By Warren Howard | December 23, 2025| 5 Comments

Carrying your meds on a trip isn’t just about tossing pills into a bag. One wrong move-like packing Xanax in a ziplock in your checked luggage-and you could face delays, confiscation, or worse. In 2024, over 12% of international travelers had medication seized at borders. That’s not a rare glitch. It’s a predictable outcome when people don’t know the rules.

Know What’s Allowed Before You Fly

Not all medications are treated the same, even within the U.S. The TSA lets you bring pills, capsules, and liquids for medical use without needing a prescription, but that doesn’t mean your destination agrees. Japan bans anything with pseudoephedrine-common in cold meds. Thailand requires written permission to bring alprazolam (Xanax). The UAE doesn’t allow opioids at all. And Adderall? Banned in 17 countries including France, Sweden, and Australia.

The CDC’s 2025 Yellow Book lists hydrocodone, oxycodone, diazepam, zolpidem, and amphetamines as high-risk meds for international travel. Twenty-eight percent of countries restrict at least one of these. Even if it’s legal at home, it might be illegal abroad. Don’t assume. Check the U.S. State Department’s country-specific guidelines or contact the embassy of your destination. The International Narcotics Control Board (INCB) says this is the only reliable way to avoid trouble.

Pack Smart: Containers, Labels, and Documentation

TSA officers see hundreds of bags a day. If your meds are in unlabeled bottles, they’ll take longer to inspect-and you might get flagged. Medications in original pharmacy containers with clear labels reduce inspection time by 63%, according to TSA’s 2025 data. That’s not a suggestion. It’s your best defense.

Bring a doctor’s letter. It doesn’t need to be fancy. Just a note on letterhead saying you have a medical condition, the name of the medication, dosage, and that it’s necessary for your health. The CDC says this is required for every international trip. For non-English-speaking countries, get it translated. Eighty-three percent of travelers who skipped this step ran into problems.

For liquids: You can bring more than 3.4 ounces (100ml) if it’s medically necessary. But you must declare it at the checkpoint. Don’t hide it. Say it out loud. TSA agents are trained to handle this. They’ll swab it, ask a few questions, and let you through. No drama. Just be upfront.

Storage: Heat, Cold, and Keeping It Safe

Insulin, biologics, and some antibiotics need to stay cool. The FDA says insulin must be kept between 36°F and 46°F (2°C-8°C). Left in a hot car or checked baggage in the cargo hold? It’s ruined. No second chances.

Use a pharmaceutical-grade cooling wallet. These aren’t fancy lunchboxes. They’re insulated pouches with phase-change material that maintain 2°C-8°C for up to 72 hours-even in 40°C heat. A 2025 Diabetes Travel Survey found 73% of users who relied on these had zero issues during tropical trips. Skip the regular ice packs-they melt, leak, and can trigger alarms.

For electronic devices like insulin pumps or nebulizers: Keep them in your carry-on. FAA rules (Advisory Circular 120-86B, updated Jan 2025) require lithium batteries in medical devices to stay with you. Power banks for these devices can’t exceed 100 watt-hours without airline approval. Most portable pumps use under 20 watt-hours, so you’re fine. But if you’re carrying a backup battery, make sure it’s labeled and in your pocket, not in your suitcase.

Cooling wallet with insulin pump in carry-on bag against tropical backdrop

Refills: What to Do When You’re Staying Longer

The FDA lets you bring a 90-day supply for personal use. That’s fine for a two-week vacation. But what if you’re staying three months? You can’t just walk into a pharmacy abroad and refill a U.S. prescription. Most countries don’t recognize foreign prescriptions.

Here’s the fix: Arrange mail delivery. The FDA allows foreign nationals to ship additional medication for extended stays, as long as you include:

  • A copy of your passport or visa
  • A doctor’s letter explaining the need
  • A copy of your original prescription in English

Some pharmacies in the U.S. offer international shipping for prescriptions. Others don’t. Call ahead. If you’re in Europe or Asia, ask your hotel concierge-they often know local clinics that can help. Don’t wait until you’re out of pills. Plan this before you leave.

Security Checkpoints: What to Expect

TSA has a program called Cares. It’s designed for travelers with medical needs. Request it at the checkpoint. You’ll get a sunflower lanyard. That tells agents you need extra time or assistance. In 2025, travelers using Cares saw security processing drop by 41%.

Here’s what to do at the screen:

  1. Take your meds out of your bag before going through the X-ray.
  2. Place them in a clear plastic bin-separate from other items.
  3. Tell the officer: “I have medication here.”
  4. Hand them your doctor’s letter if asked.

You don’t need to explain your condition. You don’t need to prove you’re sick. Just declare it. TSA officers have broad discretion to approve medically necessary items. Since the Cares program launched in 2023, confiscations dropped by 78%.

Globe showing restricted countries with labeled medication suitcase

International Differences: Know Your Destination

The world doesn’t follow U.S. rules. Here’s a quick snapshot of what’s banned or restricted:

Medications Restricted or Banned in Key Countries (2025)
Medication Restricted in Notes
Pseudoephedrine 22 countries Banned in Japan, Singapore, UAE, Australia
Alprazolam (Xanax) 18 countries Requires pre-approval in Thailand, Malaysia
Oxycodone/Hydrocodone 25 countries Illegal in UAE, Saudi Arabia, Singapore
Adderall/Vyvanse 17 countries Banned in France, Sweden, Japan, Australia
CBD (any THC) 29 countries Illegal in Dubai, Singapore, Russia-even if legal in U.S.

Even if you’re flying from London to Berlin, check local laws. Germany allows most U.S. prescriptions, but France doesn’t recognize prescriptions for stimulants. And don’t forget: some countries require you to declare meds upon arrival-even if you’re just transiting.

What to Do If You’re Denied Entry or Confiscated

It’s rare-but it happens. If your meds are taken:

  • Ask for a written receipt. It’s your legal right.
  • Contact the nearest U.S. embassy or consulate immediately.
  • Have your doctor’s contact info ready-they can fax a letter to local authorities.
  • If you’re hospitalized abroad, the embassy can help coordinate care and medication access.

Don’t try to bribe or argue. Stay calm. Document everything. The State Department handled over 43,000 medical cases involving U.S. citizens abroad in 2024. They’ve seen it all.

Pro Tips for Stress-Free Travel

  • Split your meds: Keep half in your carry-on, half in your checked bag. If one gets lost, you’re not out of pills.
  • Carry a printed copy of your prescription-even if you have a digital one. Power can die. Phones can break.
  • Use a pill organizer only for daily doses. Keep the rest in original bottles. TSA prefers real containers.
  • Bring 10% extra. Delays happen. Flights get canceled. Don’t risk running out.
  • Download the INCB Traveler’s Guide app. It’s free. Updated daily. Covers 193 countries.

Traveling with meds isn’t about fear. It’s about preparation. The system works if you play by the rules. 92% of travelers who followed the 2025 guidelines had zero issues. You can be one of them.

Can I bring my insulin pump on a plane?

Yes. Insulin pumps and other medical devices with lithium batteries must be carried in your hand luggage. The FAA requires this for safety. Never check them. You can bring extra batteries, but they must be in original packaging and under 100 watt-hours. Declare the device at security-you won’t be stopped if you’re clear and calm.

Do I need a prescription to bring pills into the U.S.?

No, if you’re bringing back a 90-day supply for personal use. The FDA allows this under its Personal Importation Policy. But if you’re shipping more than that, you need a doctor’s letter, your passport copy, and a copy of the prescription. Controlled substances like opioids require DEA coordination. Always keep original containers.

Is CBD oil allowed when flying internationally?

TSA allows CBD with less than 0.3% THC on U.S. domestic flights. But internationally? 29 countries ban it entirely-even if it’s legal in the U.S. Dubai, Singapore, Japan, and Russia have zero-tolerance policies. Don’t assume it’s safe. Check the INCB database before you go. One confiscated bottle can ruin your trip.

What if I need a refill while abroad?

You can’t refill a U.S. prescription overseas. Instead, arrange mail delivery before you leave. Send extra pills via a U.S. pharmacy that ships internationally. Include your passport copy, doctor’s letter, and English prescription. Some countries have local pharmacies that can fill foreign scripts, but they’ll require a local doctor’s note. Plan ahead-don’t wait until you’re out.

Should I use a pill organizer for travel?

Only for daily doses you plan to take on the go. Keep the rest in original pharmacy bottles with labels. TSA and border agents prefer real containers. Pill organizers can raise red flags because they look like they’re hiding something. Use them as a convenience, not your main storage.