Bringing Medication to the USA: Rules for Entry, Flights and Return

You may bring medication for your own use into the USA. U.S. Customs and Border Protection (CBP) recommends the original packaging, a prescription or doctor's note in English and, as a rule of thumb, no more than a 90-day supply; the Food and Drug Administration (FDA) allows foreign visitors to bring a 90-day supply. Stricter rules apply to controlled substances such as many ADHD medications, strong painkillers or benzodiazepines: they must be in their original container and declared on arrival. Cannabis remains prohibited at entry under federal law, even with a prescription and even if it is legal in the state you are visiting.

This guide goes deeper than the short note on medication in our overview First trip to the USA: tips and complements our article U.S. entry: CBP and customs. It explains the rules of the FDA, CBP, the Drug Enforcement Administration (DEA) and the Transportation Security Administration (TSA), but it does not give medical advice. Which medication to take, in what quantity, and whether there are alternatives for the trip is something to discuss with your doctor or pharmacist. Decisions on entry rest solely with the U.S. authorities.

What rules apply to medication when entering the USA?

In most circumstances it is illegal to import drugs into the USA for personal use, the FDA says. For visitors, however, it makes a clear exception: foreign nationals may bring or ship a 90-day supply of drug products. Those staying longer can have additional medication sent to them. As supporting documents, the FDA lists a copy of the visa and passport, a doctor's letter and a copy of the prescription in English.

CBP, which inspects you on arrival, gives visitors these recommendations:

• Original container: the medication should be in its original container, ideally with the dosage instructions.
• Proof in English: carry a valid prescription or a doctor's note written in English.
• Personal use only: bring no more than you need during your stay, as a rule of thumb no more than 90 days' worth.
• Controlled substances: if a medication falls under U.S. controlled substances law, DEA requirements apply as well.

The German Federal Foreign Office also advises travellers to bring the medication they take regularly and, where necessary, to have a doctor certify in English that it is needed. According to CBP, counterfeit drugs and so-called miracle cures may not be imported.

What should the doctor's note contain?

No specific format is required. A short letter in English has proven useful, ideally on practice letterhead with stamp and signature, containing:

• your name and date of birth as shown in your passport,
• the active ingredient of each medication (international non-proprietary name) and the brand name,
• dosage form, single and daily dose, and the quantity you are carrying,
• length and destination of the trip,
• required supplies such as syringes, pens, an insulin pump or a glucose sensor,
• the practice's contact details for queries.

The active ingredient matters because brand names in the USA are often different. The diagnosis does not have to be stated in every case; discuss what makes sense with your doctor.

How to prepare for a trip with medication

1. Talk to your practice early, ideally six to eight weeks before departure: how much do you need, does an active ingredient fall under U.S. controlled substances law, is there an alternative for prohibited substances?
2. Have a note issued in English. For narcotics under German law, an official certification is added; more on this below.
3. Pack your supply in its original packaging, for no more than 90 days and with a small buffer for delays.
4. Put everything in your hand luggage. Suitcases can get lost or arrive late. Keep liquid medication and insulin separately ready for the security check.
5. Answer honestly on arrival and declare controlled substances to the CBP officer.
6. Keep copies: prescription, note and insurance details as photos on your phone and on paper.

What applies to ADHD medication, strong painkillers and sleeping pills?

The USA classifies narcotics and other controlled substances into five lists, the DEA's Schedules I to V (21 CFR Part 1308). Schedule I covers substances without accepted medical use, Schedule V those with the lowest potential for abuse. Many medications routinely prescribed in Germany appear on these lists (lists as of 2 November 2026):

• Schedule II: ADHD substances such as methylphenidate, lisdexamfetamine and amphetamine; strong painkillers such as oxycodone, morphine, hydromorphone, fentanyl and tapentadol; codeine as a single substance.
• Schedule IV: benzodiazepines such as diazepam, lorazepam, alprazolam and clonazepam; sleeping pills such as zolpidem and zopiclone; also tramadol and modafinil.
• Schedule V: among others pregabalin.
• Schedule I: among others marijuana and the painkiller tilidine, which is widely used in Germany.

For Schedules II to V there is an exemption for personal medical use (21 CFR 1301.26). You may bring such a medication if you obtained it lawfully for yourself and meet two conditions: the medication is in the original container in which it was dispensed to you, and you declare it to the customs officer. You state that it is for your personal use and give its trade or chemical name and the quantity. The limit of 50 dosage units in the same rule applies only to U.S. residents who obtained medication abroad.

There is no such exemption for Schedule I. You therefore may not bring medication containing tilidine into the USA, even with a German prescription. Talk to your doctor in good time about an alternative for the trip, and never stop taking medication on your own.

Many of these substances are also narcotics under German law, including common ADHD medications and strong painkillers such as morphine. For trips to countries outside the Schengen area, the Federal Opium Agency at Germany's BfArM recommends a multilingual doctor's certificate following the guidelines of the International Narcotics Control Board (INCB), stating single and daily doses, the active ingredient and the length of the trip. This certificate must be certified by the highest health authority of the German federal state or a body it has appointed. The guidelines provide for carrying narcotics for no more than 30 days; for longer trips, clarify the procedure with your practice and the authority. Allow time for the certification. Your practice or pharmacy can tell you whether a medication falls under the German Narcotics Act.

Warning: Tilidine and cannabis are in Schedule I in the USA. There is no exemption for travellers, not even with a prescription or a certificate.

Cannabis and CBD: what is allowed at entry?

You may not bring cannabis (marijuana) into the USA, not even as medical cannabis with a German prescription. Under federal law, marijuana is still in Schedule I (as of November 2026). Since April 2026, only US state-licensed medical marijuana and FDA-approved products have been in Schedule III; German medical cannabis is not covered. The personal-use exemption does not apply to Schedule I. This does not change because cannabis is legal for medical or recreational use in many states, nor because possession is now partly legal in Germany. Airports and border crossings are controlled by CBP as a federal agency, and federal law applies there. The German Federal Foreign Office warns that possessing even the smallest amounts of drugs can lead to long prison sentences and entry bans.

If you are prescribed cannabis or a cannabinoid medication in Germany, clarify with your doctor before the trip how your treatment can continue during your stay.

CBD is more complicated. Under U.S. federal law, hemp with no more than 0.3 percent THC on a dry weight basis is not considered marijuana. However, Congress tightened this definition in a law from November 2025 (Public Law 119-37): finished hemp products with more than 0.4 milligrams of THC per container, as well as products with synthesized cannabinoids, will no longer count as hemp. The new rules take effect in stages from late 2026. Many full-spectrum oils from Germany are likely to exceed the new limit, and nobody can reliably prove a product's actual THC content at the border.

Tip: Leave CBD oils, capsules, gummies and vape liquids at home. The risk of seizure or further consequences is out of proportion to the benefit.

Insulin, syringes and liquid medication on the plane

The 100-millilitre rule at security does not apply to liquid medication. The TSA, which runs airport security in the USA, allows medically necessary liquids, gels and aerosols in reasonable quantities for your trip in carry-on bags. You must, however, declare them at the checkpoint for inspection. These rules apply on domestic flights and when departing from the USA. On your outbound flight from Germany, European security rules apply, which usually also permit liquid medication; if in doubt, ask your airline.

What the TSA specifies for medication and medical supplies:

• Pills and other solid forms are screened as well. Clear labelling makes screening easier.
• Ice packs, gel packs and other accessories for cooling medically necessary liquids may be brought to the checkpoint.
• Syringes, pumps and IV bags associated with medical liquids are screened too.
• If you do not want liquid medication X-rayed or opened, tell the officer; another type of screening will follow.
• Devices attached to your body such as an insulin pump or a glucose sensor do not have to be removed. You can ask for them not to be X-rayed; additional screening may then follow, for example a pat-down of the device.
• With the TSA Notification Card you can discreetly inform officers about a condition or a device. Through the TSA Cares programme you can request assistance at the checkpoint in advance.

For insulin, also bring enough supply and spare materials, label insulin clearly and ask your pharmacist how long your insulin keeps without refrigeration. How to adjust your dosing across several time zones is something to discuss with your diabetes team before the trip. The general rules for liquids, connections and the second security check are explained in our guide Connecting and domestic flights in the USA.

Is a German prescription valid in U.S. pharmacies?

Generally not. U.S. pharmacies as a rule dispense prescription medication only on the order of doctors licensed in the USA. For controlled substances, federal law expressly requires that the prescriber be authorised in their state and registered with the DEA (21 CFR 1306.03). If you run out of medication during your trip:

1. Call your insurer's emergency hotline. It can name practices nearby and clarify which costs are covered.
2. Visit a doctor's office or urgent care clinic. A U.S. doctor can issue a new prescription that you can fill at a U.S. pharmacy. Show your English note with the active ingredient.
3. Keep the receipts. You need the bill, prescription and pharmacy receipt for reimbursement. What travel health insurance should cover is explained in our guide Travel health insurance for the USA.
4. Have medication sent only with documents. The FDA allows visitors to receive additional medication by mail if copies of passport or visa, a doctor's letter and a prescription in English are included. For controlled substances, the DEA decides whether import is possible; do not rely on it.

Do not order medication from unknown online pharmacies. Counterfeit or unapproved drugs may not be imported and can be dangerous.

Melatonin and over-the-counter medication in the USA

U.S. drugstores and supermarkets sell many products without a prescription that in Germany are only available in pharmacies or not at all. A well-known example is melatonin. In the USA it is considered a dietary supplement and is therefore regulated less strictly than a drug, explains the U.S. National Center for Complementary and Integrative Health (NCCIH); in several other countries it is available only with a prescription. Quality varies: in a 2017 study, the amount of melatonin in most of 31 tested products did not match the label. According to NCCIH, people taking other medicines should consult a health care provider before using melatonin, and people with epilepsy or on blood thinners should only take it under medical supervision.

For other over-the-counter products, check the active ingredient and dose, because pack sizes and strengths often differ from German products. At the pharmacy, the pharmacist can advise you. According to the FDA, some cold medicines, for example those containing pseudoephedrine, are kept behind the counter and sold only with photo ID and in limited quantities.

Returning to Germany: customs and narcotics

When you return to Germany, German customs (Zoll) allows you to bring medication in a quantity matching your usual personal needs, meaning no more than three months' supply per medicine. It does not matter whether you took the medication from Germany or bought it in the USA, or whether it is approved in Germany. Note that dietary supplements, high-dose vitamins or herbal products can count as medicines in Germany, especially if they are marketed as treatments for diseases. Prohibited items include counterfeit medicines and certain doping substances such as testosterone in more than small quantities.

For narcotics: medication prescribed for your own use may be taken out of and back into Germany in a quantity appropriate for the trip; the doctor's certificate serves as proof. When entering from countries outside the Schengen area such as the USA, customs recommends the multilingual certificate stating single and daily doses, active ingredient and length of trip, which you already need for the outbound journey.

The well-known certificate under Article 75 of the Schengen Implementing Convention, by contrast, applies only to trips to Schengen states, for a maximum of 30 days and separately for each narcotic. It does not replace the multilingual certificate for the USA. It becomes relevant if you combine your USA trip with a stay in another Schengen country, for example a stopover in Paris or Amsterdam. It, too, must be certified by the responsible state authority before the trip.

Overview: which rule applies to which medication?

The table summarises the rules for entering the USA and returning to Germany (as of November 2026). It does not replace checking your individual case.

Next steps

Start with a conversation at your practice and find out which of your medications fall under U.S. controlled substances law. Then come the note, certification where needed and packing your hand luggage. What else to expect at the border, from passport control to the customs declaration, is explained in our article U.S. entry: CBP and customs.

Our visa check shows in a few minutes whether you need ESTA or a visa for your trip. If you plan a longer stay in the USA, for example for medical treatment or an extended family visit on a visitor visa, we support you with the application and appointment; you will find an overview under Services.

This article is non-binding guidance, not medical or legal advice. Which medication you take is for you to decide with your doctor or pharmacist. Decisions on entry, including on medication you carry, rest solely with the U.S. authorities.