Saturday 9 July 2011

Traveling From California to Australia With Humira

I recently traveled from San Francisco, California to Sydney, Australia with 2 Humira injections. When I decided to make the trip I searched around on the web for information on how to keep the medicine in the recommended temperature range throughout a journey this long and didn't find any guidelines that were specific enough, so I came up with my own guidelines. Now that my journey is complete I'd like to share them in the hopes that they will be useful to others.


I should mention up front that Abbott Labs has a hotline you can can call to speak to a nurse about traveling with Humira. The nurse I spoke to was super helpful and emailed me a pdf with guidelines for keeping the medicine cool, but the guidelines just weren't specific enough for someone taking a 14.5 hour plane ride with a few hours of travel/airport waiting on either side.


First, some disclaimers.  I'm not a doctor, or a pharmacist, or someone who understands how Humira works. I have no affiliation with Abbott Labs (the company that makes Humira) or the companies that manufacture or sell the products I used to keep Humira cool during my journey. I was going to sign up for some ads to run alongside this blog to see if a few nickels landed in my account but my wife said I shouldn't profit from sick people and she's (almost) always right, so no ads. In short, I stand to gain nothing from this. I'm just trying to help out other people who need to travel a long way with medicine that needs to stay very cold. I can't promise these steps will work for you.


The first thing I did was order a Medication Cooler Kit and a Wireless Thermometer from Amazon. The cooler came with 2 Techni Ice reusable ice packs, a sealable tupperware container large enough to contain the box with my 2 Humira injections, and a couple foam inserts to separate the ice packs from the tupperware container. In the weeks leading up to my trip I did about 10 test runs with this equipment but without the medicine and ultimately settled on the following steps:

  • I froze the ice packs in my freezer at -2ºF for 24 hours prior to my departure.
  • I had my Humira in the refrigerator at 40ºF for 24 hours prior to my departure.
  • When it was time to leave for the airport I placed the Humira in the room-temperature tupperware container (about 65ºF) along with the wireless thermometer sensor, and sealed the lid. I placed one Techni Ice pack on the bottom of the cooler, placed a foam insert on top, placed the tupperware container on top of the foam insert, placed another foam insert on top of the tupperware container, placed the second Techni Ice pack on top of the foam insert, and zipped up the cooler.
    • Note that I did not have the tupperware container in the refrigerator before I left. I tried this during one of my test runs and saw that the temperature inside the tupperware container dropped too low (32ºF) during the first hour in the cooler if I did this.
  • I grabbed 5 quart-size, sealable ziploc baggies and headed for the airport. The temperature in the cooler dropped down to 37ºF within about an hour.
  • At the airport I told the TSA officer that I was traveling with refrigerated medication and they sent it through the screening machine without asking me to open anything up. I had a doctor's note with me but nobody ever asked to see it. I brought the cooler on the plane as a carry-on "personal item" and stowed it in the overhead bin.
  • During my test runs, the cooler would stay in the recommended temperature range for about 10 hours before getting too warm. This is approximately how long it stayed in the recommended range on the plane, but I'd suggest starting to check the wireless thermometer regularly after about 8 hours just to be safe.
  • When the temperature reading indicated that the cooler was almost too warm I took one of my ziploc baggies back to the galley, told a flight attendant that I was trying to keep some medicine cold, and asked for some ice. He happily obliged. Normally I like to pretend that I'm the healthiest person on earth (even though I'm clearly not), but I recommend specifically saying that you're trying to keep medicine cool - it makes it much less likely that you're going to have an issue getting what you want.
  • With my baggie full of ice in hand I went back to my seat, quickly opened the cooler, put the bag of ice in, closed it, and stuffed it back in the overhead bin.
  • Here's where things on the plane behaved differently from all my test runs. At home, adding a 1 quart ziploc baggie filled with ice brought the temperature of the cooler back down to 37ºF within about 30 minutes and kept the cooler within the recommended temperature range for another 4 hours. On the plane, adding the baggie full of ice didn't change the temperature, and neither did the second baggie full of ice. I needed to add 3 baggies of ice underneath the top Techni Ice pack to get the temperature heading south again! Why? I can't say. I'm guessing the ice from the galley on the plane isn't as cold as the ice from my freezer. Anyway, this is why the extra baggies and the wireless thermometer are both super important.
  • The 3 baggies of ice were enough to keep things cool enough for the remainder of my journey.  Fridge to fridge my journey was 19 hours.
As I said before, I can't promise this will work for you but it did work for me. Whatever your approach, make sure you do a bunch of test runs in advance so you're comfortable with the equipment, so you know what to expect, and so you don't freak out if things behave a bit differently in the air. Good luck, and stay healthy!

Big thanks to the fine people who make Polar Bear Coolers.  Great product!  And even bigger thanks to the big brains at Abbott Labs.  Traveling with Humira is a hassle, but without Humira there's no way I'd have been healthy enough to take this trip in the first place so it's definitely worth the hassle.

27 comments:

  1. Extremely helpful, thank you.
    How many were you able to store in the Large cooler? Did you find that that was plenty of room, or just enough?

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    Replies
    1. I get Humira in boxes containing 2 doses. The plastic tupperware that goes inside the Large cooler is big enough to contain 2 boxes, so a total of 4 doses. If you take the injections out of the Humira box I'm sure you could fit quite a few more.

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  2. Thank you so much for this information. I now find myself taking Humira for my Crohn's Disease and was in need of safe traveling methods. After I called Abbot for information I realized 10 degrees of variance wasn't much play room and I needed to get serious about find a viable/unfailable solution.

    Your blog post not only saved me a ton of time, but it made me so confident in your advice that I immediately managed to find the product online (your old link is no longer selling on amazon, but I found the equivalent of it on Polar Bear website. http://www.polarbearcoolers.com/med/mdm-med-cooler.html I also got the same thermometer off Amazon.

    PS: I chuckled at the part you wrote about always wanting to "appear" as someone who is 100% healthy (when requesting the ice)... I suppose we all are a like in that regard. I do agree with you, honesty and humility for important things is usually the best way to evoke positive reaction in others.

    Thank you so much for posting this information for all the Humira users out there. I wish you continued health and safe travels!

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    Replies
    1. Thanks for posting an updated link for the cooler!

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  3. Thank you for your thorough and detailed post. I was anxious about traveling with my son's Humira on a recent 10 hour flight. Thankfully, I found your post. I ended up following your suggestions--including using the same cooler and thermometer--and it worked out perfectly. We actually didn't even need to add any ice during the flight, but were thankful we brought baggies in case we did.

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  4. Thank you! I am just starting Humira and I was curious about how it would work to travel, so this was very helpful!

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  5. Thank you for your thoughts! My son is traveling to Russia in 2 months and will be taking one dose with him ... Unfortunately, he and his group will be 'traveling around' for a week before he needs to get the dose --so it could be cumbersome to keep up with the temp --but this is VERY helpful!

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  6. Thank you so much for this post!! My husband was just diagnosed with psoriatic arthritis, and has received his first dose of Humira. We have some travels planned this summer and this is very helpful information. It sounds like you are very positive about taking this medication, which is encouraging to us as well. Continued good health to you!

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  7. I can recommend the Medactiv iCool Prestige bag when travelling with Humira.
    www.medactiv.com.au

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  8. Thank you very much, am travelling from Venezuela to France in September, i'll let you know how it goes

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  9. If you want to travel with more medication, there is no question that you should use the iCool MediCube. The cavity inside is much bigger and you can then easily put many pens inside, and it will really keep them between 2 and 8°C for and incredible 36 hours.
    The only drawback of the MediCube is that it is much bigger than the Medactiv iCool Prestige and measures 20 x 20 x 20 cm, but apart from that it is a perfect product for traveling with Humira.

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  10. Hi,

    I have recently started taking humira for crohns. The help line advised me that they have recently changed the guide lines for traveling with humira and suggest that it can be kept unrefrigerated for up to 2 weeks as long as it is kept at a temperature below 20 degrees celcius.

    I cant see this on their website, so best to check for yourself before doing so if you are traveling.

    Thanks,

    Enda

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  11. Hi! Do you have any information whether it's ok for Humira to go through the x-ray machine? I'm wondering if it can be negatively affected by the radiation.

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    Replies
    1. I sent mine through the x-ray machine, used it, and didn't get sick. That's hardly proof though. :-)

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  12. thanks so much for all the information. Did you ask if the airline would put your Humira in the refrigerator? I'm traveling to France (from Oregon) in September and with your help I think I'll be able to do this

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    Replies
    1. I did not ask the airline to put it in their fridge because I wanted to be in control of the temp (some fridges can get way too cold).

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  13. Thanks for this! I'd be afraid to put it in their fridge on the plane, because I might forget it there! I came across this post because I injected myself today but left the 2nd injection in the box outside the fridge for 2 hours, house is around 25c / 77f . The pharmacists always give me ice and check I'm going straight home so I was worried the 2nd syringe might be spoiled but now I'm thinking that it should still be okay to inject in 2 weeks (I put it straight back in fridge) - would you agree?

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  14. Hi Leonie,

    I'm not a doctor or a pharmacist so I really can't give you this kind of advice. I recommend you call the Humira support line to ask this question. They have nurses on staff that should be able to help you.

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  15. Our travel experience with keeping it at temperature for almost a week!

    Thank you for this very helpful advice. We started with the ice packs in our deep freeze (-5F). Our injectables were placed inside a quart ziplock back together with the wireless transmitter. After 6 test runs, we found we were able to keep the product cool for up to 36 hours, by keeping it between two freezer packs in the travel bag recommended above (but with a separately purchased wireless thermometer). For our final travel, we put three or four ice packs in the Humira provided zipper bag, and wrapped both bags in a cut up Walmart frozen food bag (about $3). All this was carried in a 30" carry-on bag.

    Two hours travel from home to the airport, and Our flight from Atlanta to Rome had one connection. No problems with security or TSA, and upon arrival we boarded a train with a couple connections to Florence italy. At the 30 hour point the temp inside the bag was still in the range, and on arrival at our hotel we had a "mini bar" fridge. Now here's the key: we emptied the mini bar fridge, and put our two zippered bags (one with the injections and two ice packs, plus the Humira bag with extra ice), and closed the door and kept it closed. We could still monitor the temp using the wireless. Four days later, the temp was still the same. The insulation of the mini bar fridge, kept our medicine at the same temp, almost indefinitely! That morning (5th day) we swapped ice packs around to put the coldest on the injectables and continued on our way.

    So, keep things wrapped, keep them cold and the more insulation you can put around it, and keeping the door closed, will keep your meds colder longer. We probably could do this more efficiently by finding a newer technology rigid cooler, but long term travel will probably require a portable freezer or reliable fridge.

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  16. Hi, I have Ankylosing Spondylitis and take Humira for this, I travel all over the world with my job and found the cool packs/bags and cool boxes not very good!! My problem is waiting time and problems with fridges at work destinations, I purchased a Nomad cool box with thermometer built in, this is good but still it causes concerns for me when I finally arive because I can never be sure they will have a fridge at the work place, So I have gone and spent £300 uk pounds!! On a Dison bc1500a.... This is a powered cooler box that runs on its own battery and also 12volt or household mains power, I also fill it with ice packs so it is not working too hard and wasting its battery power!! This machine works well for me and very pleased with it because I can simply plug it into the mains if they have no fridge for my medication. The downside is the cost !!
    Hope this helps as I was in the same position as a lot of others trying to find advice!!

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    Replies
    1. Hi Woody. I also have AS and take Humira. Any more info about how you got on with the Nomad cool box? I'm going to be travelling for about 30 hours and wondering if this will do the job. There will be a fridge when I get there so that helps. Thanks for the info!

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  17. Thanks a lot for sharing this information! I live in Argentina and I will have a long flight to Europe. I was worried and I had started doing tests at home with a telgopor box. I'm glad there is a solution that has worked before!!! Thanks again!!!!

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  18. Thank you so much a great help

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  19. We are headed to Australia and I was curious if you had any problem declaring it when you arrived? Did you have to take any special steps to take it into the country or were you allowed to walk right in?

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    Replies
    1. This was 8 years ago so it's possible things have changed, but in 2011 I didn't do anything special to bring the medicine in.

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