intended to be consumed as food (including all horses) unless the product has been authorized by Health Canada for such use. This means that the drug must either be market authorized for sale in Canada, be on List B: List of Certain Veterinary Drugs Which May Be Imported But Not Sold or be a notified VHP.

Drugs imported corresponding to List B products must:

• match the criteria on List B including brand name, manufacturer, country in which product has been authorized for sale, dosage form and strength
• be brought in to treat the appropriate species as detailed on List B and
• not exceed a personal quantity based on the number of animals to be treated under your care and the drug's directions for use

If you want to import a drug that is not already on List B, a request must be submitted to Health Canada for the product to be added to List B. See Appendix B - Contact us for information about how to request a drug to be added to List B.

Can my doctor/veterinarian access health products for me that are not available in Canada?

You may be able to gain access to drugs and medical devices that are not available in Canada through a Canadian doctor using the Special Access Program (SAP).

The SAP is available to Canadian doctors to obtain drugs for their patients under the following circumstances:

• the drug is not available for sale in Canada
• have been considered and ruled out
• have failed
• are unsuitable
• are unavailable

You may be able to gain access to veterinary drugs that are not available in Canada through a Canadian veterinarian using the Emergency Drug Release (EDR) program.

The EDR program considers requests for access to drugs for veterinary use that are:

• unavailable for sale in Canada; and
• submitted by veterinarians for the purpose of diagnosing or treating a medical emergency in a patient (or group of animals) under their care.

Some health products that are legal in Canada may be illegal in other countries. You are subject to the laws of the country you are entering, so it is up to you to learn about that country's rules and restrictions before you leave Canada. You can do this by contacting the embassy, consulate or mission of the country you will be entering. Health Canada also recommends you carry a copy of your prescription with you when travelling.

Exportation for "personal use" is exportation for an individual's own personal use, the use of a person for whom they are responsible or for use on an animal for which they are responsible.

Larger volumes shipments, multiple repeat shipments of the same product within short periods of time (<3 months), shipments accompanied by or associated with materials to be used for advertising or promotion, and/or shipments that indicate a Canadian business is involved in the transaction, will be considered commercial shipments. See Importing or exporting health products for commercial use (GUI-0117) for a description of the rules commercial exporters must follow.

Appendix A - Glossary

These definitions explain how terms are used in this document. If there is a conflict with the definitions below, the definition in the Act /Regulations prevails.

Advertise: Includes any representation by any means whatever for the purpose of promoting directly or indirectly the sale or disposal of any food, drug, cosmetic or device.

Commercial importation: includes but is not limited to a shipment destined for a retailer, distributor, or other commercial establishment. This includes shipments being sent to independent sales contractors/distributors, or to a practitioner for use in their practice (See GUI-0117 for specific examples of commercial importation).

Device: Means an instrument, apparatus, contrivance or other similar article, or an in vitro reagent, including a component, part or accessory of any of them, that is manufactured, sold or represented for use in:

• diagnosing, treating, mitigating or preventing a disease, disorder or abnormal physical state, or any of their symptoms, in human beings or animals,
• restoring, modifying or correcting the body structure of human beings or animals or the functioning of any part of the bodies of human beings or animals,
• diagnosing pregnancy in human beings or animals,
• caring for human beings or animals during pregnancy or at or after the birth of the offspring, including caring for the offspring, or
• preventing conception in human beings or animals;
• however, it does not include such an instrument, apparatus, contrivance or article, or a component, part or accessory of any of them, that does any of the actions referred to in paragraphs (a) to (e) solely by pharmacological, immunological or metabolic means or solely by chemical means in or on the body of a human being or animal (Section 2 of the Act ).

Drug: Includes any substance or mixture of substances manufactured, sold or represented for use in:

• the diagnosis, treatment, mitigation or prevention of a disease, disorder or abnormal physical state, or its symptoms, in human beings or animals;
• restoring, correcting or modifying organic functions in human beings or animals, or
• disinfection in premises in which food is manufactured, prepared or kept (Section 2 of the Act ).

Emergency Drug Release (EDR): for Veterinary Drugs not available in Canada: Emergency Drug Release (EDR), via exemptions set out in C.08.010 and C.08.011 of the Food and Drugs Act , allows practitioners (i.e. those who are registered and entitled under the laws of a province or territory to practice the profession of veterinary medicine) to access veterinary drugs that have not been granted a market authorization in Canada. If authorization is granted, Health Canada will provide an "Emergency Drug Release Authorization" to the practitioner. A copy of this authorization should be sent with the shipment to allow timely entry of the drug into Canada.

Export:  For the purposes of this guidance document, "export" includes, in addition to the sending or transporting of a health product abroad, the sale or advertising over the Internet of a health product to a foreign jurisdiction.

Import:  For the purposes of this guidance document, "import" is any action that causes a product to cross the Canadian border from outside Canada regardless if under Customs bond.

List B: means the document, as per the Food and Drug Regulations , entitled List of Certain Veterinary Drugs Which May be Imported But Not Sold .

List C: means the document, entitled Veterinary Health Products , that is published by the Government of Canada on its website, as amended from time to time (C.01.001(1) of the FDR)

Market authorization: A legal document issued by Health Canada authorizing the sale of a drug or a device based on the health and safety requirements of the Food and Drugs Act and its associated Regulations. The marketing authorization may be in the form of a Notice of Compliance (NOC), Drug Identification Number (DIN), a device licence for classes II, III and IV medical devices, or a natural product number (NPN) or homeopathic DIN (DIN-HM).

Medical device: Any device (see definition of device above) within the meaning of the Food and Drugs Act , but does not include any device that is intended for use in relation to animals.

Natural Health Product (NHP): A substance set out in Schedule 1 of the Natural Health Products Regulations or a combination of substances in which all the medicinal ingredients are substances set-out in Schedule 1, a homeopathic medicine or a traditional medicine that is manufactured, sold or represented for use in:

• The diagnosis, treatment, mitigation or prevention of a disease, disorder or abnormal physical state or its symptoms in humans;
• Restoring or correcting organic functions in humans; or
• Modifying organic functions in humans, such as modifying those functions in a manner that maintains or promotes health.
• However, a natural health product does not include a substance set-out in Schedule 2 of the Natural Health Products Regulations (NHPR), any combination of substances that includes a substance set-out in Schedule 2, or a homeopathic medicine or a traditional medicine that is or includes a substance set-out in Schedule 2.
• Also, in accordance with subsection 2(2) of the NHPR, a substance or combination of substances or a traditional medicine is not considered to be a natural health product if its sale, under the Food and Drug Regulations (FDR), is required to be pursuant to a prescription when it is sold other than in accordance with section C.01.043 of the FDR.

Personal Use Importation: Refers to importation by an individual for their own use, or for a person/animal under that individual's care or guardianship, and not for further sale and is generally less than a 90-day supply. It does not apply to a practitioner (Doctor, Veterinarian etc.) importing drugs for patients/animals under their care, which is considered commercial importation.

Prescription Drug: A drug that is set out in the Prescription Drug List, as amended from time to time, or a drug that is part of a class of drugs that is set out in it.

Prescription Drug List: The list established by the Minister under section 29.1 of the Food and Drugs Act .

Sell:  includes

• offer for sale, expose for sale or have in possession for sale - or distribute to one or more persons, whether or not the distribution is made for consideration, and
• lease, offer for lease, expose for lease or have in possession for lease

Shipment: A load of goods from one shipper destined to an importer irrespective of the quantity or number of containers, package or pieces.

Special Access Program (SAP) for Drugs and Medical Devices not available in Canada: The Special Access Program (SAP), via exemptions set out in C.08.010 and C.08.011 of the Food and Drug Regulations and Part 2 Section 69-78 of the Medical Devices Regulations, allows physicians and dentists to gain access to health products for human use that have not been granted market authorization in Canada. Decisions to authorize these exemptions are based on the circumstances and details of each situation. If authorization is granted, Health Canada provides a Letter of Authorization (LOA) to the manufacturer of the drug or device authorizing its sale to the requesting practitioner. A copy of this letter is sent to the practitioner. A copy of this letter must be sent with the shipment to allow timely entry of the drug/medical device into Canada.

Veterinary practitioner: means a person who is registered and entitled under the laws of a province to practice the profession of veterinary medicine.

Veterinary Health Product (VHP): low risk drugs in dosage (ready to use) form. They are used to maintain or promote the health and welfare of companion and food-producing animals. They are not for use to treat, prevent or cure disease. VHPs must be made using permitted, active, homeopathic, and traditional medicine substances according to conditions outlined on List C: Veterinary Health Products (e.g. acceptable animal to be treated and route of administration).

Visitor: a person who is not a Canadian resident. It is a person that is not living in Canada and who is in Canada for visiting, studying or for work under a work visa. Residential address will be used to determine if an individual with dual citizenship is a visitor or not.

• Email: [email protected] Phone: 1-833-622-0414 (Canada or U.S.A.) 204-594-8061 (all other countries)
• For questions about controlled substances, contact the Office of Controlled Substances .
• PHAC's Office of Laboratory Security (OLS) Email: [email protected] Phone: 613-957-1779
• CFIA National Import Service Centre Phone: 1-800-835-4486 (Canada or U.S.A.) 289-247-4099 (local calls and all other countries) Facsimile: 613-773-9999
• telephone: 613-954-5687
• email: [email protected]

Please see information on the criteria and how to add a drug to List B .

• Email: [email protected]
• Teletypewriter: 1-800-465-7735

Appendix C - References

• Assisted Human Reproduction Act https://laws-lois.justice.gc.ca/eng/acts/a-13.4/
• Controlled Drugs and Substances Act https://laws-lois.justice.gc.ca/eng/acts/C-38.8/index.html
• Customs Act https://laws-lois.justice.gc.ca/eng/acts/C-52.6/
• Food and Drugs Act https://laws-lois.justice.gc.ca/eng/acts/f-27/
• Food and Drug Regulations https://laws.justice.gc.ca/eng/regulations/c.r.c.,_c._870/index.html
• Medical Devices Regulations https://laws-lois.justice.gc.ca/eng/regulations/SOR-98-282/
• Natural Health Products Regulations https://laws-lois.justice.gc.ca/eng/regulations/SOR-2003-196/
• Safety of Sperm and Ova Regulations https://laws-lois.justice.gc.ca/eng/regulations/SOR-2019-192/index.html
• Compliance and enforcement policy for health products (POL-0001) https://www.canada.ca/en/health-canada/services/drugs-health-products/compliance-enforcement/good-manufacturing-practices/policies-standards/compliance-enforcement-policy-0001.html
• Guidance Document - Safety of Sperm and Ova Regulations https://www.canada.ca/en/health-canada/programs/consultation-safety-sperm-ova-regulations/document.html
• Importing or exporting health products for commercial use (GUI-0117) https://www.canada.ca/en/health-canada/services/drugs-health-products/compliance-enforcement/importation-exportation/commercial-use-health-products-guidance.html
• Buying drugs over the internet https://www.canada.ca/en/health-canada/services/buying-drugs-over-internet.html
• Buying Medical Devices from the Internet https://www.canada.ca/en/health-canada/services/healthy-living/your-health/medical-information/buying-medical-devices-over-internet.html
• Convention on International Trade in Endangered Species of Wild Fauna and Flora http://www.cites.org/
• Drugs - Special Access Program   https://www.canada.ca/en/health-canada/services/drugs-health-products/special-access
• Emergency Drug Release https://www.canada.ca/en/health-canada/services/drugs-health-products/special-access/veterinary-drug.html
• Establishment Licences https://www.canada.ca/en/health-canada/services/drugs-health-products/compliance-enforcement/establishment-licences.html
• Information on the criteria and how to add a drug to List B https://www.canada.ca/en/public-health/services/antibiotic-antimicrobial-resistance/animals/personal-importation-certain-drugs-food-producing-animals.html
• List B: List of Certain Veterinary Drugs Which May Be Imported But Not Sold https://www.canada.ca/en/public-health/services/antibiotic-antimicrobial-resistance/animals/personal-importation-certain-drugs-food-producing-animals/list-b.html
• List C: Veterinary Health Products https://www.canada.ca/en/public-health/services/antibiotic-antimicrobial-resistance/animals/veterinary-health-products/list-c.html
• List of Notified Products https://health-products.canada.ca/vhp-psa/en/product-list
• Medical Devices - Special Access Program https://www.canada.ca/en/health-canada/services/drugs-health-products/special-access/medical-devices.html
• Natural health product site licence https://www.canada.ca/en/health-canada/services/drugs-health-products/natural-non-prescription/applications-submissions/site-licensing.html
• Office of Controlled Substances https://www.canada.ca/en/health-canada/corporate/contact-us/office-controlled-substances.html
• Online Pharmacies (National Association of Pharmacy Regulatory Authorities) https://napra.ca/online-pharmacies
• Prescription Drug List https://www.canada.ca/en/health-canada/services/drugs-health-products/drug-products/prescription-drug-list/list.html
• Recalls and safety alerts database https://healthycanadians.gc.ca/recall-alert-rappel-avis/index-eng.php?cat=3
• Risks of buying natural health products online https://www.canada.ca/en/health-canada/services/natural-health-products/risks-buying-natural-health-products-online.html

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Traveling with Medications: What You Need to Know

Lindsay Tigar

Lindsay Tigar is a travel and lifestyle writer with a constant thirst for adventure and exploring new lands. You can find Lindsay globetrotting when the mood strikes, making sure to find time to explore both the wine and fitness scene in countries across the globe. Her work has appeared across dozens of outlets; learn more at LindsayTigar.com .

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If you’re heading out on a long trip—or moving abroad—and you rely on prescriptions, it’s vital to your health to know the rules about traveling with medication. “Millions of Americans are dependent on medicines and with the globalization of travel, access to prescription medicine is even more crucial,” explains Dr. Robert Quigley, senior vice president and regional medical director at International SOS .

From how to get more than a 30-day supply of pills to what you’ll need from your stateside doctor to get a prescription abroad, here’s advice from international healthcare experts about traveling with medication.

Bring a Note from Your Doctor

Dr. Christopher C. Hollingsworth, MD, a general and endovascular surgeon who has practiced in Europe and the United States, says it’s unlikely you’ll get stopped at customs or border control because you’re carrying more than a month’s supply of medicine. However, having an official prescription on hand when traveling with prescription medication is never a bad idea.

“In general, countries honor the rights of travelers to transport their prescribed medications with them,” Dr. Hollingsworth explains. As long as you have supporting documentation about your medical condition (ID cards or a letter from a physician), you are unlikely to have a problem.

Dr. Brendan Anzalone, a doctor of osteopathic medicine and the president and chief medical officer at AeroMD Air Ambulance , suggests going digital with these forms, as they can get lost or creased throughout your travels. This will ensure you won’t have to go digging if you’re questioned.

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Keep Medicines in Their Original Bottles

Again, while it’s unlikely you will face any sort of issue when you’re flying with medication, Dr. Anzalone still recommends keeping your pills in the original bottle—complete with the sticker on the front with your name and doctor’s name—as an extra safety precaution. “Carrying your medication in [its] original prescription bottle with a label on it from the pharmacy is helpful if there are any questions in the security line,” he explains.

If you don’t have room in your luggage for the full-size bottles and must downsize, you can pack a small day-of-the-week pill organizer rather than several bulky bottles. Ensure you have documentation from your physician to avoid any potential issues. Paul Tanenbaum, R.Ph., a retired pharmacist, offers this tip if your original prescription bottle is too large: “Make friends with your pharmacist and see if he or she could make you a smaller travel-size bottle for you to fill up.”

Learn the Laws Around Traveling Internationally with Medications

The recommendations for domestic trips also apply to traveling abroad with medication. When flying internationally with prescription medications, the U.S. Department of State  recommends storing medications in their original labeled containers and bringing a copy of a doctor’s letter to show customs officers and other officials if necessary. The prescription should note the brand and generic name of the drug.

If you’re taking an unusual drug or one that contains narcotics such as sedatives, carry a note from your doctor explaining what the medication is and why you need it.

Note that some over-the-counter drugs legal in the U.S. may be illegal elsewhere. For example, painkillers containing codeine are prohibited in the United Arab Emirates. Always double-check before you fly.

Exercise Caution with Herbal Medicines

Flying with herbal medicines or supplements to international destinations can be tricky since each country has its own laws about what’s allowed in. To find out what may be restricted in the countries you’ll be visiting or transiting through, refer to the  embassy website  or contact local consulates.

Make sure herbal remedies and Ayurvedic medicines are in clearly labeled, well-sealed containers, preferably in original bottles. Although the TSA doesn’t require it, it may be helpful to bring a doctor’s note explaining your remedies’ intended use. Keep up to date with any changes in TSA rules by downloading its free MyTSA app ( iOS | Android ).

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Always Pack Medicine in Your Carry-On

Now that you have the prescriptions you need and the note from your doc to prove your case, it’s time to pack. Depending on how much medicine you need each day, you may be tempted to shove your pill pack into your checked bag, but Dr. Anzalone warns against it: “It is best to keep medications in your carry-on baggage. If your checked baggage gets lost, you will still have your prescription medications with you. Remember some aircraft cargo holds are not temperature controlled, which may affect temperature-sensitive medications.”

If you’re worried about bringing medication that must be refrigerated (like insulin, for example) on a plane, Dr. Hollingsworth offers the TSA regulations on cool packs that are allowed through the gates. “Domestically, gel-cooling packs are allowed if frozen at time of presentation to security,” he notes.

Liquid medications (prescription or over-the-counter, like saline solution or eye drops) aren’t subject to the TSA’s three-ounce limits. However, you are required to declare anything over that amount to security officers and present it for inspection.

You may also travel with accompanying items, such as IV bags, pumps, and syringes, as long as they’re declared before you begin the screening process. All of these items will be X-rayed unless you request a manual inspection.

Bring Extra Medication

Dr. Hollingsworth’s rule of thumb is to bring twice the amount of medicine you need and to separate the bottles between your carry-on and your personal item. Why? Two words: flight troubles. “Changes or delays can have a butterfly effect that can have repercussions for the rest of your trip. Plan for the unexpected and pack extra medication you might need for an unplanned longer stay,” he says.

Exercise Caution When Flying with Narcotics

If you’re traveling with any type of prescribed narcotic used to relieve pain, such as Vicodin, Oxycontin, Percocet, or codeine, you might want to bring your prescription documentation, as well as a doctor’s note. Though this is not required by the TSA, it may prove helpful when getting through security. Since these types of drugs are widely abused, security screeners may be suspicious if they are unaccompanied by the proper paperwork. Having the original prescription will prove the pills’ necessity, and avoid any further delays or additional questioning.

The trouble of traveling with only a doctor’s note is that unless it was written in the previous month, it may lose validity. Prescriptions are clearly dated and include the signature of your doctor. Simply make a photocopy of each prescription before you have it filled. The photocopied version will be null and void, but this does not alter it as a valid document.

To take extra precaution, you may also want to travel with phone numbers for your pharmacy and prescribing doctor. This may seem like an unnecessary hassle, but it could prevent delays and problems at the airport.

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Be Strategic About Your Meds

If your carry-on is just too heavy to meet those puddle-jumper restrictions, Dr. Hollingsworth challenges you to be strategic. While you might want to take your mini-sized bottle of Advil, those sorts of medications are available everywhere.

“Give priority to any medications that are vital to your functioning or survival. Asthma inhalers, diabetic medications, anti-seizure medications, and blood pressure medications come to mind. Make sure to bring medications that have rebound or withdrawal symptoms if you run out,” he says. “A trip is not a good time to see how you function without your arthritis or anti-anxiety medications.”

Consider Travel Insurance

Many factors influence whether you should purchase travel insurance . How long will you be traveling? Where are you going? Will you be lounging by a beach for a week or undertaking adventure activities in a rainforest? Do you have ongoing medical conditions that might need care?

If you’ll need health insurance for your trip, Dr. Quigley recommends exploring your options before heading overseas to determine what policy and plan are best for you. You can also work with assistance companies—like International SOS—to help you if you’re struggling with a health situation overseas.

Make a Date with Your Doctors

If you’re leaving the U.S. for an extended time, in addition to getting foreign currency and shedding tears at your farewell party, you should schedule pre-departure appointments with your doctors. During these visits, get a full physical and begin a discussion about your wellness needs while traveling. Work with your physician to plan for the medications you’ll need. Medical professionals can help you secure more than a 30-day supply of any medicines along with the necessary paperwork. They can also offer advice about what you need to bring to keep your health top-notch.

Find the Loopholes for Refilling Prescriptions Overseas

Dr. Quigley explains that prescriptions cannot be filled abroad, nor can your primary care doctor call in a prescription for you. But there is a way around it: Know the generic forms and other names of the same medicine. Depending on the country, you may be able to get the medicine without a prescription.

As an example, Dr. Hollingsworth was able to walk into a pharmacy in Paris and receive antibiotics for a pal with a serious ear infection—no note required. Even so, packing a few “just in case” prescriptions before you leave will help ease your worries. Your primary care doctor or a travel clinic can help you navigate the options.

Tanenbaum recommends caution: “If you must obtain your meds from somewhere other than your U.S. pharmacy, beware that there is a major problem of counterfeit drugs out there.” He also notes that brand and generic drug names may differ from one country to another: “The same name may be for a totally different medication; if you have to get some while overseas, it may not be what you usually take so that it does not treat your medical condition, and may actually be dangerous for you to take.” Make sure you’re visiting a reputable pharmacist (ask for a recommendation from your hotel or the local tourist board) and that you double-check whether the drug you’re requesting actually treats your condition.

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Most Importantly, Plan Ahead

Plan ahead, especially if you are switching time zones and have to take medicine at a certain time of day. “Have a medical itinerary run parallel to your day-to-day travel itinerary. Plan out the nearest towns [to] where you’re going to be and identify the best providers for you based on your specific medical needs. Don’t let it be a fire drill when you get there,” recommends Dr. Hollingsworth. “If you know in 30 days [that] you need to have a prescription refilled, and you know where you will be within that time frame, then research which medical professional will be best for you. Do your homework.” It just may save your trip—or even your life.

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Want more expert tips and vacation inspiration? Subscribe to SmarterTravel on YouTube!

 Editor’s note: This story was originally published in 2017. It has been updated to reflect the most current information. Molly Feltner, Jessica Labrencis, Patricia Magaña, and Michele Sponagle contributed to this story. A previous version of this story had an incorrect spelling of Paul Tanenbaum’s name. It has been corrected. Some of the links featured in this story are affiliate links, and SmarterTravel may collect a commission (at no cost to you) if you shop through them. As an Amazon Associate, we earn from qualifying purchases.

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We hand-pick everything we recommend and select items through testing and reviews. Some products are sent to us free of charge with no incentive to offer a favorable review. We offer our unbiased opinions and do not accept compensation to review products. All items are in stock and prices are accurate at the time of publication. If you buy something through our links, we may earn a commission.

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Travel vaccinations

Measles cases are increasing worldwide.

Before travelling, check that you and your family have received the recommended measles vaccinations.

Do not travel if you have symptoms of measles or have been in contact with someone with measles.

If you develop symptoms of measles after your return to Canada, call a health care provider right away.

Global Measles Notice

When travelling outside Canada, you may be at risk for a number of vaccine preventable illnesses.

You should consult a health care provider or visit a travel health clinic preferably six weeks before you travel. This is an opportunity to:

• review your immunization history
• make sure your provincial/territorial vaccination schedule is up-to-date
• discuss any trip-related health concerns you may have
• assess your needs based on where you plan to travel and what you plan to do

You may need additional vaccinations depending on your age, planned travel activities and local conditions. Preventing disease through vaccination is a lifelong process.

Use the reference below to determine which vaccinations may be recommended or required for your destination.

Vaccination recommendations by destination

Yellow fever vaccination.

Some countries require proof that you have received a yellow fever vaccination before allowing you to enter the country. Consult an embassy or consulate of your destination country in Canada for up-to-date information on its entry and exit requirements before you travel abroad.

Other countries may require you to have been vaccinated for yellow fever if you have passed through an area where yellow fever may occur .

Proof of vaccination must be documented on an International Certificate of Vaccination or Prophylaxis . You must carry the original certificate with you.

In Canada, the vaccination is only given at designated yellow fever vaccination centres .

Immunization records

• Download the free CANImmunize app from the iOS App Store or Google Play, and manage your family’s vaccination records on the go.
• Carry copies of your family’s immunization records while you travel and leave the originals at home.
• Sickness or injury
• Travel Advice and Advisories
• If you get sick after travelling
• Receiving medical care in other countries
• Travel health kit
• Travel insurance
• Well on Your Way - A Canadian’s Guide to Healthy Travel Abroad
• Yellow Fever Vaccination Centres in Canada , Public Health Agency of Canada (PHAC)
• Recommended Immunization Schedules , PHAC

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Travelling with Medication to the U.S. - a Canadian Snowbird’s Guide

Most Canadian snowbirds need to take a supply of prescription medication with them when travelling to their winter home. If you fall into this category, it is imperative that you know the rules or risk having your medication confiscated at the border.

While this guide focuses on travel to the U.S., the same principle applies if you plan on visiting other counties as well, so no matter where you’re travelling, it’s critical that you check the rules and regulations in advance surrounding which drugs and medication you can – and more importantly cannot-- bring with you.

It’s equally important to understand your options for having medications couriered or mailed to you while you’re away, as well as travelling with medical equipment, batteries and medical devices.

The Government of Canada website also has some helpful tips for Canadians travelling with medication .

How much prescription medication can I bring to the U.S.?

This is a difficult question to answer. Strictly speaking, the U.S. Customs and Border Protection Agency (CBP) can enforce a three month limit for prescription medication when you enter the United States. However, they are sometimes more lenient if you have a letter from your doctor and explain that you need to have the additional supply -- but you cannot rely on this absolutely. Check the CBP’s website for more information about travelling to the U.S. with medication .

All medication you take with you must be in its original containers issued by your pharmacy with your name, your doctor’s name, dosage instructions and all other labels left intact. Do not merge any pills into different containers to save room.  

It is a good idea to have a doctor’s letter with you attesting to your medical condition(s) and the need for the medication(s) and /or a copy of the original prescriptions.

If any of your medications contain narcotics or controlled substances, you may be subject to a maximum 30 day supply. Some medications are legal in Canada but not in the U.S. such as those containing codeine. Be sure to check with the CBP and the FDA that you can bring the medication with you. You must declare these medications at customs.

The U.S. Food & Drug Administration (FDA) regulates all prescription drugs in the U.S. so it is important to check the FDA’s website for information on the importation of drugs or call them to ensure that you are only bringing approved drugs (and dosages) into the U.S.  

When flying, always pack all of your medications in your carry-on luggage, never in your checked baggage. They need to be accessible for customs and security screening. Liquid medications are exempt from regular liquid restrictions on aircraft, but you must show them to the security officer and they must be in their original labelled containers. Check with your airline about the number of syringes you are allowed to carry on board, as there may be restrictions. 

It is recommended to use the Family/Special Needs security line as those officers are trained to offer additional assistance and are knowledgeable about medications.

Can I have my prescription medications shipped to the U.S.?

This leaves the question of what to do if you are staying for longer than three months. It is possible to have prescription medications shipped or couriered to you but they may be opened and examined at the border and could be seized if they do not have the correct paperwork – or if they contain substances banned in the U.S. or are readily available in the U.S.  

In most cases, it is illegal to import drugs into the United States for personal use. That’s largely because drugs available in Canada haven’t been evaluated or approved by FDA for use or sale in the U.S.

The FDA’s Personal Importation Policy provides instructions for FDA personnel relating to the personal importation of drugs that may be illegal in the United States. The FDA considers the following when reviewing such an application:

• The drug is for a serious condition for which there is no effective treatment available in the U.S.
• There is no marketing or promotion of the drug to U.S. residents.
• The drug doesn’t represent an unreasonable health risk.
• You verify in writing that you’re importing the drug for your own personal use.
• You have a letter, written in English, from your doctor saying the drug is a continuation of treatment that began outside the United States or you provide the name and address of a U.S. licensed physician who will supervise your use of the foreign drug. The letter should accompany the package and be addressed to a Customs and Border Protection officer or broker.
• You’re not importing more than a three-month supply of the drug.

The best option is to send the package by a courier and clearly label it so the U.S. Customs broker will alert FDA inspectors about the special circumstances for sending the package. 

Check here for the top 5 FDA tips for travelling with medication .

Non-prescription medications can be problematic too

Over the counter medications can also create a problem at the border, both entering the U.S. and returning to Canada because each country has different restrictions on what medications and dosages can be sold over the counter as well as in health food stores.

Make sure your any over the counter medications are in their original packaging and be aware that it is possible some over the counter medications could be seized at the border. 

Finding a family doctor or clinic in the U.S.

To avoid all the trouble of travelling with medication, many snowbirds establish a relationship with a family doctor in the U.S. or with a clinic, so that they can get their prescriptions filled while they are away.  This is a simpler solution than importing your prescriptions once you are over your three month supply. 

However, if you’re considering going this route you’ll want to see if the drugs you require are available in the United States and compare the cost in the U.S. vs. Canada, as prescription drugs can often be far more expensive in the United States. In addition, if you have a drug plan you’ll need to find out if it will cover prescriptions filled outside Canada. 

Travelling with medical aids and medical equipment 

If you need to travel with personal medical equipment or devices such as Personal Oxygen Concentrators (POCs), wheelchairs, electric wheelchairs and scooters or CPAP and BiPAP machines for breathing disorders and sleep apnea that require batteries, you MUST check with your airline at least 48 hours ahead of time, or preferably at time of booking, to make sure you know what is accepted in the cabin and as checked baggage.

In particular, it’s important to understand the policies that apply to batteries for medical devices. Usually these must be carried on-board and normally do not count towards your carry-on bag allowance. 

Each airline’s policy may be different so make sure you notify the airline of any special medical equipment you must bring with you and any other special needs that you may have. Airlines must accommodate Special Needs passengers, but they do have some restrictions.

Bringing your prescription medication back to Canada

Of course, Canada has its own rules about carrying prescription medication across the border. If you have been prescribed a prescription drug while in the United States, Health Canada may approve your bringing up to a 90 day supply back to Canada. The drug must be for your personal use and be in its original packaging with the original labelling. If the drug contains narcotics, only a 30-day supply can be brought in.

If you are bringing back your ongoing prescription medications, you can only bring up to a 30 day supply.

If you take a cruise while in the U.S.

Many snowbirds will take advantage of the many cruises available from U.S. ports while they are there for the winter. If you take a cruise, beware of vendors selling prescription medications to cruise passengers in foreign cruise ports and destinations. There is no way to verify that these drugs are legitimate, so don’t be tempted by the cheap prices!

Disclaimer:  The material provided on the SnowbirdAdvisor.ca website is for informational purposes only and does NOT constitute legal, tax, accounting, financial, real estate, medical or other advice, and should not be relied on as such. If you require such advice, you should retain a qualified professional to advise you.

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Transforming Lives.

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The MediCube will keep your injectable medications at fridge temperature (2 to 8 °C) for up to 36 hours! With ample storage and insulated walls, you can store your medication and supplies while you are on long road trips or overseas flights. The comfortable carry handles and high quality zipper will last you for years and all your future travels. The reusable, replaceable gel packs ensure your medication is at exactly the temperature you need.

The iCool Prestige is our premiere medication cooler bag. With multiple pockets to hold syringes, test strips, even your cellphone (yes it stays that dry), the Prestige will keep your medications at fridge temperature between 2 and 8 °C for up to 24 hours. The high quality, durable gel packs have been designed to last for years and keep your temperature sensitive medication safe while you travel.

Compact and robust, the EasyBag Single will keep medications between 16 and 25 °C for 3 to 5 days! Reusable hundreds of times, the patented polymer bag simply needs to be soaked in cool water for under a minute and your medication will stay cool (and dry, no condensation!) for days. Whether you're at the beach, hiking, travelling, or everyday travel, you can be confident your medication is at it's most effective and safe.

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Tips For Keeping Your Emgality Cool And Effective While Traveling

• Last updated May 11, 2024
• Difficulty Advanced

• Category Travel

When it comes to traveling, maintaining the effectiveness and freshness of your medication is vital. If you're on Emgality, an injectable medication used to prevent migraines, you need to ensure that it stays cool and effective throughout your trips. Whether you're going on a short getaway or an extended journey, these tips will help you keep your Emgality cool and ready to provide relief whenever you need it.

What You'll Learn

Packing and storing emgality for travel, tips for keeping emgality at the right temperature on the go, cool storage options for traveling with emgality, precautions for traveling to ensure proper cooling of emgality.

If you're traveling and rely on Emgality for migraine relief, it's important to properly pack and store your medication to ensure its effectiveness. Here are some tips on how to pack and store Emgality for travel:

Keep Emgality refrigerated:

• Emgality needs to be stored in the refrigerator at a temperature between 36°F and 46°F (2°C and 8°C).
• Before you travel, check if the place you're staying at has a refrigerator or mini-fridge you can use to store your medication.
• If not, pack your Emgality in a small insulated cooler bag with ice packs to keep it cool during transportation.
• Try to keep the temperature of the cooler bag around 36°F to 46°F as much as possible.

Protect your Emgality from freezing:

• Emgality should not be frozen. Freezing may affect its potency and render it ineffective.
• Make sure to place your Emgality in a part of the cooler bag where it won't come in direct contact with ice packs.
• If using ice packs, wrap them in a cloth or towel before placing them in the cooler bag to provide some insulation and prevent direct contact with the medication.

Use a travel-sized cooler bag:

• Look for a small cooler bag that is specifically designed for travel and easily fits inside a suitcase or carry-on bag.
• Consider purchasing a cooler bag with insulation and temperature-controlling features to ensure the medication stays within the recommended temperature range.

Keep Emgality in its original packaging:

• Emgality comes in a pre-filled syringe or autoinjector pen. It is crucial to keep the medication in its original packaging during travel.
• The packaging provides protection from light and helps maintain the integrity of the medication.

Bring a thermometer:

• Having a portable thermometer can help you monitor the temperature inside your cooler bag.
• Regularly check the temperature to ensure it stays within the recommended range.
• If the temperature inside the cooler bag exceeds the recommended range, find a way to cool it down, such as replacing the ice packs or keeping it in a cooler environment.

Plan ahead:

• If you're traveling for an extended period, consider contacting the hotel or accommodation in advance to request access to a refrigerator.
• Alternatively, you can inquire about nearby pharmacies or medical facilities where you can store your medication if refrigeration is not available.

Remember to always follow the storage instructions provided by your healthcare provider and the manufacturer of Emgality. By properly packing and storing your Emgality while traveling, you can ensure its effectiveness and continue managing your migraines without interruption.

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Traveling can often present challenges when it comes to properly storing medications that need to be kept at a specific temperature. This is especially true for those who need to travel with Emgality, a medication used to prevent migraines. Emgality needs to be kept cool to maintain its effectiveness. Here are some tips to help you keep your Emgality at the right temperature while on the go:

• Use a portable cooler: Invest in a portable cooler that is designed to keep medications cool. Look for one that is small enough to fit inside your bag or carry-on luggage. Insulated lunch bags or cooler boxes can also work well.
• Freeze gel packs: Place gel packs or ice packs in the freezer overnight. These frozen packs can help maintain the temperature of your Emgality during travel. Wrap the frozen packs in a soft towel or cloth before placing them in your cooler to prevent direct contact with the medication.
• Keep the cooler closed: Once you have packed your Emgality and frozen gel packs in the cooler, try to keep it closed as much as possible. Opening the cooler frequently can let warm air in, which can affect the temperature inside.
• Use an insulated travel bag: Consider using an insulated travel bag specifically designed for medication storage. These bags are lined with thermal material, which can help maintain the temperature of your Emgality. Some bags even come with built-in thermometers, allowing you to monitor the temperature easily.
• Store the cooler in the shade: When traveling by car, make sure to keep the cooler out of direct sunlight. Heat from the sun can easily raise the temperature inside the cooler, potentially affecting the effectiveness of your medication. Place the cooler in the backseat or trunk where it will be shielded from direct sunlight.
• Plan for long flights or road trips: If you are traveling for an extended period, you may need to plan ahead. Ask your airline or transportation service if they can store your medication in a temperature-controlled area. If this is not possible, consider using a portable mini fridge or cooler that can be powered by a car adapter. These devices can help keep your Emgality at the right temperature during long trips.
• Pack extra supplies: It is always a good idea to have extra doses of Emgality with you when traveling. In case of delays or unforeseen circumstances, having extra medication can provide peace of mind. Keep the extra doses in a separate insulated container to ensure they remain at the correct temperature.

Remember, it is essential to follow the storage instructions provided by your healthcare provider or on the medication label. It is also a good idea to consult your healthcare provider for any additional tips or specific instructions for storing Emgality while traveling. By taking these precautions, you can ensure the effectiveness of your medication and have peace of mind while on the go.

Traveling to Canada with a US Student Visa: What You Need to Know

If you suffer from migraines and are being treated with Emgality, you know how important it is to keep your medication cool, especially when you are traveling. Emgality is a medication that needs to be stored in the refrigerator, and maintaining the right temperature is crucial to its effectiveness. Fortunately, there are several cool storage options available that will help you keep your Emgality cool and safe during your journeys.

• Insulated Travel Bag: Investing in an insulated travel bag is a smart choice for keeping your Emgality cool during travel. These bags are designed to maintain a specific temperature for an extended period. Look for a bag that is made from high-quality materials, such as insulated nylon or neoprene, which provide excellent insulation. Some insulated bags also come with gel packs or built-in cooling systems to further regulate the temperature. Make sure to choose a bag that is the right size to hold your Emgality pen or syringe and any other medications you may need to carry.
• Cooler Packs: Reusable cooler packs are a convenient option for keeping your Emgality cool while you travel. These packs can be placed in an insulated bag or cooler to maintain a low temperature. Before leaving for your trip, place the cooler pack in the freezer overnight. Once frozen, it can be used to keep your Emgality cool for several hours during travel. Remember to wrap your Emgality pen or syringe in a cloth or paper towel before placing it next to the cooler pack to avoid direct contact and potential freezing.
• Insulated Water Bottle: An insulated water bottle can serve a dual purpose when it comes to keeping your Emgality cool during travel. Fill the bottle with ice cubes or cold water and place your Emgality pen or syringe in a small plastic bag. Immerse the bag in the cold water inside the insulated bottle. The insulation will help maintain a cool temperature, and the cold water will keep your medication at the desired level.
• Portable Mini-Fridge: If you frequently travel and need to keep your Emgality at a consistently cool temperature, investing in a portable mini-fridge may be a practical solution. These mini-fridges are designed specifically for medications that require refrigeration. They are compact, lightweight, and come with both cooling and warming functions. Most portable mini-fridges can be plugged into your car's cigarette lighter or a standard wall outlet, making them ideal for road trips or hotel stays.

Remember, it's essential to check the manufacturer's guidelines for storing Emgality and follow their recommendations regarding temperature and storage. If you are unsure about traveling with your Emgality or have specific concerns, consult your healthcare provider or pharmacist for personalized advice.

When it comes to traveling with Emgality, ensuring the medication remains cool is crucial for its efficacy. By using insulated travel bags, reusable cooler packs, insulated water bottles, or investing in a portable mini-fridge, you can have peace of mind knowing your Emgality will stay cool and effective throughout your journey. Don't let migraines hold you back from enjoying life – take the necessary precautions to keep your Emgality cool while you travel!

Does Travel from the U.S. to Spain Require a Visa?

When traveling, it is important to take proper precautions to ensure that your Emgality medication is stored and kept cool. This is crucial because Emgality needs to be kept at a specific temperature to remain effective. Here are some simple steps you can take to ensure the proper cooling of Emgality while traveling:

• Use a portable cooler: Investing in a portable cooler is a great way to keep your Emgality medication cool when traveling. Look for a cooler that is small enough to fit in your bag or suitcase, but large enough to accommodate your medication and ice packs.
• Freeze gel ice packs: Before you start your journey, freeze gel ice packs or ice cubes and place them in the cooler alongside your Emgality medication. These frozen packs will help maintain a consistently cool temperature for your medication.
• Use insulated packaging: Consider packing your Emgality medication in an insulated box or bag. This will provide an additional layer of protection and help to regulate the temperature more effectively.
• Avoid direct sunlight and heat exposure: While traveling, do your best to keep your Emgality medication away from direct sunlight and sources of heat. Keep it in the shade or store it in a cool place, such as the air-conditioned interior of your car or the hotel refrigerator.
• Check the temperature regularly: It is important to regularly check the temperature inside the cooler or packaging to ensure that it is maintaining the recommended range for Emgality storage. Use a portable thermometer to monitor the temperature and make adjustments if necessary.
• Plan for contingencies: In case of unexpected delays or longer travel times, consider carrying an extra set of Emgality medication or contacting your healthcare provider to ensure that you have a backup plan in case your stored medication loses its effectiveness.
• Follow the manufacturer's instructions: Always refer to the manufacturer's instructions for storing Emgality medication. These guidelines will provide specific temperature ranges and storage recommendations that you should follow to ensure the medication remains effective.
• Keep prescriptions and documents handy: It is important to carry your Emgality prescription, along with any necessary documents, when traveling. This will help you in case of any emergency or if you need to get replacement medication on the road.

By following these precautions, you can ensure that your Emgality medication remains properly cooled and effective while traveling. Remember to plan ahead, take necessary steps, and be mindful of your medication's temperature to ensure a worry-free journey. Safe travels!

Traveling Outside the US with an H1B Visa: What You Need to Know

Frequently asked questions.

To keep your Emgality cool when traveling, you can use insulated travel bags or coolers with ice packs or gel packs. These bags are specifically designed to keep medications at proper temperatures.

Yes, using a portable mini fridge is a great option to keep your Emgality cool while traveling. Make sure to set the fridge at the recommended temperature for storing the medication.

When traveling with Emgality, it is important to keep it at the recommended temperature range (2°C to 8°C or 36°F to 46°F). Avoid direct exposure to heat, sunlight, and extreme temperatures. Always check the manufacturer's instructions for specific storage guidelines and consult your healthcare provider for further advice.

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• Melissa Carey Author Reviewer Traveller

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Watch CBS News

3 surfers from Australia and the U.S. were killed in Mexico's Baja California. Here's what we know.

Updated on: May 7, 2024 / 4:08 PM EDT / CBS/AP

Two Australians and an American were doing what they loved on the stunning, largely isolated stretch of Baja California's Pacific coast. Their last images on social media showed them sitting and gazing at the waves.

What happened to end their lives may have been as random as a passing pickup truck full of people with ill intent. The  surfers were shot in the head , their bodies dumped in a covered well miles away. Here's what we know:

Who were the victims?

Brothers Jake and Callum Robinson from Australia and American Jack Carter Rhoad had apparently stopped to surf the breaks between Punta San José, about 50 miles south of Ensenada, and La Bocana, further north on the coast.

Callum Robinson's Instagram page showed several images from the trio's Mexico trip: enjoying beers with their feet up in a bar, lazing in a jacuzzi, eating roadside tacos, looking out at the surf.

Callum, who was six-foot-four, had played in the U.S. Premier Lacrosse League, which left a  message on its website  saying the lacrosse world was "heartbroken by the tragic loss" of the trio.

"We offer our hearts, support and prayers to the Robinson and Rhoad Families, as well as all who loved Callum, Jake and Jack," it said.

On social media, his devastated girlfriend shared a black and white photo of the couple kissing, with the message: "You are one of one. I will love you forever."

In another photo she shared, in which the two can be seen embracing,  she wrote: "My heart is shattered into a million pieces. I don't have the words right now."

Jake Robinson was a doctor in Perth, according to Australian media.

Rhoad was engaged and set to marry Natalie Weirtz on Aug. 17 in Columbus, Ohio, according to a  Zola  online wedding registry. A GoFundMe which was launched to "rally support for Natalie" had raised over $57,000 as of Tuesday morning.

"In the wake of the heartbreaking loss of Carter Rhoad, Callum Robinson, and Jake Robinson, our hearts ache with grief for their families, friends, and community," reads a separate GoFundMe set up for Rhoad's family.

What happened to them?

The three friends were attacked there on April 28 or 29.

As soon as police arrived at their last known camp site, it was clear that something had gone violently wrong.

There were bloodstains and marks "as if heavy objects had been dragged," leading to suspicions of an attack, the Baja California state prosecutor's office said in an attempt to reconstruct the scene.

Chief state prosecutor María Elena Andrade Ramírez described what likely would have been moments of terror that ended the trip for the three men.

She theorized the killers drove by and saw the foreigners' pickup truck and tents and wanted to steal the truck's tires and other parts. But "when (the foreigners) came up and caught them, surely, they resisted."

She said that's when the killers would have shot the men. She said they were likely not attacked because they were tourists. "The evidence suggests they (the killers) did not know where they were from."

Andrade Ramírez said the reconstruction of events was based on the forensic examiner's reports, noting all three had bullet wounds to the head.

There was a hurried attempt to destroy evidence. The foreigners' tents were apparently burned. The pickup truck was driven miles away and burned. The assailants' truck was later found with a gun inside.

Then, at "a site that is extremely hard to get to," the bodies were dumped into a well about 4 miles (6 kilometers) away. Investigators were surprised when, underneath the bodies of the three foreigners, a fourth body was found that had been there much longer.

"They had to have previous knowledge of it," Andrade Ramírez said of the attackers, acknowledging the possibility they were behind the previous killing.

The well had been covered with boards. "It was literally almost impossible to find it," Andrade Ramírez said. It took two hours to winch the bodies out.

Who are the suspects?

Prosecutors have said they were questioning three people in the killings. Two were caught with methamphetamines. One of them, a woman, had one of the victims' cellphones when she was caught. Prosecutors said the two were being held pending drug charges but continue to be suspects in the killings.

A third man was arrested on charges of a crime equivalent to kidnapping, but that was before the bodies were found. It was unclear if he might face more charges.

The third man was believed to have directly participated in the killings. In keeping with Mexican law, prosecutors identified him by his first name, Jesús Gerardo, alias "el Kekas," a slang word that means quesadillas, or cheese tortillas.

Andrade Ramírez said he had a criminal record that included drug dealing, vehicle theft and domestic violence, adding, "We are certain that more people were involved."

She emphasized that she could not discuss anything related to the suspects, or their possible statements, because that was not allowed under Mexican law and might prejudice the case against them.

Andrade Ramírez noted that the victims' families said the brothers and Rhoad had come many times to the seaside spot and never had any problem. This time, however, "there was no way to ask for help when the attackers showed up."

What's next?

In a statement to CBS News, the FBI said it "continues to work with our international law enforcement partners in resolving this ongoing situation" and has been in contact with the family of the American victim.

"While we cannot comment on specifics to preserve the sanctity of the investigative and legal processes, along with protecting the privacy of those impacted, we can assure you that we are assessing every tip. If credible, we will pursue those leads with rigor," the FBI said.

Australian Prime Minister Anthony Albanese said on Tuesday he had requested an opportunity to speak to the brothers' parents Deborah and Martin Robinson.

"This is a terrible tragedy and my heart goes out to them. To identify these wonderful young men and they have been travelling in Mexico. We've been dealing with them through the Department of Foreign Affairs and Trade. I've indicated that I wish to speak to them at an appropriate time of their choosing," Albanese told reporters in the Queensland state town of Rockhampton.

AFP contributed to this report.

More from CBS News

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More than a dozen addictions doctors have written to the federal government, calling on the Liberals to ensure that safe-supply drugs are provided in a supervised fashion or not at all.

Addictions doctors urge feds to supervise hydromorphone or stop handing out free drugs Back to video

In recent months, debate has exploded over Canada’s use of pharmaceutical-grade hydromorphone as an alternative for street drugs such as heroin or fentanyl, with the hope of reducing opioid overdose deaths. In 2020, the federal government funded 10 pilot projects that distributed hydropmorphone to opioid addicts in British Columbia, Ontario and New Brunswick.

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“We are regularly seeing and hearing in our practices that diverted hydromorphone is causing harm to both adults and children,” the letter states. “We call on the government to ensure that all hydromorphone prescribed to people with opioid addiction is provided in a supervised fashion or that funding be ceased for the current harmful practice.”

Research on safer-supply programs, such as a June 2023 report in the Harm Reduction Journal , has concluded that enrolment in safer-supply programs leads to “fewer overdoses and overdose-related deaths, reduced drug-related harms, and improved health and social outcomes.”

But critics have said that these programs have created a number of other problems. The authors of the open letter, addressed to Ya’ara Saks, the minister of addictions and mental health, argue the research on safer supply is “methodologically weak” — which the researchers dispute — and that the program should be reformed, or cancelled altogether. Saks’s office did not respond to a request for comment.

In the letter, the 17 signatories refer to the program as “Unsupervised Free Government Funded Hydromorphone,” and argue that it is “causing further harm to our communities by increasing the total amount of opioids on the streets and providing essentially unlimited amounts of opioids to vulnerable people with addiction.”

“As a result of this practice, we are witnessing new patients suffering from opioid addiction, and additional unnecessary overdoses and death,” they write.

I'm not against them trying to help addicts, because that's what my job is. But this way, it is reckless

Dr. Rob Cooper, the author of the letter, said that he had a patient who was receiving safe supply treatment. “She’s now dead. She was selling the hydromorphone she was getting and she was buying fentanyl,” Cooper said. “The problem here is there’s no safety measures protecting that person or the public.”

Dr. Paxton Bach, the co-medical director at B.C. Centre on Substance Use and an addiction medicine physician at St Paul’s Hospital in Vancouver, said that what’s killing people in Canada is not increasing rates of addiction — it’s the drug supply.

“What is killing people is an increasingly toxic and unpredictable drug supply…. The idea is giving people an alternative to that that is predictable,” said Bach, who did not sign the letter.

But he said that the concerns elucidated in the letter are genuine ones.

“It’s not as if our field is in disarray in disagreement around sort of the more conventional treatment of addictions. This is a very specific item which has a lot of controversy associated with it,” Bach said.

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Dr. Clement Sun, the founder of the ACT Addictions Clinic chain in Ontario and a signatory of the letter, told National Post in an interview that it’s “almost like we’re getting back to the days … that the source of the drug is not from the illegal dealer (but) is from these safe clinics,” similar to how over-prescribed OxyContin fuelled the opioid crisis.

“I’m not against them trying to help addicts, because that’s what my job is. But this way, it is reckless,” Sun said.

The authors argue that drug users receive their safer supply drugs, then turn around on the streets and sell them. The money from so-called “diversion,” they argue, is “commonly used to purchase more potent opioids such as fentanyl,” since that remains the drug of choice.

“There is widespread evidence that this is occurring,” they write. They further argue that diverted hydromorphone is “creating more children with addiction in our Junior High and High Schools,” and that addictions doctors are seeing evidence of diversion and childhood addiction in their practices.

But Gillian Kolla, a postdoctoral researcher at the Canadian Institute for Substance Use Research at the University of Victoria wrote in an email that the open letter “does not cite any evidence at all in support of its claims.” Earlier this year, Lisa Lapointe, British Columbia’s chief coroner, called claims about diversion an urban myth when giving the keynote address at the B.C. Centre of Substance Use conference.

“It is not true,” said Lapointe. “We are monitoring obviously very, very closely the results of those who die of the toxic drug supply. Youth are not dying from diverted supply.”

Jennifer Charlesworth, B.C.’s representative for children and youth, also said there is “ no indication from our data that diverted safe supply is causing overdoses for children and youth.”

Data from British Columbia shows that hydromorphone was present in just five per cent of the province’s opioid deaths, compared to fentanyl, which was present in 88 per cent of deaths. But Sun said he believes these deaths might not be showing up yet.

“They’re not seeing it, because they’re selling it to the kids and they haven’t overdosed yet,” said Sun. “We’re not talking about people dying. We’re talking about the fact that you’re spreading a medication that’s addictive and being the supplier to the dealers, to the people who are selling it.”

Dr. Bonnie Henry, B.C.’s chief medical officer of health, also said there was no evidence in the province that diverted opioids were leading to new diagnoses of opioid use disorder in children.

“A lack of evidence doesn’t mean it’s not happening,” countered Cooper. “There were certainly less overdose deaths with OxyContin and oxycodone than there are with fentanyl. But it doesn’t mean it didn’t wreak havoc on people’s lives and cause homelessness and overdoses and some deaths.”

The data that we do have on safe supply, Bach said, is fairly limited. “So what ends up happening is this space is being filled with personal observations and anecdotes,” he said.

We are regularly seeing and hearing in our practices that diverted hydromorphone is causing harm to both adults and children

Some evidence, though limited, suggests that the programs can be of benefit in terms of quality life and overdose prevention, at least for some cohort of the drug-using population. “There is no evidence of any increase in overdose rates attributable to hydromorphone itself. And there is no evidence of any increase in diagnosis of opioid use disorder related to the rolling out of these programs,” Bach said. “As it stands … there is no empirical evidence that supports some of the concerns articulated in this letter.”

The letter says there are a number of risks of safer supply, including “Hepatitis C, HIV, cellulitis, bacterial endocarditis, respiratory suppression, overdose, and death” when hydromorphone is injected. A 2015 article in the New England Journal of Medicine, although it’s not dealing explicitly with safe-supply drugs, suggests that increased drug availability of opioids does not on its own reduce the spread of infectious disease, and that in order to reduce those risks, needle-exchange programs are needed so that users aren’t sharing drug paraphernalia. More recent research, published in the Canadian Medical Association Journal, found that there was no  increase in hospital visits for infections among those on safer-supply drugs.

The open letter also says safer supply can keep people addicted, and “delay people from entering other treatment modalities which have been proven to be effective” and that diversion “increases access to street fentanyl for people with addiction and also increases the availability of street hydromorphone causing more people to become addicted to opioids.”

Bach said that many people who are prescribed hydromorphone are given it alongside the gold-standard treatments, such as methodone and other treatments. Unpublished data from British Columbia suggests that those who get both hydromorphone and slow-acting opioids, are better able to stick with their treatment, he said, especially if they’re in the early days of treatment and still stabilizing.

Both Cooper and Sun suggested that those who want pharmaceutical grade opioids could be made to take them under supervision at a 24-hour pharmacy, so that they’re unable to use the pills in a manner other than prescribed or sell them or give them to friends. And Bach agreed that there are ways that such prescribing could be improved, but that there isn’t going to be a solid, countrywide reform that addresses all concerns. What might work in a large city such as Vancouver is unlikely to work in a rural area.

Such reforms, he said, could include considering prescribing other drugs — say, fentanyl — since hydromorphone isn’t a great substitute for fentanyl. “And so, one of the potential contributors to diversion is providing people with a medication that they don’t really want in the first place,” Bach said.

“I don’t think there is going to be any one solution that is universally appropriate,” he said. “But there is lots of opportunity to be thoughtful about this.”

National Post, with additional reporting by the Vancouver Sun.

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