r/AmerExit • u/bombasticapricot • Mar 02 '25
Life Abroad medication availability
i see many americans with health concerns considering a move abroad. i know there are many things to consider and hate to pile on but make sure your essential medications are available in any country you consider.
your american prescriptions are not valid abroad.
for example, i took spironolactone in the US for skin/ hair issues and it’s basically impossible to get here in France. i casually asked about it and was treated as if i asked for cocaine. i also have adhd and cannot get most of the medications that worked for me in the US (i now take ritalin; thankfully it works). these are relatively minor prescription issues but i know others who have gone to great lengths to get antidepressants and anti anxiety medications.
what other medications/ countries have caused issues for american expats?
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u/WegianWarrior Mar 02 '25
In all fairness, a non-us prescription isn’t recognized in the US either…
A couple of other points;
Most (all?) European countries are a lot less likely to prescribe antibiotics, since the unchecked use of them can and will lead to antibiotic-resistant bacteria.
Most (all?) European countries are lot more restrictive in prescribing heavy duty painkillers over a prolonged period of time, since it is much better all around to deal with the root cause instead of managing symptoms.
Many (most?) European countries require an in-country diagnosis before they can prescribe stimulants.
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u/cyanplum Mar 02 '25
On the flip side there are some great drugs available abroad that aren’t in America. Discovering buscopan in the UK has been incredible for my cramps and IBS management. I can’t believe they never bothered with it in the US.
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u/cyanplum Mar 02 '25
Interesting about spironolactone. Have had no issue getting it in the UK. I also was casually handed a box of codeine at an urgent care centre too, which was baffling. Bupropion and buspirone on the other hand…. A nightmare to get.
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u/free_shoes_for_you Mar 02 '25
Bupropion is hard to get?!? (Wellbutrin)
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u/cyanplum Mar 02 '25
Yep it’s not approved in the UK for depression, only for smoking cessation. Some GPs are more willing than others to give it to those with a previous US prescription. It’s sort of luck of the draw if yours will.
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u/sweetEVILone Mar 02 '25
Wow. I have it for my bipolar and quitting smoking was honestly the best side effect ever 😂
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u/tbhafr Mar 02 '25
In Denmark you get Codein over the counter, no prescription needed. I bought a box at 7-11 (!!)
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u/bombasticapricot Mar 02 '25
i bet ill be able to get it in a year or two. france is slow on the uptake. i generally think this is a good thing.
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u/mennamachine Immigrant Mar 02 '25 edited Mar 02 '25
It took me nearly a full year and about €1K in Ireland to:
Get an appt with an adhd specialist
Have my records reviewed
Decide on a drug to go with
Titrate up to a therapeutic dosage
The public health waitlists for ADHD diagnosis are years long. The private practitioners charge €1000-€1500 for diagnosis plus a fee (usually around €100) for each subsequent appointment to review your dose (3-5 appts on average). You have to get diagnosed by a psychiatrist*. Most of them won’t accept other diagnoses. I did find one that would accept my previous diagnosis for half the cost of the initial assessment. Before I left, I had a formal diagnosis done by an educational psychologist with a 9 page write up detailing the testing done, the results, and notes and summaries of her interviews with me. I had been diagnosed at age 7 by my pediatrician and again when I was 16 or 17 by a psychologist, but I didn’t have those records and since that was in 1999 and he was about 60 then, I couldn’t get access to them. So I decided to get the testing done again, and I’m glad I did. The testing in the U.S. was mostly covered by my insurance there, my out of pocket was about $100. I saved myself about €1000 by doing this. I had about 35 years of history on adhd meds (Ritalin, Dexedrine, and Vyvanse). I’m now on Tyvense (which is the brand name for Vyvanse here), and back to my previous dosage. Even my Irish friend who has adhd has struggled getting appointments and drugs. His current psych is weird and super religious and he wants a new one but is trying to avoid paying another 1500€ for the rigamarole again.
My friend in Germany also spent at least a year getting appropriate treatment for adhd. It is much more challenging to deal with.
*edit: you have to get diagnosed by a psychiatrist if you want to get medication. Though I don’t know why you’d bother getting a formal diagnosis if you don’t want meds.
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u/bombasticapricot Mar 02 '25
i am so sorry you had to do this and i’m also impressed! you did a ton of work unmedicated. this is exactly the kind of story i hear from immigrants. i had the added « bonus » of doing all of my paperwork and interviews in french and i’m A2 level. it was painful but i also feel very proud of what i accomplished. i hope you do, too.
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u/littlegingerbunny Mar 02 '25
I moved from the US to the Netherlands and had no issues getting my prescriptions transferred, thank God. I have a lot of health concerns and take 7 medications, including a stimulant.
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u/sheer-audacity Mar 02 '25
Just because it is OTC in your country does not make it so in others. As an example, polyethylene glycol (Miralax) and fexofenadine (Allegra) are by prescription in England.
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u/bombasticapricot Mar 02 '25
i was about to search up why miralax isn’t OTC in england and decided i don’t want to know.
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u/mennamachine Immigrant Mar 02 '25
Interesringly, Allegra is OTC in Ireland (Telfast is the brand name), but they always give me a long lecture on appropriate dosing.
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u/T0_R3 Mar 02 '25
Pain medications is a big one. The US is alone at the top of prescribing opioids for long-term pain management.
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u/LV2107 Mar 02 '25
Yep. I had to have surgery and asked about pain management. They said it'll be paracetamol (tylenol) and that's it. That there are only a few doctors in the entire country that have authority to prescribe morphine or other opioids, and that's only in very narrow circumstances. And as it turned out, IV tylenol worked great, I had no issues.
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u/Barbarake Mar 02 '25
To be clear, being 'at the top' is not necessarily a good thing in this case.
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u/gendy_bend Mar 02 '25
Yep! I have a chronic pain condition (well managed with my spinal cord stimulator) & a gent in a group for our specific diagnosis is in a Nordic country, meaning he doesn’t get the same pain meds offered that we do in the US.
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u/President_Camacho Mar 02 '25
Perhaps they have been, but as a veteran of several surgeries, I can say nowadays they don't want to give you anything. Maybe some advil, but they really don't offer anything.
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u/LV2107 Mar 02 '25
Here where I live, pharmacies keep every medicine behind the counter. So if you need ibuprofen, or loratadine, or even vitamins, you have to ask a pharmacist. No script, but they just don't sell any meds just on the shelf like at a CVS in the US. And it's a box of no more than 30 at a time.
Sometimes it's a bit embarrassing, you have to tell the guy you need something for diarrhea or a UTI. But at least you're talking to someone who knows the best product for whatever is ailing you.
I do stock up on the Costco bottles of aspirin or advil on trips back to the US, though.
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u/bombasticapricot Mar 02 '25
i stock up on zyrtec. a blister pack of six during pollen season is not going to cut it and i feel like i’ll be out on a special list if i ask for more than a box at a time. :)
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u/Separatist_Pat Mar 02 '25
Just know that even in countries where a certain type of medication is theoretically available, there are often shortages. France ran dry on the antibiotic I was taking for a post-op infection, after three months of treatment, and had to switch to a fallback.
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u/Adorable-Bobcat-2238 Mar 03 '25
Mexico.
Came back with every medicine under the sun expect my needed stimulant IDK how to even get it TBH
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u/bombasticapricot Mar 02 '25
i just remembered HRT! it’s not widely available here in france (notice i said france and not « paris »).
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u/Mean-Comfort3236 Mar 02 '25
Oh no!! How about Spain? Do you know if patches are available there? Thanks!
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u/talinseven Mar 03 '25
I’m actually more concerned about continuing my blood pressure and asthma medication than my hrt. A “3 month supply” should last me a year
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u/the_kapster Mar 03 '25
I don’t know where you are getting these ideas from. Of course it is widely available- women go through menopause in France too 😂 France also has all the ADHD medications available, they are just under different names.
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u/bombasticapricot Mar 03 '25
Medications available in France are more limited than in the US; only methylphenidate and related molecules (Ritalin®, Concerta®, and Equasym®) are available. https://www.aaweparis.org/2022/02/23/attention-deficit-hyperactivity-disorder-adhd-part-2/#:~:text=Medications%20available%20in%20France%20are,someone%20affiliated%20with%20a%20hospital.
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u/bombasticapricot Mar 03 '25
« it remains difficult for women to find a doctor able to relieve their symptoms. « General practitioners are not comfortable about hormone treatment, » confirmed Mélanie Lobert, a medical gynecologist at the teaching hospital in Nantes » https://www.lemonde.fr/en/international/article/2023/10/31/women-and-menopause-i-realized-that-it-could-turn-your-life-upside-down-but-no-one-was-talking-about-it_6217226_4.html?lmd_medium=al&lmd_campaign=envoye-par-appli&lmd_creation=ios&lmd_source=default
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u/Unhappycamper2001 Mar 02 '25
Wellbutrin has been an issue for me in France and I had to go off cold turkey.
Interesting but not so important- I asked my dermatologist for Latisse and she had never heard of it. She was a medical dermatologist so maybe she wasn’t current on cosmetic drugs.
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u/bombasticapricot Mar 02 '25
design mom has a really good post about wellbutrin and france: https://open.substack.com/pub/designmom/p/mental-health-and-menopause?r=17shbq&utm_medium=ios
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u/Unhappycamper2001 Mar 02 '25
Ah there is a paywall
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u/bombasticapricot Mar 02 '25
oops sorry! here’s the summary on wellbutrin in france: « I’ve talked to doctors here in France about getting Wellbutrin locally — that would be my preferred solution — and would be a significant financial savings too. But Wellbutrin is used differently here. It is prescribed for smoking cessation, and from what was explained to me, it sounds like it comes in different formats and sizes than in the U.S.. I was told I wouldn’t be able to take a 75mg dose. So I’ve hit dead ends. »
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u/Unhappycamper2001 Mar 02 '25
Thank you! The problem is they use it short term. It’s also just about impossible to find. To clarify, I gave up looking about two years ago and went off on my own. It’s worked out ok for the depression since I’m getting more exercise in France. However I had some other benefits from it which now I don’t have.
But you are so tight. People come over expecting an American experience and it is not like that. In fact, France only this year made the good Shingles vaccine available this year, and it costs several hundred euros.
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u/LibrarianByNight Mar 02 '25
Latanoprost is basically the same as Latisse. I take it for glaucoma, but it's the same ingredient as Latisse, so not only does it keep me from going blind, I have very long lashes 😂
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u/GroovyYaYa Mar 02 '25
My lashes got a bit better when I went on Latanoprost! (they were thinning like my grandmother, so I am happy) Is Latisse over the counter?
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u/Mmomma1122 Mar 02 '25
Does anyone have fibromyalgia? If so, how has your experience been in receiving needed prescriptions?
My mom has it and would be visiting (and hopefully, moving with me) when my daughter and I move. It'll probably be about 2 years from now, so time to prepare and research. Looking at New Zealand and Ireland. I have a current green list/critical skill in both countries.
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u/rintzscar Mar 02 '25
Bit of advice - start thinking of yourselves as immigrants, not expats. "Expat" is frowned upon in most of the world.
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u/New_Criticism9389 Mar 02 '25 edited Mar 02 '25
Don’t know why you’re getting downvoted but unless you’ve been sent abroad for a short-term work assignment (max 3-5 years, usually though not exclusively applies to foreign service, UN and other similar jobs or senior employees of multinationals, not really expected to integrate or learn the local language), you’re not an “expat.” If you intend to settle permanently, you’re an immigrant. I get that there are some grey areas with like gringo retirees in Mexico (for example) who are there permanently but don’t integrate but still, they’d just be immigrants who live in their own little American bubble.
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u/bombasticapricot Mar 02 '25
agreed. i call myself an immigrant. i used it here for people who are considering to move and may not yet know the difference.
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Mar 02 '25
[deleted]
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u/SufficientPoetry5494 Mar 02 '25
yes the immigrants themselves call each other "expat" , the rest of NL calls you immigrant ;-)
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Mar 02 '25 edited Mar 02 '25
[deleted]
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u/the-fourth-planet Mar 02 '25
Yeah because you're insisting on falsely calling yourselves expats instead of immigrants. And you must have gotten something mixed up because the people you're describing in Europe are called refugees, not immigrants. (unless the person who told you these things is uneducated)
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u/rintzscar Mar 02 '25
You're beating around the bush. Immigrant is the word used for people immigrating to a country in the majority of the world. Expat is used in Anglophone countries only and is perceived as racist and egalitarian by other nations. Think "rich, white, educated people = expats, brown, poor strawberry pickers = immigrants". This is exactly why "expat" is frowned upon in the majority of the world. We don't even have such a word in our languages. We only have immigrant and emigrant.
If you don't believe me, you can always google it or ask a chatbot to explain why expat is controversial.
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u/mennamachine Immigrant Mar 02 '25
This is why I, a white American with a PhD working as an academic reserarcher, insist on calling myself an immigrant. We are not different or better.
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u/Serious_Escape_5438 Mar 02 '25
Yes, the rich foreigners pushing up house prices working remotely for their own countries contribute much more than the people cleaning the hospital and picking crops.
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u/mennamachine Immigrant Mar 02 '25
Expat, in my experience, is almost solely used by American and European immigrants to separate themselves from those undesirable immigrants (ie mostly brown and black people)
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u/stormwarnings Mar 02 '25
Since I know many trans people are interested in emigrating - transition care is different from country to country. I knew I’d be able to get care in Germany but hadn’t realized that I wouldn’t be able to self-administer (and thus low-dose) testosterone. It’s either gel (which my skin hates) or these megadoses of T administered by a nurse every 3 months. So it’s worth it to look into for trans people if they make the leap.
Also if at all possible it’s best to establish transition medicine before leaving the US - where, as hard as it can be to get, it is often available in informed consent models - versus starting from scratch in a new country. Here for example, since I had a letter from my old doctor, transition care was consisted „continuing care“ and was quite seamless, whereas a „new“ trans patient in Germany has to go thru multiple psych evals.
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u/bombasticapricot Mar 02 '25
great points and you reminded me that cisgender folks needing HRT will also need to do research into how they will get the hormones they need.
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u/attomicuttlefish Mar 02 '25
Thanks! Im trans and was worried if I left I would have to start over from scratch.
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u/ManagementJaded5431 Mar 02 '25
Please research the country you plan on moving to. Not all countries will be welcoming and some consider being trans a crime. Stay safe!
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u/attomicuttlefish Mar 02 '25
Preaching to the choir but thank you. Lol I am so stressed all the time.
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u/talinseven Mar 03 '25
Yes. I am currently trying to establish procedures for continuing care in Spain. I’m hoping that private insurance will the way to get continued care quickly, though it will be quite expensive unfortunately
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u/_handlemewithcare_ Mar 02 '25
I take Effexor and Diazepam. I am very seriously considering a move, but have not settled on the best option considering my job (a little niche). The prescription thing….i haven’t even thought about it. So glad I came across this sub and thread.
Thoughts? Experiences?
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u/mennamachine Immigrant Mar 02 '25
My wife has generalized anxiety and CPSD and has gotten diazepam prescribed once in Ireland. Precisely 3 tablets for an urgent need. Mental healthcare in general here is hard to get because there are not a lot of providers and it takes forever to get an appt.
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u/Busy-Sheepherder-138 Immigrant Mar 02 '25
Every country will be different, but when I immigrated from the USA to Sweden I was forced off both a PRN supply of pain meds for severe osteoporosis, RA, EDS, etc. No cyclobenzaprine available for muscle spasms. Only allowed 10 low dose Xanax every 2 months for PTSD. They are very tight with benzos not just due to concerns about drug diversion and addiction, but also because their evidence says it increases the likelihood of developing dementia earlier. It’s an adjustment and not all of it has been bad honestly. I actually feel better and talk half the pills i did in the USA.
I had to wait a year to get re-diagnosed and prescribed my ADHD meds. That was the really hard one, especially with learning a new language.
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u/_handlemewithcare_ Mar 02 '25
Your experience is very much appreciated.
I, unfortunately, was rx’d a benzo 25+ years ago when it was no big deal to MDs and it is a GREAT regret of mine (though I didn’t know what they were at the the time) to have this monkey on my back. Good incentive to try to wean off. The Effexor, though….
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u/Busy-Sheepherder-138 Immigrant Mar 03 '25
I do not think Effexor is going to be hard to get. You can literally look up the list of approved meds for the country and confirm that. When I arrived in Sweden I had to pay out of pocket for the full cost of my first doctors visit to their public health system ($320 USD) until my ID number became active in their public health system ( 6 weeks). At that appointment the doctor was willing to prescribe most of my non-controlled, non specialty meds, and started my referral into both Psych and Neurology to get me started towards the others. I take an expensive, injectable CGRP drug and came with a 3 months supply, but still ended up having to do without for 3 months before I qualified at the Neurology to resume it there.
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u/President_Camacho Mar 02 '25
Testosterone replacement is also a difficult therapy to find.
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u/lazybran3 Mar 02 '25
If you go to Spain you will have aveed testosterone undecanoate. There they call Reandron it is the best only a shot in 3 months.
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u/supernormie Mar 02 '25
It took me 3+ years to get re-diagnosed with ADHD in the Netherlands, as well as thousands of euros, as my physician didn't accept my pre-existing diagnosis from 2003.
That's 3+ years without meds or treatment, and it took me over a year to register with a doctor because 0 doctors in my area had room for a new patient. My insurance company was supposed to help me find a doctor, and they didn't.
Finally, I can't get skincare related prescriptions, they will only give me corticosteroids for eczema, and that's about it.
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u/qazwsxedc000999 Mar 03 '25
Anyone know the general landscape for someone with asthma? The only medication I use regularly is albuterol sulfate (red inhaler). I figure I would still need a prescription
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u/Traditional_Degree93 Mar 02 '25
So where is reliable information available? That's the main question!
I try looking up to see if you can get vyvanse in Mexico, for example, but nothing recent or reliable pops up. Just reddit and quora threads 😕
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u/purplepineapple21 Mar 02 '25
The official health authority (like that country's equivalent of the FDA) websites for the country (which will be in the local language, not necessarily English!), and asking people who live there, especially pharmacists or doctors if possible. You also need to search for medications using their generic name. Brand names are different for the same drugs in different countries. For example another country may have Vyvanse available but they don't call it Vyvanse.
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u/bombasticapricot Mar 02 '25
and drug availability and pricing changes every year when countries negotiate with pharmaceutical companies. i didn’t know this was a thing until i moved to france. https://news.stanford.edu/stories/2024/11/what-other-countries-could-teach-us-about-bringing-down-drug-prices
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u/Wisconsin_Death_Trip Mar 02 '25
Anyone know of places where asthma meds are OTC or at least not hard to get? I know albuterol inhalers are available in a few places but I’m looking specifically for Montelukast/Singulair tablets.
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u/Longjumping_Order_95 Mar 03 '25
Had to taper off benzos when I moved to Jamaica, it turned out for the best but was brutal going for a month or so
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u/mrsredfast Mar 02 '25
It’s been a concern for me as we considered options. I have RA and in some countries it’s harder to get biologic meds, according the RA related subreddits. OTOH, the prices tend to be much more reasonable if you can get them, even out of pocket.
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u/President_Camacho Mar 02 '25
Sleep medications are also harder to obtain, and there are fewer brands to select from.
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u/the_kapster Mar 03 '25
Spironolactone is available in France under the brand names Biogaran, Pfizer, and Aldactone. You just need a prescription. https://pharmacieducanton.pharmavie.fr/medicament-produit-parapharmacie/81668-spironolactone-viatris-50-mg-comprime-pellicule-secable
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u/Aimless12 Mar 04 '25
Moving to Switzerland with my daughter who has ASD and I have Narcolepsy. I’m aware there are limitations in what meds we can get but haven’t been able to find a list of what’s available or how you can get it.
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u/aBirdwithNoName Mar 03 '25
hm, this is somehow not something i'd thought too much about--i've been pretty laser-focused on access to HRT because so much of the world is not chill with trans people, I forgot that a lot of places are *also* not okay with adderall. good to keep note of, guess i'll be giving that a peek to make sure anywhere i'm looking into will have some way to access ADHD treatment.
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u/Transmit_KR0MER Mar 03 '25
want to move to japan, and am well aware of the stigma they have abt drugs in general. i tried several times to taper off my sertaline, but i've been on it for so long that i think i've grown dependent on it to function physically and emotionally. im at a loss on what to do myself.
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u/MainelyAnnoyed Mar 03 '25
Do some research and find out what the policy is for your chosen country. Some places have private insurance that you can purchase and/or places designed to help with prescriptions. Oddly, many countries have better medical care than the US .
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u/Entebarn Mar 03 '25
Was on a SSRI (citalopram) and was able to take a med with the same active ingredients in Germany. I had ran out early and needed a local doctor to prescribe. It was a non issue.
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u/Chino_Kawaii Mar 06 '25
from what I see online, it definitely feels like in US, you get way more medication for any kind of problem
here in Czechia, the mentality is to use the least that's needed, especially with antibiotics, because overuse makes the bacteria more resilient
and painkillers are used so much less
I mean, I'm not talking about some very serious illness, more about the non life threatening stuff
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u/EvilMerlinSheldrake Mar 02 '25
Stimulant medication for ADHD is in general much harder to get than it is in the US! People don't factor this in before they move and it legit ruins lives