In previous blogs, I’ve discussed how to help your parents pack their medications and medical devices (such as oxygen) and what to do if your prescriptions are lost or stolen while on the road. However, I’ve yet to tackle how to handle traveling with medication that requires refrigeration (e.g. if your parent suffers from rheumatoid arthritis, certain prescriptions may fall into this category). Your first thought may be that you have to remain within a certain radius as your parent cannot be far from home (and their refrigerator).

Oh contraire! With a little bit of planning, you’ll be off on a cross-country adventure (or boarding that flight to Bali!).

The main thing you’ll need when travelling with medication that require refrigeration is a travel cooler specifically designed to keep ice from melting for long periods of time. This is not a cooler you buy at CVS to take on a picnic! This is a specially designed medical cooler that can maintain temperatures for up to 6 hours. Whoever provides your parent’s medicine may be able to provide the proper cooler free of charge or at the very least, they will be able to provide a recommendation on where to find the correct make/model for your impending adventure.

Before climbing in the car or heading to the airport, pack the dosages you’ll need while traveling (plus two days’ extra to account for any delays), one or two ice or gel packs (check the directions for proper quantity as specified by the drug’s manufacturer) and Ziploc baggies.

If you’re flying to your destination, do not pack your medication in your checked luggage as the baggage hold on planes is not temperature controlled (and thus gets very cold when you’re at altitude, potentially freezing your medication). The TSA allows passengers to bring medically necessary liquids through security although you’ll need a prescription stating such. Ice and/or gel packs are also allowed if your medicine requires refrigeration. Medically necessary liquids are not limited to 3.4 ounces and do not have to be stuffed into a Ziploc bag (as other non-medicinal liquids require) although the TSA typically requires the medicines to be in a separate container.

Be prepared for the TSA agents to look inside the cooler and declare the medicines before sending it through the x-ray machine (it will make it much quicker to get through for you and your parent). It is critical to carry the original box showing the doctor’s prescription with you as the agent will typically scrutinize any liquid medications you’re carrying (and if you’re going to a foreign country, they will also look closely before allowing you to enter). If your medication requires syringes to administer the dosage, you’ll also need the prescription as well as a sharps-disposable container (which you can also get through the supplier). If you have any questions, check out the TSA’s website (www.tsa.gov/traveler-information/medically-necessary-liquids-gels-and-aerosols) for additional details.

If you’re on a long haul flight, speak with the flight attendant as you get on the plane about restocking your travel cooler with ice or using their on-board refrigerator. If traveling by Amtrak or other rail service, they may also have a refrigerator you can use although be sure and ask if you can access your medications whenever needed (in case the kitchen car closes in the wee hours). If you’ll be using a carrier’s refrigerator, be sure and label your medications and set an alarm on your watch or phone to ensure you don’t leave them when you get disembark!

When booking a hotel, ask about the availability of in-room refrigerators that you can actually put stuff in (vs. merely taking out their pre-stocked beverages). If they do not offer one in-room, ask about renting one for the duration of your stay or as a last resort, you can also inquire about using their refrigerator. If you use the hotel’s refrigerator, check to make sure it doesn’t get too cold (as many are set for very low temperatures to counter for the door being opened more frequently). Also clearly label the container with your name and contact information (and room # if this is the only hotel you’ll be staying in). It may be worthwhile to attach first-aid stickers on the outside to ensure anyone who comes across your package knows it’s medicine and not to be touched!

In many hotels in Europe and Asia, when you enter a room, you’re required to put your room key in a slot to turn on the electricity. Even if you leave a key in while you’re out sightseeing, as a normal course of cleaning the room, the hotel staff will typically take the key out of the slot (thus turning off the electricity to the room). To ensure your medications are never without temperature control, you may want to use the hotels’ fridge while you’re out and about during the day.

If you’re hotel does not have a fridge, just continue to refresh the ice in the cooler using the Ziploc baggies you placed in there on the day of your departure. Even if you’re driving cross-country by car, most gas stations or convenience marts will have ice that will allow you to refill your travel cooler.

Storing a medication that requires refrigeration at a temperature outside of the specified range can have a number of consequences, including reduced shelf-life of the medicine, loss of physical integrity (e.g., suppositories melt), and partial or total loss of the effectiveness of the medicine. However, with a little pre-planning, it’s easily accomplished and you can go about anywhere (as long as they have electricity and can freeze ice!).