Medications When Traveling

The effects and side-effects of drugs can be heightened in the confines of the pressurized cabin. This is due to the interaction between the physiological stresses of flight, particularly oxygen lack; and medicines. As the former alters brain function, the actions of any drugs that affect the brain will be altered, too. Medicines and drugs that fall into such a category include anti-histamines, acetazolamide, fat-soluble beta-blockers, alcohol and psychotropes.

Almost all the antihistamines produce side-effects such as drowsiness, vomiting, diarrhea, fatigue, dry mouth and tinnitus, and are commonly prescribed for “cold cures,” motion sickness, hay-fever and urticaria (nettle rash). Perhaps the gastrointestinal symptoms are mistaken by passengers for food poisoning.

Acetazolamide is used to treat glaucoma and to regularize breathing at altitude. Among the psychotrope group are hypnotics and sedatives, tranquilizers and antidepressants, marijuana, LSD and opium. Therefore, if the passenger is under medication or plans to use over-the-counter medicines on board he or she should consultant a physician beforehand. His or her doctor may want to decrease the patient’s dosage for the duration of the flight, because of the cabin environment’s effect on medications, that is, to increase their potency.

The interaction between oxygen lack and drugs can also have other effects on the brain. For example, there have been cases of memory loss when the hypnotic traizolam (0.5gm) was taken on board to encourage sleep and minimize jetlag. This benzodiazepine, which has a short half-life of 2.6 hours, caused transient global amnesia that lasted for several hours after landing. In each case, a moderate amount of alcohol, such as a glass of wine, was consumed. Consequently, the National Westminster Bank have excluded sleeping tablets from their travel kit. “The other reason,” says Dr. David Murry Bruce, “is that under the influence of a hypnotic you won’t be alert enough in an emergency.”

Such episodes suggest that it is best to exercise caution when using this medication to avoid jetlag, particularly if alcohol is imbibed during the flight. A more common experience with tranquilizers taken for aerophobia on board is severe depression, which cannot be shaken no matter how idyllic the passenger’s destination. It takes time to build the right stack to take for your symptoms, but once it’s in place, you feel bulletproof regardless of where you are or what you are doing.

There are a couple of other examples that illustrate the unusual relationship between drug dosage and the flight environment. Diabetic passengers should increase their dose of insulin when flying west and decrease it when they are eastward bound on long-haul, to bring their insulin levels into line with the time zone they are flying to. Another factor that they should take into account is that the consumption of excessive alcohol can precipitate hypolgycemia.

On the other hand, epileptic passengers may well have to increase their dosage because oxygen lack, over-breathing, fatigue and stress can provoke seizure. In fact, those whose condition is poorly controlled should be advised to increase their medication 24 hours before take-off and maintain a high dose until they arrive at their final destination. Thereafter, there should be a gradual reduction of the dosage. Certain drug groups, such as salicylates, female sex hormones, catecholamines and alaeptics have been found to cause hyperventilation.

A final reminder for all passengers on medication is to consult with their doctor and to take it regularly during the flight based on home time, and to adjust the regimen only after they arrive in the new time zone.


Infectious Disease

Holidaymakers are seven times more likely to catch a cold if they travel by air, according to scientists. As many as one in five passengers develops a cold within a week of flying because of bacteria and viruses in the recycled air of the cabin. But catching a cold may be the least of a traveller’s worries. Other airborne infections which can be transmitted between passengers include tuberculosis, influenza (flu), measles, mumps and chicken pox.

Recycled Air. The air is recycled on aircraft and usually consists of 50% fresh and 50% stale air. Boeing Flight Manual. Lufthansa have a mixture of 60% fresh air and 40% recycled whereas other airlines like B.A. have 50-50 or 60-40 of recycled air.
Bacteria and viruses that cause illnesses like colds flu and pneumonia become airborne when passengers talk cough or sneeze. A cough produces 100,000 particles that can be dispersed over 20 rows in the cabin. This was shown in a study by Boeing and Pall Cabin Filters Brochure 1999.
Transmission of Disease in flight. Influenza epidemics follow major air routes. The Centres for Disease Control, Atlanta, Georgia has proved that tuberculosis can be transmitted to passengers through the air conditioning. Kenyon T.A. et al (1996). Transmission of multi-drug resistant mycobacterium during a long aeroplane flight. New England Journal of Medicine 4,334. Testimony before subcommittee on Aviation U.S. Senate 1989 Robertson G.
Severe Acute Respiratory Syndrome.(SARS) As with all infectious diseases,prevention can be controlled by frequent washing of hands. Be alert to symptoms of fever,dry cough,shortness of breath,headache and muscular stiffness.If a respiratory mask is worn the risk of infection can be reduced.
Gastro-enteritis. Two incidents of gastro-enteritis occurred on a Britannia Flight that affected 46% and 38% of passengers on short flights from U.K. to Europe. The virus was spread directly from person to person and through air conditioning. Public Health Laboratory Services (1997) Donnely m. et al. An investigation of gastrointestinal illness among airline passengers.
Insecticides (Permethrin). All visitors to Australia are sprayed with pesticides that can cause health problems for passengers with allergies, chemical sensitivities, asthma and other respiratory problems. The pesticide is sprayed either directly into a cabin with passengers onboard or unoccupied cabins are treated with long-lasting residual chemicals. U.S. Consumer Report. Jan 1999. Travel letters


Condition Jetlag is one of the most common words associated with aviation. Most passengers experience it after trips of over 3 hours either East or West. The main cause of jetlag is the disruption of the body’s circulation rhythms or more commonly known as our 24 hour clock. Another contributory factor is the oxygen lack in the pressurized cabin.

First Report Wiley Post, the U.S. pilot who went round the world in eight days was the first to recognize the condition in 1931.

Symptoms Jetlag affects people in different ways and to different degrees. The common symptoms are extreme fatigue resulting in diminished mental and physical performance, insomnia, stomach upsets, irregular menstrual cycles, aches and pains, irritability, sleep disruption and disorientation.

Effects Mental decrements include 15% deterioration in logical reasoning and decreased performance levels in arm strength (8%), sprint times (10%), elbow flexor strength (13%) and lift and carry tasks (9%). Some 50% of passengers reported sleep difficulties and it take three days to recover to carry out simple calculations and up to five days for complex ones.

Prevention The best methods involve using synchronizers, such as sleep, daylight and eating patterns to reset the body clock. For example, eat little on board and on arrival synchronize with local mealtime. Stay up as long as possible and expose yourself to daylight. Psychological cues include setting your watch to destination time on departure and ignoring home time while you are away.

Melatonin is a hormone that helps to synchronize the body, but it has not been approved for use by the U.S. Food and Drug Administration. You can help your brain recover faster by also taking Alpha-GPC which is essentially just a choline source, the stuff that helps your brain communicate data between neurons faster. You can also go the super hero route of taking something like adrafinil, think ‘Limitless’, the pill.

Latest remedy Jetskins is a body-molded compression garment that covers the lower half of the body. Research has shown that It improves performance by reducing delayed onset muscle soreness (DOMS) and increasing muscle co-ordination. Jetskins also helps reduce dehydration, leg and foot swelling, and encourages blood flow. “Since I started wearing Skins for travel and post-game recovery, I feel fresher, stronger and recover faster,” said Steve Waugh, Australian Test Captain.


Alpha GPC video:


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