Which travel medications are worth it + the true cost of Dukoral

Have you ever gone to the pharmacy before your vacation and stared helplessly at the over-the-counter travel medications? I know I have. Should I go for name brand allergy medication or the generic? Does Dukoral, the vaccine for traveller’s diarrhea really prevent you from getting the runs on your trip? Is the cost of Dukoral worth it?

I contacted Amani Chehade, a pharmacist and associate owner at Shoppers Drug Mart in Aspen Landing, Calgary to get the scoop on what’s essential before your next trip. 

What’s the best medication to take for traveller’s diarrhea?

To prevent traveller’s diarrhea, you want to take good food and water precautions. When eating, follow the guidelines of peel it, cook it, boil it, but that doesn’t always work.

Dukoral is known as the vaccine to prevent traveller’s diarrhea. It’s an oral vaccine that works against Cholera and the e. Coli virus. It can be taken by anyone over 3-years-old, and is smart to take if you have low immunity or a chronic condition. It’s best taken at least 2 weeks before your departure.

Does Dukoral prevent you from getting diarrhea?

The e. Coli bacteria accounts for 50% of all traveller’s diarrhea. The main study showed the Dukoral vaccine to be around 60% effective.

What’s the cost of Dukoral?

In most Canadian provinces, you don’t need a prescription to purchase Dukoral from a pharmacy (except in Quebec). Because of this, you’re going to be paying for it over the counter, which makes it more expensive than if your health insurance provider covers it. Still, the cost of Dukoral is sometimes be covered by group health insurance plans as other travel medications are.

Dukoral isn’t crazy expensive, but every province and every drug store is going to price differently. Think of how much you paid for your vacation. Imagine you were out of commission for two days during your trip (perhaps stuck on the toilet!). How much would you pay to not be in that situation? To me, that’s the true cost of travel meds like Dukoral.

How to treat traveller’s diarrhea

Try as you might, you still may be find yourself coming down with traveller’s diarrhea. If that’s the case, here’s the best treatment options:

1. Oral rehydrating solutions have the right mix of salt, sugar and potassium to replace lost fluids. Gastrolyte  is a popular brand for adults, while Pedialyte is recommended for children.
2. Antibiotics such as Azithromycine, Ciprofloxacin and Rifaximin can be used to treat diarrhea.
3. Loperamide which is Imodium, stops diarrhea. It can be purchased over the counter and used on those 3-years and older.

What drug stores can prescribe antibiotics? 

Many pharmacists in Canada now have prescribing authority. Just tell them where you’re going and they can prescribe certain antibiotics and vaccines (like Dukoral for traveller’s diarrhea) based on your destination.

How long can you use travel medications past their expiry date?

Some products can be used up to 3 months after their expiry date, but it depends on the product. After the expiry date, the medicine loses its effectiveness and it may be no better than a placebo. (Jody rushes to her first-aid kit and throws out some very old Imodium and Children’s Tylenol with a 2008 expiry!)

What are the best travel medications for kids?

• Gravel Kids for tykes over three-years-old
• Oral rehydration packets or solution in case of vomiting or diarrhea
• Topical cortisone cream to treat bug bites
• Sunscreen
• Stool softener – Lax-A-Day is one brand that safely helps constipated kids
• Band-aids
• Fever and pain medication such as Children’s Advil or Tylenol
• Antihistamines
• Thermometer
• Saline nasal drops in case of congestion (Kids under 6-years can’t take decongestants.)

Pack their regular medication (for asthma, ADHD, etc…), and be sure to have both the brand and generic name, dosage and prescription from the doctor in your carry-on bag. (You can get a copy of the prescription from your pharmacist.) Best is to get a letter with all this information from your doctor, including the reason your child is taking the medication. Keep the medications in its original containers.

(Check out Jody’s top tips for avoiding jet lag and tummy troubles here.)

Can you use DEET on children?

DEET is something I feel comfortable putting on my own kids. The side effects are rare – mostly eye irritations. In over 30 years with a billion users, there’s only been about 30 cases of toxicity. Most of these used excessive amounts over a prolonged period of time.

There are DEET concentrations made especially for children. In Canada the concentration level is 10%, whereas in the U.S. it’s 30%. Canadians would have to apply the insect repellent more often as it only offers 2 to 4 hours protection, but you get up to 8 hours with the American kind.

A good alternative to DEET are bug sprays containing Icaridin (like Avon Skin So Soft). You can buy Icaridin products over the counter and they smell much nicer than DEET. After spraying anything on my or my kids skin, I make sure to hit the shower before bed. 

What should I look for in an organic sunscreen?

If going the organic route, best are products with zinc oxide and titanium dioxide. These provide physical barriers (as opposed to chemical barriers), but they also offer UVA and UVB protection. It should be noted the UVA protection in organic sunscreens isn’t as effective as what you’d find in a traditional one.

If buying chemical sunscreen, look for one with avobenzone and mexoryl as ingredients. These are safer ingredients compared to the other chemicals found in non-organic sunscreens. Some of the best sunscreens are made by LaRoche-Posay.

What’s the best treatment for sunburn?

If it’s a mild sunburn, place a cold towel over the spot for 15 minutes. Moisturize the area with a lotion that has aloe vera or soy in it. Don’t use Vaseline or thick ointments. They trap in the heat.

For pain, Ibuprofen (Advil) works as an anti-inflammatory. Seek medical attention for serious sunburns.

What’s the best way to treat bug bites?

If you’re travelling to an area where you know there are bugs (and you react to bites), take Claritin once daily as a preventative measure. After you’ve been bitten, use Benadryl to reduce itchiness. It’ll make you drowsy, but it works.

Put a cool compresses on the area and apply calamine lotion. You can also use hydrocortisone cream topically. If the bug bite becomes infected, check with a pharmacist or doctor to determine if you need an antibiotic cream or if Polysporin is enough.

How do you prep for your travels?

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