Travelling with a pen

The one rule that prevents most disasters

The medicine travels with you, in the bag that stays on your body. Not in the hold, not in the boot at a service station, not in a friend's rucksack. Hold luggage goes missing, and hold temperatures on some aircraft and in some cargo areas swing well outside anything a peptide is happy with. Noor, who runs our travel circle and has done this on four continents, says every genuinely bad story she has heard began with a pen in a suitcase.

The second rule is redundancy. Split your supply if you can — some with you, some with a travelling companion, or two separate insulated pouches in two different bags you are carrying. Members who travel for work do this as a matter of course after the first time a bag went to a different city.

The third is paperwork. Keep the medicine in its original carton with the pharmacy label attached. That label, with your name on it, is what turns an unexplained injectable into an obviously legitimate prescription in the eyes of a security officer or a customs official. Loose pens in a wash bag are the version that causes questions.

None of this is exotic. People have been flying with insulin for decades and the systems are built for it — you are walking a well-trodden path, even if it is your first time.

Keeping it cold on the move

For a day trip or a short domestic hop, most products tolerate ordinary room temperature for far longer than the journey lasts — but check your own leaflet, since in-use and unopened windows differ.

For anything longer, an insulated medical wallet is the standard answer. Two kinds exist. Gel-pack wallets need a fridge or freezer at some point to recharge, which is fine for hotels and hopeless for camping. Evaporative wallets, the ones you soak in water, hold a cool temperature for days without any power at all and are the favourite among members doing long or off-grid trips — Rowan crossed Spain in August with one and arrived with everything intact.

Whatever you use, the medicine should not sit in direct contact with a frozen block. Wrap it, or use the sleeve the wallet came with. A pen against a freezer pack is a freezing risk, and freezing is the one failure that cannot be recovered.

Two things to avoid: dry ice, which airlines restrict and which is far too cold anyway, and the aeroplane's own cabin fridge, which crew are usually not permitted to use for passenger medication and which nobody will accept responsibility for. Keep it with you.

At the other end, ask the hotel for a proper fridge rather than trusting a minibar. See what goes in your fridge and what does not for why minibars are so often useless.

Airport security, without the anxiety

Injectable medicines, needles and cool packs are permitted in hand luggage. The rules are written for people who need medication and security officers see this daily.

What helps, in practice: keep everything in one clear bag you can lift out in a single movement, keep the pharmacy label visible, and say plainly at the start of the screening that you are carrying prescribed injectable medication and a cool pack. Members overwhelmingly report that volunteering it up front makes the whole thing a ten-second conversation.

Liquids over the usual limit are allowed when they are medicines, but they may be screened separately, and in some airports gel packs get tested. Bring more time than you think you need for the first trip.

On whether to let the pens go through the X-ray: most manufacturers say ordinary security scanners have not been shown to damage their products, and huge numbers of people fly with insulin and GLP-1 pens through scanners every day without incident. If you would rather ask for a visual inspection, you are entitled to ask, and it is not a fuss. Both choices are reasonable.

A letter from your prescriber, or a printed copy of the prescription, costs nothing to carry and occasionally saves a great deal of trouble at a land border or a smaller airport. Ask for one at your next appointment rather than the week you fly.

Borders, time zones and injection day

Countries differ, sometimes sharply, on what you may bring in. Some require a doctor's letter for any injectable, some limit quantities to a stated number of days' supply, and a few have restrictions that will genuinely surprise you. The reliable move is to check the destination country's own official guidance for travellers carrying medicines, and to do it a fortnight ahead rather than the night before. Members in our travel and holidays circle have compiled a lot of this between them, and someone has usually already been where you are going.

Within the EU, carrying prescribed medicine for personal use across internal borders is generally straightforward, and there is a certificate process for controlled medicines that does not usually apply to GLP-1 products. Between the UK and Ireland, and within Australia and Canada, members report almost no difficulty when the pharmacy label and carton are intact. The US is generally comfortable with medicines carried for personal use with documentation; the friction there is more often about supply than about entry.

Time zones are the question we get most. The honest answer is that we do not give dose-timing advice, because your product, your schedule and your prescriber's view all matter and none of them are visible to us. What we will say is that this is a question worth asking in advance, and that pharmacists answer it well. Ask before you book, not from a departure lounge.

When something goes wrong away from home

A bag goes missing. This is why you split the supply. If you did not, contact a pharmacy locally — in most of Europe, Canada and Australia a pharmacist can advise and often liaise with a local prescriber, though a foreign prescription is rarely dispensed directly. Travel insurance sometimes covers emergency replacement of prescribed medicines, and it is worth knowing whether yours does before you need it.

It gets warm. Record what happened and how long, then ring your usual pharmacy at home for advice rather than deciding alone. Storage and the cold chain has more on excursions.

You miss the day. It happens on holiday more than anywhere else. What to do if you miss a dose covers it, and the short version is: consult your leaflet, do not double up, and ask rather than improvise.

Used needles. Take a small travel sharps container, or ask a local pharmacy — most countries have some route. Never loose in a bin, a hotel drawer, or your luggage. Sharps disposal has the regional detail.

Symptoms flare. Long flights, heat, unfamiliar food and disrupted routine are a lot at once. Take whatever you normally use for nausea and constipation, because finding an equivalent in an unfamiliar pharmacy while feeling awful is nobody's idea of a holiday.

The part that is not logistics

Travel puts these medicines into contact with everything social about eating — long meals, other people's hospitality, hours between food, a heat that kills appetite entirely. Members frequently report that the trip they dreaded went fine and the thing that caught them out was a four-hour family lunch on day three.

Two practical kindnesses. Carry something you know you can eat, so that a bad appetite day away from home does not turn into a day of nothing. And decide beforehand what you are telling your travelling companions, because doing it in the moment while somebody asks why you are not drinking is much harder.

Holidays and family meals and dining out without dread are the two guides members reread before a trip, and the travel and holidays circle is quietly one of the most useful places on this site for the fortnight before you go.

And do go. Sam spent a year turning down trips because of the logistics and now takes an evaporative wallet to work conferences without a second thought. The first trip is the hard one.