Travel medicine kit: what actually belongs in it

Before a long-haul trip, the medicine bag tends to fill up on the principle of "better too much than too little": charcoal tablets, probiotics, an antibiotic "just in case", perhaps some homeopathic pills. A smaller, more targeted selection is more useful – and so is preparation that matters more than any tablet: your vaccination status, protection against mosquito bites, and insurance that pays for repatriation if things go wrong. This article sorts out what current recommendations from the German Society for Tropical Medicine (DTG), Germany's Standing Committee on Vaccination (STIKO) and the US Centers for Disease Control and Prevention (CDC) say belongs in almost every travel kit, what depends on where you are going, and what you can safely leave at home. We deliberately give no doses – those belong on the package leaflet and in a conversation with your pharmacist or doctor.

The basics: what belongs in almost every kit

Your own regular medicines

The most important item in any travel kit is what you take every day anyway. Pack a generous reserve for delays (checklists suggest at least 50% more than you will need) and split it: the main supply goes in your hand luggage, a second set in your checked bag. Insulin and other sensitive products always go in hand luggage, because the hold can get too cold. Keep medicines in their original packaging with the leaflet where possible. A list of your medicines by active ingredient (not just brand names), with diagnoses and allergies, ideally in English or the local language, plus copies of key medical letters, is very helpful.

Pain and fever

A painkiller and fever reducer such as paracetamol or ibuprofen belongs in the kit – amounts and intervals as stated on the leaflet or advised by your pharmacist. One important caveat: in dengue areas, the CDC advises paracetamol for fever and explicitly advises against aspirin and ibuprofen. A thermometer belongs in the bag too: whether you have a fever is no minor detail in malaria areas (see below).

Diarrhoea: drink first

Travellers' diarrhoea affects many long-haul travellers, and the most important treatment is replacing fluid. For mild diarrhoea, any drink you tolerate will do, according to the CDC; with more significant fluid loss, packaged oral rehydration salts (electrolyte powder dissolved in boiled or treated water) are the treatment of choice – especially for children, older adults and people with chronic illness. Loperamide can reduce the number of trips to the toilet, for example before a long bus journey. But it is meant for short-term use only and is not suitable on its own if you have a fever or blood in the stool – then you need medical help. Different rules apply to children.

Wounds, blisters, ticks

An antiseptic, plasters, blister plasters, sterile dressings, an elastic bandage, small scissors and tweezers or a tick card cover most minor injuries. On hikes in tick or mountain regions, this is no luxury.

Sun and mosquitoes

Sunscreen (the CDC suggests SPF 30 or higher) and a lip balm with UV protection go without saying. For mosquito protection, the evidence is particularly clear. The DTG calls DEET the gold standard; for malaria areas, products with 30–50% are considered optimal, protecting for about four to eight hours. Icaridin (also called picaridin) works similarly well at a concentration of at least 20% and is better tolerated. IR3535 is less effective against malaria mosquitoes and is not the first choice there. Garlic, vitamin B12 and repellent wristbands do not protect. In malaria areas, add permethrin-treated clothing and bed nets – permethrin goes on fabric, not skin. Because many viruses are transmitted by day-biting mosquitoes, protection is needed around the clock.

Allergies

An oral antihistamine helps with hay fever, itching after insect bites or mild allergic skin reactions. Older drugs in this group cause drowsiness – keep that in mind if you are driving. Anyone who has had a severe allergic reaction should carry their emergency kit with an adrenaline (epinephrine) auto-injector.

Depending on destination and traveller

Malaria: prophylaxis or stand-by emergency treatment

Whether you need malaria medicines at all depends on destination, season, type of travel and your own health, and according to the DTG must be decided individually. For high-risk areas, the DTG recommends preventive medication (chemoprophylaxis). In moderate-risk areas, for remote trips where medical care cannot reliably be reached within 48 hours, stand-by emergency treatment is an option: a three-day course carried along and taken only if malaria is suspected. The DTG stresses that this should be limited to risk situations and that a medical check-up is still urgently needed afterwards. More important than any medicine: any unexplained fever from the seventh day after arriving in a malaria area, and for months after returning, must be checked for malaria immediately.

Antibiotics for travellers' diarrhoea: contested

An antibiotic shortens bacterial travellers' diarrhoea by about one to two days. The cost is often overlooked. In a Finnish study of 430 travellers, 21% returned colonised with gut bacteria that can break down certain antibiotics (ESBL-producing Enterobacteriaceae). Those who had taken an antibiotic for diarrhoea had roughly three times the risk; among travellers to South Asia with diarrhoea who took antibiotics, 80% were colonised. Such colonisation can make later infections – of the urinary tract, for example – harder to treat, and can spread to others. The CDC advises against antibiotics for mild diarrhoea and reserves them for moderate and severe cases. An antibiotic for self-treatment is therefore mainly for travel to remote areas – and only after medical advice, with a clear agreement on when to take it.

Motion sickness

If you are prone to nausea on boats, buses or winding roads, ask your pharmacist for advice. These medicines work best when taken preventively and can cause drowsiness – do not drive.

Blood clots on long-haul flights

For healthy people without risk factors, the American Society of Hematology (ASH) recommends neither compression stockings nor heparin nor aspirin for flights longer than four hours. For people at substantially increased risk – for example after recent surgery, a previous clot, shortly after giving birth, with active cancer or several risk factors – it suggests compression stockings or a low-molecular-weight heparin, though with very low certainty of evidence. A Cochrane review found clearly fewer symptomless leg-vein clots in stocking wearers (3 versus 47 cases among about 2,900 participants); whether this prevents pulmonary embolism could not be assessed. Whether you need an anticoagulant is a question for an individual medical consultation. For more on the strain of long flights, see our piece on jet lag and cardiovascular risk.

High altitude

The most important protection against altitude sickness is ascending slowly: above roughly 3,000 metres, sleeping altitude should rise by no more than about 500 metres per night, according to the Wilderness Medical Society guideline. Preventive acetazolamide is intended for travellers at moderate or high risk, for example with rapid ascent or previous altitude sickness – discuss it with a doctor beforehand.

Overrated

Before the trip: as important as the contents

Book travel-medicine advice early. Some vaccine series take time – a primary rabies course, for example, about four weeks. So plan your consultation at least four weeks before departure where possible; even at short notice it is still worthwhile. For pregnant women, children under five, travellers over 65, and people with complex conditions or weakened immunity, the DTG recommends advice from a tropical-medicine specialist or a very experienced travel-medicine doctor.

Check your vaccinations. Start with the routine ones: tetanus, diphtheria, whooping cough, measles and – depending on age – flu, pneumococcal and others (see our article on adult vaccinations). Then, depending on destination, travel vaccines as set out in STIKO's travel recommendations (Epidemiologisches Bulletin 14/2025): hepatitis A, typhoid (among others for all travel to South Asia), rabies, yellow fever (an entry requirement in some countries), Japanese encephalitis, cholera, and tick-borne encephalitis and chikungunya in specific situations. For dengue, STIKO currently recommends vaccination only for people aged four and over who have had a laboratory-confirmed dengue infection and are travelling to an endemic area with increased risk; a German travel-medicine society is now calling for a broader recommendation. In Germany, vaccines for private travel are not a mandatory benefit of statutory health insurance – ask your insurer whether it pays voluntarily.

Take out travel health insurance. German statutory insurance never pays for repatriation, and even within Europe you may be left with costs. Germany's consumer advice centres recommend policies that cover repatriation when it is "medically sensible and justifiable" – not only when it is "medically necessary".

Controlled drugs only with a certificate. If you need strong painkillers, certain ADHD medicines or medical cannabis, travel within the Schengen area requires a certificate under Article 75 of the Schengen Implementing Convention: completed by your doctor, certified by the local health authority, valid for a maximum of 30 days, one per medicine. For other countries, Germany's Federal Institute for Drugs and Medical Devices (BfArM) recommends a multilingual certificate based on the guidance of the International Narcotics Control Board (INCB). Some countries require import permits or ban certain substances outright – check with the embassy of your destination and transit countries in advance.

Mind the heat. Most medicines should be stored below 25 °C. Suppositories can melt, creams can separate, asthma inhalers can become hard to dose. Insulin should travel cool but not frozen – never leave medicines in direct sun or in a hot car.

This article is general information and not individual medical advice. Decisions about tests and treatment belong in a conversation with your own physician.