Never Buy These Medicines When Traveling: A Simple Guide to Avoiding Poisoning Risks

Introduction

In 2022, more than 70 children in The Gambia died after taking cough syrup contaminated with diethylene glycol (DEG) and ethylene glycol (EG). Similar tragedies happened in Uzbekistan, Nigeria, and Panama over the last decades. This is not a rare story; it is a reminder that some medicines abroad are not safe, even when the box looks perfect and the pharmacy looks legit. See the WHO’s overview of the global problem in its open‑access article on substandard and falsified medicines (about 1 in 10 in low‑ and middle‑income countries) — we’ll refer to it again below for context: WHO analysis.

This guide explains in very clear language which medicines you should never buy abroad, how to spot fakes, what symptoms to watch for, and how to act fast if something feels wrong. We keep it practical, travel‑friendly, and focused on decisions you can make today.

The Hidden Danger: Contaminated and Counterfeit Medicines

Let’s keep the terms simple:

• Counterfeit (falsified) medicines: products that pretend to be real but are not. They may copy a brand name and box design but contain the wrong or toxic ingredients.
• Substandard medicines: made by licensed companies but fail quality standards because of poor production or storage.

Both can harm you through wrong doses, no real active ingredient, toxic contaminants (like DEG/EG), or bacteria. The WHO’s data shows why vigilance matters: WHO analysis.

These are well‑documented outbreaks where toxic solvents replaced safe ingredients in liquid medicines:

A concise news summary of how global authorities responded in 2023 is here: Reuters coverage.

Why Travelers Are Especially at Risk

• Urgency: You’re sick abroad and need relief fast — urgency pushes people toward the nearest seller, even if quality is unclear.
• Language barriers: Labels, warnings, and pharmacist advice may be hard to understand.
• Unfamiliar systems: Rules and oversight can vary widely; a place that looks like a pharmacy may not be licensed.
• Online traps: “Convenient” delivery or tourist‑area shops may offer suspiciously cheap products.

Bottom line: If you cannot fully trust the supply chain, the safest decision is not to buy.

Medicines You Should Never Buy Abroad

Below are the categories with the highest travel risk. If you need them, bring them from home instead.

a) Liquid medicines and syrups (highest risk)

Cough syrups, liquid acetaminophen/paracetamol, teething drops. These are the products most often implicated in DEG/EG poisonings. For kids, the risk is unacceptable. Do not buy liquid medicines abroad.

b) Antimalarial drugs

In some regions, a significant share of antimalarials may be fake or substandard. Treatment failure can be deadly and fuels resistance. Get antimalarials before travel from a trusted pharmacy at home.

c) Antibiotics

Commonly counterfeited. Wrong dose or no real ingredient means your infection can worsen — and resistance grows. Only use antibiotics prescribed by a doctor and dispensed by a licensed pharmacy.

d) Painkillers and opioids

Fake pain pills sold to tourists (e.g., in border or resort towns) have been found to contain fentanyl (often lethal in tiny doses). A clear consumer warning comes from U.S. authorities: see the FDA’s page on counterfeit medicine risks here: FDA guidance.

e) Erectile‑dysfunction pills

Among the most counterfeited drugs worldwide. Unknown ingredients and dosing can trigger serious heart issues. Avoid tourist‑area sales and online offers.

f) Cancer, HIV/TB, and heart medicines

These life‑critical drugs must be authentic and properly stored. Fake versions lead to rapid disease progression or dangerous crises. Never gamble on these abroad.

g) Vaccines and injectables outside clinical settings

Counterfeit vaccines and non‑sterile injectables can cause infections and provide no protection. Only receive shots in licensed clinics/hospitals.

How to Recognize a Problem (fast checks)

You can’t lab‑test a product on the road, but you can spot red flags:

• Packaging looks off: blurry print, thin cardboard, inconsistent fonts/colors.
• Label errors: spelling mistakes, missing batch/expiry, mismatched dates.
• Odd product: pill color/shape differs from what you use at home; tablets crumble or look sticky; liquids separate and don’t re‑suspend when shaken.
• Suspicious price or access: much cheaper than normal; offered without a prescription when it’s usually required.

For a concise, traveler‑focused checklist on avoiding fake medicines, use the CDC’s guide for travelers: CDC counterfeit‑medicine advice.

Symptoms of Medicine Poisoning (what to watch for)

DEG/EG poisoning (from contaminated liquids): symptoms can appear within 1–7 days.

• Kidney injury: little or no urine output; swelling; severe fatigue.
• GI symptoms: nausea, vomiting, abdominal pain.
• Metabolic signs: rapid breathing, confusion (due to acidosis).
• Neurologic signs (severe cases): weakness, loss of reflexes, visual problems, coma.
  
  

Other counterfeit/contaminated products:

• Treatment doesn’t work as expected; illness worsens.
• Unusual side effects or allergic reactions.
• Signs of overdose despite taking the “right” dose.

For clinicians and travelers who want the formal medical overview of toxic exposures on the road, see the CDC Yellow Book chapter on travel toxicology: CDC Yellow Book – toxic exposures.

Your Safe‑Buying Plan (when you must purchase abroad)

If you cannot avoid buying medicine while traveling, use this simple, strict plan:

Where to buy

• Prefer hospital or government‑run pharmacies; otherwise, large well‑known chains.
• Avoid tourist‑only shops, open markets, street sellers, and unverified delivery apps.
  
  

How to check

• Inspect box/blister: batch number, expiry date, manufacturer details.
• Compare pill size/shape/color to what you know (if you use the same brand at home).
• Ask the pharmacist to print a receipt with the pharmacy’s full details.
• If something feels wrong (price, look, story) — don’t buy.
  
  

Storage and handling

• Heat and moisture can ruin medicines. Keep them in a cool, dry place; avoid car glove boxes and sunny windows.
• Liquids are most fragile: don’t buy them abroad; if you must use a local liquid (e.g., no alternative), confirm it’s from a hospital pharmacy — but the safest option remains to avoid.

Emergency backup

• If you’re unsure what’s safe locally, contact your embassy/consulate for help finding reputable providers. Basic pre‑trip rules for traveling with your own prescriptions are summarized here: CDC travel‑with‑medicine tips.

Pack This Instead (preventive checklist)

Use this pre‑trip list to avoid risky last‑minute purchases:

• Your regular prescriptions for the full trip + extra 1–2 weeks for delays.
• Pain/fever tablets in solid form (from home, sealed, labeled).
• Antidiarrheals and oral rehydration salts in packets.
• Antihistamines for allergies.
• Printed medication list (generic names, doses) and doctor’s note for customs.
• Pill organizer and zip bags to keep tablets dry and separate.

For families: pack child‑safe solid formulations (e.g., dispersible tablets) prescribed at home, to avoid buying liquids abroad.

High‑Risk Regions (very short guide)

Risk exists everywhere, but vigilance should be highest in:

• Parts of West and Central Africa, South/Southeast Asia, and Latin America where oversight is variable and street sales are common.
• Border/tourist zones where fake painkillers and ED pills are marketed to travelers.
• Online marketplaces shipping across borders with unclear sourcing.
  
  

Reminder: in high‑income countries, the share of falsified products is much lower, but the risk rises again when you buy from unverified online sellers. For a global snapshot and definitions, revisit the WHO analysis.

What To Do if You Suspect a Problem (step‑by‑step)

1. Stop taking the medicine immediately.
2. Seek medical care now. Bring the package, receipt, and a list of every dose you took.
3. Save the remaining product for testing (do not discard).
4. Report the case to local health authorities and your embassy/consulate.
5. Serious exposure may require specific treatments (e.g., fomepizole and dialysis for DEG/EG). A quick primer on counterfeit risks and reporting routes for travelers is in the CDC’s guide: CDC counterfeit‑medicine advice.

Quick Reference: The “Never Buy Abroad” List

• Liquid medicines/syrups (especially for children)
• Antimalarials (get them at home)
• Antibiotics (only with prescription, licensed pharmacy)
• Opioid‑class painkillers and any “strong” pain pills from tourist areas
• ED pills from non‑licensed sources
• Cancer, HIV/TB, heart medicines outside trusted supply chains
• Vaccines/injectables outside clinical settings

Print or save this list in your phone’s notes.

Final Thoughts

Most travel days will be healthy and uneventful. But if you do get sick, the safest choice is usually the simplest: use the medicines you brought from home, and if you must buy abroad, do it only in licensed settings after basic checks.

Real tragedies — like the Gambia cough‑syrup disaster — show that one bad bottle can change everything. Stay cautious, plan ahead, and share this guide with your travel group.