July 29, 2009

• Bring everything that you will need. Do not assume that you can obtain your medication or any related products (e.g., medication administration equipment, testing supplies, etc.) in a foreign country. Keep in mind that shipping medical supplies overseas is generally not a viable option.
  
  
• Bring extras. I generally travel with two to three times the supplies I anticipate actually using. On more than one occasion, medications and medical supplies have gotten lost or broken or I have ended up needing more than I originally expected.
  
  
• Do your homework before traveling. Talk to your doctor about possible issues and back-up plans. Are there any substitute medications that would suffice? Would your medication be available in the country to which you are traveling? Is it called something different overseas?  Also, consider temporary alternative medications (or means of medication administration) while traveling. For example, preloaded, injectable medication pens can reduce sharps disposal and ease concerns over traveling with syringes. Some medications (like hormone treatments and some migraine medications) are available in several forms: injections, tablets, nasal spray, patches, etc; generally speaking, traveling with pills is easiest.  
  
  
• Consider storage and handling requirements. Is the medication sensitive to light? Does it require refrigeration? How tolerant is it of temperature extremes? I often travel with my insulin in a hard-sided lunchbox-size cooler. This not only protects the glass vials from being knocked around, but also offers some temperature control. Of course, I have to then find things with which to keep the cooler cold.
  
  
• Transport medications in the original packaging, especially if it displays the prescription. Repackaging medications into unlabeled containers nearly guarantees problems at security checks.
  
  
• Pack duplicate medications in both carry-on luggage and checked baggage. You should carry medications while en route for obvious reasons; however, there are also other considerations. Carry-on liquid restrictions in recent years have made traveling with large quantities of medications more difficult. In addition, it simply may not be logistically feasible to pack all medications in carry-on luggage (for me, a three-week supply of medications would take up almost my entire backpack). Another consideration is the effect of x-ray screening on medications. In the case of insulin, there is currently some debate over whether such exposure damages the medication, although studies conducted by drug manufacturers suggest that x-ray screening should have no effect. There are also concerns about packing medications in checked-luggage. For one, baggage handlers are not known to be gentle and there is some risk of items being broken or stolen. Also, keep in mind that there is no climate-control in the cargo-hold of an airplane and temperatures could easily drop well below freezing. The redundancy of packing medications in both carry-on and checked luggage reduces the chance of being affected by these issues.
  
  
• Be conscientious to changing conditions brought on by travel. Adjustments may be needed as time-zones, activity level, food, and other life-style factors change. Also, consider whether medications that you may be taking specifically for traveling (such as malaria chemo-prophylaxis or seasickness) interact with other treatments.

Prior planning and careful consideration of the situation are the keys to successfully traveling with medications. Expect issues to arise and plan accordingly. The good news is that, with a little forethought, most of these challenges can be overcome. I have been very fortunate to travel the world, albeit with a cooler of insulin in hand.

By Robin Nesbeda