What goes in your suitcase is mostly a medicines question, and it is less fraught than it looks. Tick what you’d otherwise pack below and we’ll turn it into the one list you hand your doctor. The clothes, the plug adapters and the customs rules follow.
The real cost gap isn’t the paracetamol. It’s the system around it. Any antibiotic in the US means a doctor’s appointment first, which costs $100 to $200 without insurance, plus a pharmacy trip. At home it’s ₹80 at your chemist. That is why a documented 90-day supply of whatever you take daily matters far more than any over-the-counter item you’re thinking of packing.
Customs, in six rules
You don’t need to be nervous about this part. Medicine that is declared and documented almost never causes a problem at the border. The trouble starts with what you didn’t declare, and everything below follows from that.
01
Declare everything
Declare all medication to CBP on arrival. A declared, documented packet almost never causes a problem. An undeclared one is where the trouble starts.
02
Original packaging only
Don’t bring loose strips in a ziplock or unlabelled pill boxes. The box with the printed name on it is the point.
03
Paper, in English
Carry prescription copies and a doctor’s letter for anything past basic over-the-counter items. The letter should name the condition, the drug and the dosage.
04
90 days, and 50 units
Ninety days is the FDA’s allowance for medicine arriving with a foreign national. It is published policy rather than hard law, which is exactly why you keep the packet clean. Controlled medicines, like sleeping pills and codeine, are separate. Those have a hard cap of 50 dosage units in total, in the original pharmacy containers, under a rule called 21 CFR 1301.26.
05
Posting it later doesn’t work
The personal-use allowance applies at the border, with you present. Prescription drugs posted from India afterwards are routinely held at international mail facilities. Carry what you need rather than planning a top-up.
06
Legal at home isn’t importable
Your chemist selling it over the counter in India has no bearing at the US border. What protects you is the paperwork, not the purchase having been legal at home. Anything prescription-only in the US is strictly so.
Carry it or buy it there
Tick everything you’d otherwise pack. {{ g.otc.tag }}{{ g.otc.def }} means you can buy it off the shelf. {{ g.rx.tag }}{{ g.rx.def }} means a doctor first, every time.
THE MEDICINES KIT — TICK WHAT YOU’D PACK{{ medCount }}
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YOUR LISTHAND THIS TO YOUR DOCTOR
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Print this page and take the list to your doctor. The letter needs to be in English and name the condition, the drug and the dosage for each item.
CAUTION — REFILLS IN THE US
No US pharmacy can fill an Indian prescription. A US-licensed prescriber has to rewrite it, which is why the 90 days you carry is the plan and not the buffer. New-patient waits with a primary care doctor run around a month in big metros, so book that appointment in your first week rather than when the strip runs low. A telehealth visit (Sesame runs from $34) can rewrite common chronic meds the same day after reviewing your Indian prescription, and that is the backup rather than the plan. Do not count on it for controlled substances: most consumer platforms will not prescribe them to new patients. Generics are cheap even uninsured, with metformin around $7 and atorvastatin around $7.50 for a 30-day fill on a free GoodRx coupon.
spend your last month at the dentist
Finish any dental work and get an eye test in India before you fly. Both are expensive and slow here, and neither is covered the way you’d expect. Carry a spare pair of spectacles and your lens prescription, because replacing frames on a US high street costs more than the flight home would suggest.
Clothes for a city with five climates
Summer here is the cold, foggy season, and it catches every July arrival by surprise. You don’t need a new wardrobe for it. You need layers and one good jacket.
ONE JULY AFTERNOON, TWO NEIGHBOURHOODS20 MIN APART
52°F
OCEAN BEACH
IN WIND
65°F
THE MISSION
40°FTHE YEAR-ROUND BAND, MID-40s TO LOW-70s80°F
Thirteen degrees apart, on the same afternoon, twenty minutes’ drive from each other. The local rule is to dress for the coldest neighbourhood you’ll pass through, then shed layers as you head east.
The one purchase worth making before you fly is a windproof, water-resistant shell with a hood. It is the SF uniform, and you will wear it more than anything else you own. Skip the umbrella entirely. The wind here destroys them, so let the hood do that job.
Leave the Delhi-winter parka. It never gets cold enough to justify the suitcase space. It is also the wrong tool: the problem here is wind and damp at 52°F, not dry cold at 4°C.
THE CLOTHES LIST9 LINES
t-shirts and base layers
2 or 3 sweaters or fleeces
one windproof, water-resistant shell
one light down jacket
jeans and chinos
walking shoes you can do hills in
one smart-casual outfit
one set of Indian formalwear, for weddings and Diwali
a beanie
The rest of the bag
FOUR THINGS THAT EARN THEIR WEIGHT
The documents folder, on paper
Passport and visa, prescriptions, degree certificates, bank statements, India rental references, and six to eight passport photos. Photograph all of it into the cloud as well.
Three or four plug adapters
Indian Type D and M plugs do not fit US Type A and B sockets. Laptop and phone chargers are dual-voltage and fine. Anything 220V-only, meaning the mixer, hair dryer and iron, is not: leave them.
The kitchen shortlist
A stovetop pressure cooker if you cook Indian daily, a masala dabba, and spare gaskets. An Instant Pot bought there is the alternative if you would rather not carry it.
Food, declared
Sealed, commercially packaged spices and snacks are generally fine, and you declare all of it on the customs form. No fresh produce, seeds, meat or dairy. Khoya and homemade milk sweets are the risky ones.
What not to bring
CAUTION — CONTROLLED SUBSTANCES
Codeine-containing cough syrups, tramadol, and sleeping pills, unless you have complete paperwork. These carry a hard cap of 50 dosage units, and this is the one category with real seizure risk, where getting it wrong costs you more than the medicine. Worth knowing both halves: the Corex DX sold in India today is dextromethorphan-based rather than codeine, and no over-the-counter codeine syrup exists in the US in any form. If you genuinely need one of these, that is a conversation with your doctor about documentation, not a packing decision.
ALSO LEAVE BEHIND
Bulk antibiotics for friends
Quantities past personal use read as importation rather than as a favour.
220V appliances and heavy bedding
SF flats are small and Costco is cheap. A suitcase of clothes you will not wear is the most common packing mistake.
Loose unlabelled ayurvedic powders
They are legal in small amounts, but they are also a reliable way to invite an inspection delay you did not need.
What to do now
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