Fear of Flying
We do not prescript sedatives for fear of flying. This policy decision has been made by the GP Partners and is adhered to by all prescribers working in the practice. The reasons for this can be found below:
- Diazepam is a sedative, which means it makes you sleepy and more relaxed. If there is an emergency during the flight it may impair your ability to concentrate, follow instructions and react to the situation. This could have serious safety consequences for you and those around you.
- Sedative drugs can make you fall asleep, however when you do sleep it is an unnatural non-REM sleep. This means you won’t move around as much as during natural sleep. This can cause you to be at increased risk of developing a blood clot (DVT) in the leg or even the lung. Blood clots are very dangerous and can even prove fatal. This risk is even greater if your flight is greater than four hours.
- Whilst most people find benzodiazepines like diazepam sedating, a small number have paradoxical agitation and in aggression. They can also cause disinhibition and lead you to behave in a way that you would not normally. This could impact on your safety as well as that of other passengers and could also get you into trouble with the law.
- According to the prescribing guidelines doctors follow (BNF) Benzodiazepines are contraindicated (not allowed) in phobia. Your doctor is taking a significant legal risk by prescribing against these guidelines. They are only licensed short term for a crisis in generalised anxiety. If this is the case, you should be getting proper care and support for your mental health and not going on a flight.
- Diazepam and similar drugs are illegal in a number of countries. They may be confiscated or you may find yourself in trouble with the police.
- Diazepam stays in your system for quite a while. If your job requires you to submit to random drug testing you may fail this having taken diazepam.
We appreciate that fear of flying is very real and very frightening. A much better approach is to tackle this properly with a Fear of Flying course run by the airlines and we have listed a number of these below.
A number of airlines run courses aimed at alleviating fear of flying. Some of these are listed here:
Postponement of Mensuration
Prescribing of medication in order to postpone menstruation for e.g. a holiday or event will not be provided on NHS prescriptions.
If a GP deems a prescription to be clinically appropriate it can be provided on a private prescription.
Some community pharmacies (via their online services) and some travel clinics offer this treatment.
Medication (e.g. melatonin) used for jet lag would be classified as a medicine used for travel and in anticipation of an ailment. GPs should therefore not provide a NHS prescription. Private prescriptions may be written for this purpose if deemed clinically appropriate by the GP.
Regular Medications for existing long term conditions
Can my GP prescribe extra medicines to cover my time away?
If you are travelling abroad for up to 3 months then your GP may supply you with a prescription to cover this period.
If you are going to be out of the country for longer than this your GP may supply you with sufficient medication to get you to your destination country. Once you reach your destination you will need to register for medical services there to make arrangements for ongoing supplies of your medicines.
Will I be allowed to take my medications into the country I am visiting?
Different countries have different rules and regulations for medicines – including those you can buy over the counter in the UK.
There may be restrictions on the types of medicines and/or the quantities that you are allowed to travel with. To make sure you don’t break any laws you should contact the Embassy for the country you are travelling to.
As a general rule you should always carry medicines in their original packaging, correctly labelled and with a copy of your repeat prescription.
Some countries may require that you carry a letter from your GP stating the reason you are taking your medicines, dosages etc. If so, you should speak to your GP surgery in good time to allow them to write the letter. There may be a charge for this.
Are there any special requirements for controlled drugs?
The rules for controlled drugs depend on the country you are travelling to and the airline you are flying with (if applicable). It is advisable to check directly with your destination Embassy and airline to check their exact requirements.
Anyone taking controlled drugs into/out of the UK also needs to conform to Home Office import/export regulations.
If you are travelling for less than 3 months you will not require a special license. However, the Home Office advises that you obtain a letter from your GP or drug worker, which should confirm name, travel itinerary, names of prescribed controlled drugs, dosages and total amounts of each to be carried.
If you are travelling for more than 3 months it is expected that you will register for medical services in your destination country to continue to obtain your medicines. To take more than 3 months’ worth of controlled drugs out of the UK you will need to obtain a Personal License from the Home Office. The application form can be found online and needs to be submitted with a letter from your GP/drug worker at least 10 days prior to travel.
Other countries may also have import regulations so it is important to check this when you contact the Embassy.
Will I be allowed to take needles/syringes in my hand luggage when I fly?
Yes. You will need to take the items in the original, correctly labelled, packaging along with a copy of your prescription. In addition they may require you to carry a letter from your GP. It’s a good idea to contact the airline you are flying with to check their exact requirements.
Will the 100ml liquid restrictions apply to medicines I need to carry in my hand luggage?
Essential medication required during air travel may be exempt from the maximum 100ml liquid restriction but this requires a letter and prior approval from the airport and airline. You should contact the airline in advance to make arrangements for this.
Just in case Medications
Will my GP prescribe me ‘just in case’ medicines such as antibiotics or oral rehydration sachets?
A GP will only prescribe for your current clinical needs. Therefore ‘just in case’ medicines are not available on the NHS.
If your GP feels they are appropriate they may offer to provide you with a private prescription.
It’s a good idea to prepare a first aid kit when travelling abroad and your community Pharmacist will be able to give you advice on products that can be purchased over the counter, such as oral rehydration sachets, anti-diarrhoea medicines, antiseptics etc.
Prevention of Deep Vein Thrombosis
If you think you may be at risk of developing deep vein thrombosis (DVT), seek advice from your GP. For more information please also visit: www.nhs.uk/deep-vein-thrombosis-dvt
Can I get compression stockings on the NHS?
Compression stockings are not available on the NHS for preventing travel related DVT. If, after discussion with a GP or Nurse you choose to do so, these can be purchased over the counter at a community pharmacy.
Travel Insurance & Health Insurance Cards
Comprehensive travel insurance is essential for all travellers and you should ensure that this provides adequate cover for your current health needs and any planned activities.
What is an GHIC card and how do I get one?
Please see NHS website for Details: Applying for healthcare cover abroad (GHIC and EHIC) – NHS (www.nhs.uk)
If you should require a private travel vaccine, (this includes Yellow Fever, Rabies, Japanese Encephalitis), then these are not available on the NHS. Please talk to your local pharmacist who may be able to help or you can google “private travel vaccines”.
Should you require further information about the countries you are travelling to, you will find this on www.fitfortravel.nhs.uk
Travelling in Europe
If you are travelling to Europe the EU has published useful information for travellers on the European website: europa.eu/european-union/travel-tourism
Can I go to my GP practice for travel vaccinations?
Yes, although not all vaccines are available on the NHS.
The first thing to do is to contact your GP practice so that a GP or nurse can check your notes to make sure you are up to date with routine vaccinations and advise of any requirements for the country you are travelling to.
Try to make sure you do this at least 8 weeks before you travel as some vaccines need to be given well in advance to ensure you are protected.
The following vaccines are funded by the NHS:
- Diphtheria, polio and tetanus (combined booster) Hepatitis A
- Cholera (depending on certain criteria that will be assessed by a healthcare professional at the clinic/GP surgery)
Will I have to pay for these travel vaccines?
The practice may give you an NHS prescription for these vaccines to be dispensed at a community pharmacy.
If you usually pay for your prescriptions, then the standard NHS prescription charge will apply.
What if I need other vaccines which aren’t available on the NHS?
If you need any other vaccinations you may still be able to get these done, privately, at your GP practice. If not, they will signpost you to a private travel clinic.
As these are not funded by the NHS there will be additional charges. These can include; a charge for writing a private prescription, the cost of the vaccine, administering the vaccine and, if applicable, any follow up blood tests and certification needed.
Visiting a Malaria Area?
You can find general advice and information from the following website: www.fitfortravel.nhs.uk/malaria
Will my GP be able to prescribe anti-malarial tablets for me?
Medicines for malaria prevention are not available on the NHS.
Some anti-malaria tablets (chloroquine and proguanil) can be purchased over the counter from a community pharmacy. If a prescription only medicine is required, a GP, certain pharmacies or a travel clinic will be able to provide you with a private prescription.