Bringing extra Epipens

[brillohead]

8 hours ago, Joseph2017China said:

Also, you can bring medicine not in the original package, but is it the recommended way?  No way.

Actually, Epipens are DESIGNED to be carried without the box -- they have their own carrying case.  So, yes way.

[Robinhill]

On 6/30/2019 at 2:22 PM, Cecilia V. said:

I will be travelling with my two daughters who have severe food allergies.  We will have Epipens in our carry-ons.

 

However, I want to bring extra Epipens.  I plan to pack several extra packs in my checked luggage; is this okay?  I don't know if Royal Caribbean goes through our luggage, but I am assuming that they would not have a problem with Epipens in our suitcases.  Is that correct?  Would it matter if the Epipens are not in their original boxes?  We don't always keep the boxes.

 

Thank you for your help.

we always take extra epipens and have never had a problem or been asked about it

[Cecilia V.]

9 minutes ago, Robinhill said:

we always take extra epipens and have never had a problem or been asked about it

Do you take the extra ones in your checked luggage?

[MaskedTurtle]

Do we still need a note from a physician if we have any injectable meds?  

[boscobeans]

On 6/30/2019 at 4:28 PM, the_dylaness said:

Check with pharmacy to see if there are temperature restrictions on epinephrine—- freezing cold on a plane or roasting hot waiting to get on the ship seems like could potentially make it less effective although I do not know this to be true. Better safe than sorry.

 

The units should be stored in the carrier tube provided at a temperature of 20-25 °C (68-77 °F); however, temperature swings between 15-30 ºC (59-86 ºF) are permitted.

 

[brillohead]

4 hours ago, MaskedTurtle said:

Do we still need a note from a physician if we have any injectable meds?  

If it's an obvious medication (like a labeled vial or a preloaded pen or syringe that is labeled as such), you shouldn't need any note from a physician.  

If it looks like heroin and you also have a spoon and a dirty syringe, you're more likely to have an issue.  But actual medications that are properly labeled are no problem -- they see all kinds of insulin and the like on a regular basis.

[Snit13]

On 6/30/2019 at 2:54 PM, Croozin Soozin said:

I would never pack anything important in luggage that I don’t have complete control over.   I’m not sure why you would want to do that and take a chance on your luggage being lost or stolen.  Small chance, but I’ve read stories recently about things happening. And on my last cruise somebody had their luggage misplaced and notices went to all cabins in an effort to find it.   Your carryon would be the proper place for medication and anything else of value. 

Spoke with a lady whose luggage was dropped in water as it was being loaded by porters/loaders onto the ship.  Luggage went sailing away and never made it to ship.  Would never pack anything of value into checked luggage.

[waterbug123]

On 6/30/2019 at 2:47 PM, Cecilia V. said:

I do plan to carry plenty in my carry-on.  I would also like some in my checked luggage.

 

I guess I don't understand why you would take a risk, even a small one, with something that is potentially the difference between life and death, rather than just taking ALL of them in your carry on.   Scratching my head over that one...

[waterbug123]

On 6/30/2019 at 2:47 PM, Cecilia V. said:

I do plan to carry plenty in my carry-on.  I would also like some in my checked luggage.

 

I guess I don't understand why you would take a risk, even a small one, with something that is potentially the difference between life and death, rather than just taking ALL of them in your carry on.   Scratching my head over that one...

[waterbug123]

On 6/30/2019 at 2:47 PM, Cecilia V. said:

I do plan to carry plenty in my carry-on.  I would also like some in my checked luggage.

 

I guess I don't understand why you would take a risk, even a small one, with something that is potentially the difference between life and death, rather than just taking ALL of them in your carry on.   Scratching my head over that one...

[Cecilia V.]

Waterbug, I wouldn't be taking a risk at all--as stated, I had PLENTY in my carry-on.  I just wanted to be extra-safe and carry a few more in packed luggage.

[cruisinfanatic]

31 minutes ago, Cecilia V. said:

Waterbug, I wouldn't be taking a risk at all--as stated, I had PLENTY in my carry-on.  I just wanted to be extra-safe and carry a few more in packed luggage.

If there is no risk, why would you bring them? I would never check any drug

[sparks1093]

3 hours ago, Cecilia V. said:

Waterbug, I wouldn't be taking a risk at all--as stated, I had PLENTY in my carry-on.  I just wanted to be extra-safe and carry a few more in packed luggage.

There's a limit on how many can be used before you need serious medical attention. My wife had two administered by the hospital after she had a reaction to the contrast dye they used for a scan. When they thought she was stable they sent her home and half way there we diverted to the ER at another hospital because she was having trouble breathing again. They administered more drugs and were very concerned because of her heart rate and they admitted her to the ICU for the night. She was fine by the next morning but too much adrenaline isn't a good thing.

[brillohead]

12 hours ago, waterbug123 said:

 

I guess I don't understand why you would take a risk, even a small one, with something that is potentially the difference between life and death, rather than just taking ALL of them in your carry on.   Scratching my head over that one...

For someone who carries Epi, it truly is the difference between life or death. 

I can give an excellent reason for having some in the checked bag and some in the carry-on:  What happens if the carry-on bag gets stolen (or even misplaced)????  

There have been times when carry-on luggage gets put in the overhead bin in a plane, and it's not near the passenger because the bins were already full near their seat, and when the passenger finally goes to retrieve their bag, it's nowhere to be found -- another passenger either stole it or took it by mistake and the bag is GONE.  

Or a bag gets stolen at a hotel, or restaurant, or forgotten in a cab, or whatever.  

If there are BACKUP Epipens in the checked baggage, then the passenger's LIFE OR DEATH situation is still covered in case of emergency, because they still have Epi at their disposal if needed.  

Trust me, people who depend on an Epipen to be able to move about in society to the point that they want to bring extra back-up pens with them, those folks probably know what they are doing...  

[waterbug123]

14 hours ago, cruisinfanatic said:

If there is no risk, why would you bring them? I would never check any drug

 

12 hours ago, sparks1093 said:

There's a limit on how many can be used before you need serious medical attention

 

Exactly.  It's not like you just keep administering them one after another, so I while there may be no particular risk to taking extras in a checked bag if you already have several in a carry on, there's also no real benefit to having that many with you.  If it got to that point you'd already be in the ER somewhere.

 

3 hours ago, brillohead said:

For someone who carries Epi, it truly is the difference between life or death. 

I can give an excellent reason for having some in the checked bag and some in the carry-on:  What happens if the carry-on bag gets stolen (or even misplaced)????  

There have been times when carry-on luggage gets put in the overhead bin in a plane, and it's not near the passenger because the bins were already full near their seat, and when the passenger finally goes to retrieve their bag, it's nowhere to be found -- another passenger either stole it or took it by mistake and the bag is GONE.  

Or a bag gets stolen at a hotel, or restaurant, or forgotten in a cab, or whatever.  

If there are BACKUP Epipens in the checked baggage, then the passenger's LIFE OR DEATH situation is still covered in case of emergency, because they still have Epi at their disposal if needed.  

Trust me, people who depend on an Epipen to be able to move about in society to the point that they want to bring extra back-up pens with them, those folks probably know what they are doing...  

 

Well first of all, I carry an epi-pen myself, so you can count me among those who "know what they are doing."  And my epi-pen stays in my personal item under the seat in front of me; it never goes in a suitcase in the overhead for all the reasons you mentioned.  Once you're on the ground, you can certainly divide up the multiple epi-pens into multiple bags for the remainder of your trip, so no real reason to worry about a bag being left in a restaurant, forgotten in a cab, or whatever.  If the prior poster wants to carry a a bunch of extras in her checked bag, she can, I just didn't see the point and still don't.  For plane travel they are safest being carried on, and in the personal item that you keep at your seat. 

 

[brillohead]

10 minutes ago, waterbug123 said:

Exactly.  It's not like you just keep administering them one after another, so I while there may be no particular risk to taking extras in a checked bag if you already have several in a carry on, there's also no real benefit to having that many with you.  If it got to that point you'd already be in the ER somewhere.

I don't think the "bringing extra" is so that they can inject ten at a time.... it's so they have access to more later in the vacation if they use some earlier in the vacation.  

Not everyplace a cruise visits is going to have a pharmacy that is open and able to dispense Epipens while you're there.  Bringing your own back-ups just makes sense.  

[sparks1093]

7 hours ago, brillohead said:

I don't think the "bringing extra" is so that they can inject ten at a time.... it's so they have access to more later in the vacation if they use some earlier in the vacation.  

Not everyplace a cruise visits is going to have a pharmacy that is open and able to dispense Epipens while you're there.  Bringing your own back-ups just makes sense.  

DW has only needed to use her epipens once in all of the time that I've known her and I've recounted that incident, but I strongly suspect that if you have a reaction severe enough to use the epipen you will need to visit medical and once you've done that you'll be on your way home (BTW DW's allergen is shellfish). Someone can carry all of the extras they want if it makes them feel more secure of course but I'm not convinced that's it's all that practical.

[sparks1093]

Here's some info I found from www.epipen.com, I've added some bolding:

"Helping your patients be prepared with an anaphylaxis action plan is an important part of managing the risk of a life-threatening allergic reaction.¹

For your patients at increased risk, being prepared means¹:

• Avoiding known allergens
• Knowing what symptoms to watch for
• Using an EpiPen^® (epinephrine injection, USP) Auto-Injector (or its authorized generic) if a life-threatening (severe) allergic reaction occurs
• Getting emergency medical help right away

It is important to communicate to your patients that if they, their child or someone they’re caring for shows signs or symptoms of an anaphylactic reaction, they should inject EpiPen^® or EpiPen Jr^® (epinephrine injection, USP) Auto-Injector—or their authorized generics—immediately and seek emergency medical attention.^2,5

After administering an initial dose of epinephrine, the NIAID Expert Panel recommends transfer to an emergency facility for observation (4-6 hours or longer, depending on severity of the reaction) and possible further treatment.¹ More than two sequential doses of epinephrine should be administered only under direct medical supervision.^2,3"

[MaryCS62]

18 hours ago, brillohead said:

For someone who carries Epi, it truly is the difference between life or death. 

I can give an excellent reason for having some in the checked bag and some in the carry-on:  What happens if the carry-on bag gets stolen (or even misplaced)????  

There have been times when carry-on luggage gets put in the overhead bin in a plane, and it's not near the passenger because the bins were already full near their seat, and when the passenger finally goes to retrieve their bag, it's nowhere to be found -- another passenger either stole it or took it by mistake and the bag is GONE.  

Or a bag gets stolen at a hotel, or restaurant, or forgotten in a cab, or whatever.  

If there are BACKUP Epipens in the checked baggage, then the passenger's LIFE OR DEATH situation is still covered in case of emergency, because they still have Epi at their disposal if needed.  

Trust me, people who depend on an Epipen to be able to move about in society to the point that they want to bring extra back-up pens with them, those folks probably know what they are doing...  

Reminds me of the time we spent 12 days in SoCal (we live on the East coast)on vacation many years ago -- my oldest DD has epilepsy, & takes multiple medications for it.  Now, I always bring extra meds when we travel -- don't want to get stuck somewhere with an insufficient supply -- but DH still insists I went overboard.  I had a 6 week supply of her meds, split into 2 week supplies in 3 different carry-on bags -- plus a copy of her Rx's, just in case.....  

When we cruise, I always have enough for the cruise, plus an extra week's worth.  I'll put a 1 week's supply in her weekly medication holder that's in one bag (mine that I'm carrying), and the remainder in whichever carryon is assigned as our medical supply bag.  Good thing she's in a wheelchair, as we can then hang the extra bags off of it

[Guest maddycat]

On 6/30/2019 at 2:42 PM, cello56 said:

If it were me, I would pack your extra Epi-pens in your carry on luggage. What it something happened to your checked bag? While unlikely, it COULD happen and then you would be without the additional medication. They don't weigh much, so just pack them all together. 

I agree.  Why take the chance that something could happen to your checked luggage.

[brillohead]

14 hours ago, sparks1093 said:

DW has only needed to use her epipens once in all of the time that I've known her and I've recounted that incident, but I strongly suspect that if you have a reaction severe enough to use the epipen you will need to visit medical and once you've done that you'll be on your way home (BTW DW's allergen is shellfish). Someone can carry all of the extras they want if it makes them feel more secure of course but I'm not convinced that's it's all that practical.

This is the part I disagree with.  

Just having an anaphylactic reaction that is properly treated and recovered from is NOT a reason to leave a vacation in the middle.  

Not everyone who has an anaphylactic reaction that is promptly and correctly treated with Epi and other medications ends up admitted to the hospital -- in fact, I'd say that the exact OPPOSITE is true.  

If you're on the ship and experience a reaction that is recognized right away (some people know the split second they contact their allergen), then Epipen is administered immediately, the patient is transported to Medical and followed up with medications and monitoring, etc., as long as the patient responded to treatment with no problems, they can go on about their business.

The need for evacuation off the ship and disruption of the vacation would be for when the reaction is not recognized and treated right away, when the patient's condition becomes life-threatening, etc.  If you're feeling fine and breathing fine and not swelled up like the Stay Puft Marshmallow Man, there is no reason to head home after an allergic reaction.

Edited September 15, 2019 by brillohead

[cured]

Doesn't anyone carry a "medical bag" on the plane?  If the bag contains only medications and/or medical equipment, under US law, it cannot be counted as a carry on or a personal item and must be allowed to be carried on as a third bag without penalty.

 

I travel with a ton of injectibles (not insulin) that needs to be refrigerated.  I purchased a crew cooler from ebags.  I carry all my meds and travel cpap in it.  It is slightly larger than a lunch box, so even if the overhead is full, I can usually find some room to shove it in or it fits under the seat with my personal item.  But I can carry so much more in meds with room for emergency extras in their own bag rather than adding them to my carry on or personal item.  It might be another option for the OP rather than putting temp sensitive meds in the belly of the plane.  

 

I have this tag (front and back) on it: (Amazon)

[momofmab]

OP has clearly indicated that she plans to carry multiple Epi-Pens in her carry on, and just wants to bring additional pens in her checked suitcase.  All she is asking is whether RCI will "flag" the Epi-Pens in her checked bag - she is NOT asking for all these doomsday scenarios in which suitcases with Epi-Pens are floating away or somehow not making it on the ship.

 

OP- You are fine with this plan!  I have cruised multiple times over many years with my daughter's Epi-Pens in my carryon and checked bag and neither scenario has resulted in any flagging or questions about the pens.  They are clearly marked on their own, without the box, and no one has ever raised an eyebrow or denied boarding.

 

Have a great trip!

[sparks1093]

10 hours ago, brillohead said:

This is the part I disagree with.  

Just having an anaphylactic reaction that is properly treated and recovered from is NOT a reason to leave a vacation in the middle.  

Not everyone who has an anaphylactic reaction that is promptly and correctly treated with Epi and other medications ends up admitted to the hospital -- in fact, I'd say that the exact OPPOSITE is true.  

If you're on the ship and experience a reaction that is recognized right away (some people know the split second they contact their allergen), then Epipen is administered immediately, the patient is transported to Medical and followed up with medications and monitoring, etc., as long as the patient responded to treatment with no problems, they can go on about their business.

The need for evacuation off the ship and disruption of the vacation would be for when the reaction is not recognized and treated right away, when the patient's condition becomes life-threatening, etc.  If you're feeling fine and breathing fine and not swelled up like the Stay Puft Marshmallow Man, there is no reason to head home after an allergic reaction.

If you read my follow on post it provides a different picture of what treatment is required but at the end of the day the decision whether to stay onboard or not will be entirely up to the doctor onboard and the Captain, not the passenger. I've heard of people with lesser medical conditions being disembarked so it wouldn't surprise me at all that someone would be disembarked after using an EpiPen. 

[LESLIEKURZ]

On 6/30/2019 at 2:47 PM, Cecilia V. said:

I do plan to carry plenty in my carry-on.  I would also like some in my checked luggage. I am just asking if Royal Caribbean would have any problem with that: I know it sounds silly, but a friend suggested that possibly the Epipens would be confiscated once the bags are checked, so now I'm just a little worried. 

I've done both and had no problems.