Repeat Prescriptions
Under NHS legislation the NHS ceases to have responsibility for people when they leave the UK. However, if you are going to be travelling abroad and need medication for a stable pre-existing health condition, your GP may prescribe you with up to 3 months medication if they deem this medically appropriate.
If you are going to be abroad for longer than 3 months, you will need to make arrangements to obtain a supply of medication at your destination. You can do this by either registering with a doctor in the country you are visiting, or buying the medication from a pharmacist while you are away.
Travel immunisations
It is recommended that you find out if there are any vaccinations that are advised for the country that you are travelling to.
If you are unsure what is recommended for the country you’re travelling to, you can access Fit for Travel, a public access website with up to date information for the UK public.
https://www.fitfortravel.nhs.uk/home
Should it be recommended that you have medication such as anti-malarial medication you are advised to seek advice from a private travel clinic.
The Lambert Medical Centre offers vaccinations that are routinely available on the NHS but does not offer a specific “travel vaccination” service.
If you require any vaccinations relating to foreign travel please download and complete our travel vaccination form and bring into the surgery, alternatively you complete our online form. Our Nursing team will then check your medical records and the destinations you are travelling and advise if you need any vaccinations.
Please do not book an appointment without having the returned advise from the Nursing team. These vaccines have to be ordered as they are not a stock vaccine.
If you require vaccines, we advise that you book your appointment for at least 2 weeks before you travel to allow the vaccines to work.
Controlled drugs
There are a number of prescribed medications that are controlled drugs. These are medications that are subject to some legal restrictions. This may be because they have the potential to cause problems such as addiction and harm if not used properly. They are subject to extra safety measures to ensure they are prescribed, supplied, used and stored legally and safely.
Examples of these medications include diazepam, morphine, pregabalin, zopiclone. See below for a full list.
https://www.gov.uk/government/publications/controlled-drugs-list–2
When leaving the UK with medicine that contains a controlled drug you should have the prescription available to show that it is yours.
However, other countries have their own import laws for controlled drugs and it is important that you check the embassy website of the country that you’re travelling to. You could get a fine or go to prison if you travel with a medicine that is illegal in another country.
https://www.gov.uk/guidance/controlled-drugs-personal-licences
Medication to postpone periods
There are times when patients may wish to postpone menstruation and there are medications that can be used for this (such as norethisterone or medroxyprogesterone). These medications should be started several days – usually 3 days – before menstruation is due to start. Should patients enquire about this, the reception team will usually ask that an e-consultation form is submitted with the necessary information.
Please note that this will be managed as a routine request and cannot be dealt with on an urgent basis. We require that any request is submitted at least 72 hours before the medication is needed.
Melatonin for jet lag
The NICE guidance on Jet Lag does not recommend the use of melatonin to promote sleep in jet lag in primary care as there is limited and conflicting evidence of benefit. Medicines are not usually needed for jet lag, which usually improves within a few days as the body adjusts to the new time zone. We do not issue prescriptions for melatonin for jet lag at the Lambert Medical Centre.
More information can be found at: https://cks.nice.org.uk/topics/sleep-disorders-shift-work-jet-lag/management/jet-lag/
Fear of flying
Lambert Medical Centre has reviewed our benzodiazepine prescribing and based on current national guidelines will no longer prescribe benzodiazepines or sedatives to patients for fear of flying.
Some people experience a fear of flying and have taken sedative medication to help with the symptoms. Typically, this medication has been a benzodiazepine such as diazepam (‘valium’), temazepam etc. In recent years the use of this medication for all reasons has declined as the side effects and potential risks are widely accepted. These medications can cause drowsiness, impair judgment and increase reaction times, and this can be made worse when taken with alcohol. In the context of flying they may cause:
- These medications cause longer reaction times and slowed thinking. Reduced reaction times in an emergency could prevent individuals from following safety instructions, posing a risk to themselves and others on the flight. There is even a risk someone could be unrousable in the case of an emergency.
- These drugs are sedating and can make you fall asleep. However, it is an unnatural non-REM sleep with less movement compared to normal sleep. This can increase the risk of a blood clot in the leg or lungs (DVT or PE), a serious condition which can be fatal. The risk is even greater when the flight is longer than 4 hours.
- The cabin of commercial jets have reduced oxygen concentrations compared to ground level (14.3% compared to 20.9%). The sedative effect of these medications can affect a persons breathing which could be harmful for some patients.
- For most people these medications are sedating, but for some people it can cause increased agitation and aggression. They can also cause disinhibition and lead you to behave in a way that you wouldn’t normally. This could affect your safety, those around you and result in rouble with the law.
- According to the British National Formulary (BNF) that guides prescribing in the UK, diazepam is not allowed for the use of phobic states, and its use to treat short term ‘mild’ anxiety is inappropriate. Doctors would be taking a significant legal risk by prescribing against these guidelines.
- Diazepam is a class C/Schedule IV controlled drug in the UK. In some countries it is illegal to import these drugs, so a different strategy will need to be used for the return journey. There is also a risk the medication could be confiscated or you may find yourself in trouble with the police.
- Benzodiazepines can stop the normal adjustment reaction that would gradually lessen the anxiety over time, and therefore can perpetuate and increase anxiety in the long term.
We do understand that flying can be a cause of significant anxiety for some despite it being very safe. There are now a number of aviation industry recommended flight anxiety courses, in person or online. Treating the cause of the fear is much preferable to masking the symptoms with risky medication. There are some resources listed below. We hope that you understand our position on the use of these medications for fear of flying.
Easyjet. www.fearlessflyer.easyjet.com
British Airways. www.flyingwithconfidence.com
Virgin: www.lovefly.co.uk