Oral diabetes medication abroad: what you need to know

The global shortage of GLP-1 receptor agonists that started in 2022 was officially resolved by the US FDA in February 2025 (all injectable semaglutide doses) and by the EMA in 2025 (semaglutide and tirzepatide). Supply at major-market pharmacies has largely stabilised, but localised stock gaps still surface — particularly for the 2 mg pen and in countries that received the smallest allocation. That is the supply story. The brand-name problem is separate, and it catches travellers just as often.

Medical disclaimer: This article provides general travel health information and does not constitute medical advice. Medication regulations, pharmacy stock levels, and import rules change. Consult your prescribing clinician and, where relevant, the health authority of your destination country before travelling. Do not adjust, substitute, or discontinue diabetes medication without medical supervision.

Why your medication disappears the moment you cross a border

Pharmaceutical companies sell the same molecule under different brand names in different markets. Metformin is sold as Dianben in Spain, Glucophage across much of Europe and the Middle East, and Diabex in Australia^[2]. If you walk into a pharmacy and ask for your home brand name, you may be told it does not exist.

The fix is straightforward: carry the INN (International Nonproprietary Name) on every prescription and medication document you travel with. The INN is the molecule name recognised by pharmacists everywhere, regardless of what brand they stock.

Common oral diabetes medications and their INNs to note: metformin, glipizide, gliclazide, glibenclamide, sitagliptin, empagliflozin, dapagliflozin, pioglitazone, and acarbose. Ask your prescriber to write the INN alongside the brand name on your documentation before you travel.

The three refill realities travellers get wrong

The prescription transfer problem. Most countries do not honour foreign prescriptions at their pharmacies^[3]. Japan, Thailand, Indonesia, and Morocco all require a local prescription to dispense even non-controlled medications like metformin. You can walk in with a clearly labelled blister pack and still be turned away without a local doctor's note.

The controlled-substance problem. SGLT2 inhibitors (empagliflozin, dapagliflozin) and GLP-1 agonists are not controlled substances, but their import is quantity-limited in several countries^[4]. Japan caps personal medication imports at a one-month supply for most drugs without a prior import certificate. Thailand applies a 30-day rule. If your trip runs longer, you need a plan before departure, not after arrival.

The generic availability problem. Generic metformin is available in nearly every country. Generic empagliflozin and generic sitagliptin are not. Patent protection and regulatory approval timelines mean that a medication freely available as a cheap generic at home may only exist as a costly branded product abroad, or may not be registered at all.

Country-by-country: what actually happens at the pharmacy

Spain stocks metformin (as Dianben or generics), gliclazide, and sitagliptin (as Januvia) at most pharmacies without issue. Empagliflozin (Jardiance) and dapagliflozin (Forxiga) are available but require a Spanish prescription^[5]. A private GP consultation to obtain one costs roughly €60 to €90 (~$65 to $98).

Thailand sells metformin and glibenclamide over the counter at most pharmacies. SGLT2 inhibitors are available at private hospital pharmacies but require a Thai prescription and cost significantly more than branded equivalents elsewhere^[6]. Empagliflozin 10 mg at a Bangkok private hospital pharmacy runs approximately ฿1,800 to ฿2,400 per month (~$50 to $67 / ~€46 to €61).

Japan is the most restrictive. SGLT2 inhibitors and DPP-4 inhibitors require a Yunyu Kakunin-sho (import confirmation certificate) for quantities exceeding a one-month supply^[7]. Metformin is available locally as Melbin or Glycoran. SGLT2 inhibitors are registered and dispensed, but only through licensed medical institutions.

Morocco and Vietnam present the starkest supply gaps. Generic metformin is available in both. Newer drug classes, including SGLT2 inhibitors and GLP-1 agonists, are either absent from community pharmacies or only stocked in major city hospital dispensaries with limited and unpredictable supply.

The GLP-1 supply picture in 2026: officially resolved, locally bumpy

If you take oral semaglutide (Rybelsus) or any injectable GLP-1 agonist, the FDA's drug shortage list has shown semaglutide and tirzepatide as resolved since 2025 — but supply is uneven outside North America and Western Europe. Compounded semaglutide is no longer legal in the US (503A pharmacies were cut off 22 April 2025; 503B outsourcing facilities on 22 May 2025), so travellers who relied on compounded prescriptions before the shortage resolved cannot fall back on that route abroad. Some markets outside the EU and North America are still working through allocated supply and have not reached steady availability. Do not assume you can refill an injectable GLP-1 at a random pharmacy in Southeast Asia, Latin America, or Africa.

The practical rule: carry your full trip supply plus a 14-day buffer. If your destination country caps imports at 30 days and your trip runs six weeks, contact the relevant health ministry or a travel medicine clinic before you fly to understand your options.

What to do before you travel: five steps that take under an hour

1

List every medication by INN. Ask your prescriber to rewrite or annotate your prescription with the INN for each drug. This single document unlocks access at pharmacies in nearly every country.

2

Check the import limit for each destination. Japan's Ministry of Health, Labour and Welfare publishes a guide in English. Thailand's Food and Drug Administration website covers its 30-day rule. If your trip duration exceeds the cap, you need either a Yunyu Kakunin-sho (Japan) or documented correspondence with local health authorities.

3

Carry your medication in original, labelled packaging. Customs officers and pharmacy staff can verify the medication identity faster, reducing delays and questions at the border.

4

Know whether any of your medications qualify as a controlled substance in your destination country. Standard oral diabetes drugs are not controlled, but if you also take a medication for a comorbidity such as anxiety or pain, check each one separately.

5

Build your International Patient Summary before you leave. An IPS contains your active medications, allergies, diagnoses, and blood type in a standardised format that any clinician can read, in any country. If you run out of medication and need a local prescription, handing a clinician your IPS cuts consultation time significantly and reduces the risk of prescribing errors.

Heat and storage: the problem most people forget until it's too late

Most oral diabetes medications are stable at room temperature up to 25°C to 30°C. Travelling in Southeast Asia, the Middle East, or North Africa in summer regularly puts ambient temperatures above that range. A blister pack left in a hot car or a bag sitting in direct sun can degrade faster than the expiry date suggests.

SGLT2 inhibitors and metformin tablets are generally robust, but combination products with a metformin extended-release component can be more sensitive to humidity. Check the storage conditions on your specific product's patient information leaflet before you travel.

The insurance blind spot

Standard travel insurance reimburses emergency treatment, not routine medication resupply. If your SGLT2 inhibitor runs out and you need a private consultation and prescription to replace it, most policies classify this as routine management of a pre-existing condition^[9]. That means the cost falls to you. In Japan, a private endocrinologist consultation costs approximately ¥5,000 to ¥15,000 (~$33 to $99 / ~€30 to €91) before medication.

Check your policy's definition of "acute onset of a pre-existing condition". Some policies will cover a diabetes-related emergency, such as hypoglycaemia requiring hospital attendance, but not the cost of replacing the prescription that caused it to be preventable. Read the exclusions before you travel, not after you are in an emergency department.

Frequently asked questions

Can I refill my metformin prescription at a pharmacy abroad?

In countries such as Thailand and Morocco, pharmacists can dispense metformin without a local prescription. In Japan, Spain, and most of the EU, a local prescription is required. Always carry documentation showing the INN and your prescribing clinician's contact details.

What is the brand name for metformin in Spain?

Metformin is sold as Dianben in Spain, alongside generic versions labelled with the INN. If you ask for metformin by INN, any Spanish pharmacist will understand the request.

Can I bring a three-month supply of empagliflozin to Japan?

Japan limits most non-controlled medication imports to a one-month supply without prior approval. To bring more than one month of empagliflozin, you need a Yunyu Kakunin-sho (import confirmation) issued by the Ministry of Health, Labour and Welfare before you travel.

Is oral semaglutide (Rybelsus) available in Southeast Asia?

Rybelsus is registered in some Southeast Asian markets but stock availability at community pharmacies is inconsistent. Do not plan to resupply in Thailand, Vietnam, or Indonesia without verifying availability with a local hospital pharmacy in advance.

Will travel insurance cover the cost of replacing diabetes medication abroad?

Most standard policies do not cover routine medication resupply for pre-existing conditions. They may cover emergency treatment if a medication gap leads to a medical crisis, but the definition varies by policy. Read the pre-existing condition exclusions carefully before departing.

What document should I carry to get a local prescription for my diabetes medication abroad?

Carry a letter from your prescribing clinician on headed paper listing each medication by INN, dose, and reason for use. An International Patient Summary in a standardised format is also accepted by clinicians in most countries and significantly speeds up local consultations.

Oral Diabetes Medication Abroad: The Refill Gaps Nobody Warns You About