Storing medication that needs refrigeration

[longterm]

On 3/20/2024 at 7:25 AM, duquephart said:

How does one keep injecter type medications cold enough on the way? From our door to the room refrigerator (assuming they have one) in the pre-extension hotel is going to be probably sixteen hours + or -.

My endocrinologist told me not to worry about it, that not being refrigerated for the flight would be okay and not damage the injectable drug.

[millybess]

So if someone was travelling with injectables for several weeks that needed to be refrigerated and it was specified that they couldn't be put back in the refrigerator after being at room temperature, what would one use?

[millybess]

Now I see @Haqdeluxe previous post.  Thanks!

[CDNPolar]

9 hours ago, millybess said:

Now I see @Haqdeluxe previous post.  Thanks!

 

10 hours ago, millybess said:

So if someone was travelling with injectables for several weeks that needed to be refrigerated and it was specified that they couldn't be put back in the refrigerator after being at room temperature, what would one use?

 

There are many options for storing injectables for travel that are TSA approved.  The best options are all available on Amazon.  READ THE REVIEWS on all the products.

 

There are some that require the refreezing of an ice pack in the tube and there are even some that are USB charged like little coolers.

 

I personally have a "Breezy Pack" and it has worked well for me.  I store my injectables outside the fridge for up to 2 months but don't need that long typically on a trip.  The one thing that I am concerned with is that I will never leave my meds in a carryon case and leave that with the luggage going to the cruise ship.  You don't know if that luggage is going to be sitting in a hot truck or out in the sunshine beside the ship and for how long.  I put my "Breezy Pack" in my shoulder bag and keep that with me until I am on the ship.  I can control where and how that bag is exposed to the sun.

 

One thing that I find interesting is that everyone has different ideas and information on how long a certain medication can be kept at room temperature.  Many statements on here contradict what my Pharmacist has told me and what is on the Pharmaceutical manufacturer's website.

 

Typically for more common meds like insulin (Tresiba), and Ozempic, they can be out of refrigeration for  almost two months.

 

From the Tresiba site:

 

How should Tresiba^® FlexTouch^® and 10-mL vial be stored? 

Not in use (unopened)

If unopened, Tresiba^® should be stored in a refrigerator (36°F to 46°F [2°C to 8°C]) until expiration date. It can also be stored at up to 86°F for 56 days.¹

In use (opened)

After first use, Tresiba^® can be stored at room temperature (up to 86°F [30°C]) or in the refrigerator (36°F to 46°F [2°C to 8°C]) without the needle attached for a maximum of 8 weeks (56 days).¹

 

From the Ozempic site:

 

[Haqdeluxe]

I take Trulicity for my type 2 diabetes. My pens can stay in the the fridge (36-46°F) until the expiry date. They can stay at room temperature (59-86°F) for up to 14 days. This 14 days is cumulative. Meaning I could fly with them at 59-86°F (the cooler the better) for say 48 hrs, put them back in the fridge, and still have 12 days at room temperature left to use.

My Lantus insulin has a 28 day window... bonus! 😉

I went to my current travel solution after we retired and we started frequently traveling on trips longer than 14 days and after I ran into a hotel room with a cooler where one expects a fridge. 

[millybess]

On 3/20/2024 at 10:08 AM, Haqdeluxe said:

https://4allfamily.com/products/portable-medical-fridge-usb-insulin-medicines?tw_source=google&tw_adid=&tw_source=google&tw_adid=&tw_campaign=18066227747&gad_source=1&gclid=CjwKCAjwkuqvBhAQEiwA65XxQPETa8Y05erpQrEiPdNjUHH1DzwTnoRRIPy5t4pzfkc9zexkEJM40BoCwWgQAvD_BwE

 

I have 2 of these and love them. As long as you have power they will maintain temp forever. Just on the gelpak they will hold a safe temp for 12-14 hours. TSA recognize them and pass them through quickly without issue. 

We now have one of these, but have yet to use it to travel.  I have read that the biogel bottle  needs to be frozen to pass TSA standards.  Do you bother taking it with you?  Or do you just plug in the "fridge" and carry a battery pack?

[millybess]

On 3/22/2024 at 6:16 AM, CDNPolar said:

I personally have a "Breezy Pack"

Thanks much for this.  I purchased one of these and we are shortly leaving for the drive to NS and I think this will work perfectly.

 

Thanks again.  😊🎂

Edited August 2 by millybess

[CDNPolar]

9 hours ago, millybess said:

Thanks much for this.  I purchased one of these and we are shortly leaving for the drive to NS and I think this will work perfectly.

 

Thanks again.  😊🎂

Hopefully it will work well for you!  

Let us know when you return.

 

This has been sufficient for my needs during travel periods keeping this in my carryon sling bag.  When I get to destination, I don't refrigerate, I just keep my pens in the Breezy Pack on the table.

 

My only real concern where I have not tested this is if you are on a land tour and full days out between hotels where you are in the sun and heat all day.  I would not leave the Breezy Pack in my luggage on the bus, as I would assume that would get very hot.  I would carry it in a sling bag.

 

For cruises and more controlled environments - like your drive - I think that this is sufficient.

 

I am considering this for a future land tour however:

 

4ALLFAMILY Cooler from Amazon

https://www.amazon.ca/4ALLFAMILY-Diabetic-Medicine-Portable-Medication/dp/B07SYZ22GS/ref=sxin_15_pa_sp_search_thematic_sspa?content-id=amzn1.sym.ea4b7f00-c440-4d65-bd3f-caa76cb13654%3Aamzn1.sym.ea4b7f00-c440-4d65-bd3f-caa76cb13654&crid=2A00VPKNZCW8L&cv_ct_cx=insulin%2Bcooler%2Btravel%2Bcase&dib=eyJ2IjoiMSJ9.cqxT89NXewEl7ZZKRi9QQiH1dPRG-sSr0xvMCQNBUuGivAVgq1rzEn0xohqOX98k-FwOvWIgFdnDdXkwl_67pA.dMHSN8ozP58da1USAFbAeSxWoXa1yQerIlpNX7lL91M&dib_tag=se&keywords=insulin%2Bcooler%2Btravel%2Bcase&pd_rd_i=B07SYZ22GS&pd_rd_r=df98a407-72c2-4f66-a799-9249a5f03fbf&pd_rd_w=uMSsg&pd_rd_wg=lfpgT&pf_rd_p=ea4b7f00-c440-4d65-bd3f-caa76cb13654&pf_rd_r=BCMXD4GVSCVZZX91WPBV&qid=1722676373&sbo=RZvfv%2F%2FHxDF%2BO5021pAnSA%3D%3D&sprefix=insulin%2Caps%2C159&sr=1-2-acb80629-ce74-4cc5-9423-11e8801573fb-spons&sp_csd=d2lkZ2V0TmFtZT1zcF9zZWFyY2hfdGhlbWF0aWM&smid=A3TCE8WYFM9DRZ&th=1

[millybess]

@CDNPolar I purchased one of those also.  These particular meds can stay out of refrigeration for 14 days, so the breezy pack works for that and the above cooler you referenced will work to travel for longer durations.

 

My information is that to pass TSA standards, the biogel bottle needs to be frozen.  So I'm not sure I would bother with the bottle.  Having the cooler plugged into a battery pack (or whatever) would suffice.😊🎂

Edited August 3 by millybess

[CDNPolar]

45 minutes ago, millybess said:

@CDNPolar I purchased one of those also.  These particular meds can stay out of refrigeration for 14 days, so the breezy pack works for that and the above cooler you referenced will work to travel for longer durations.

 

My information is that to pass TSA standards, the biogel bottle needs to be frozen.  So I'm not sure I would bother with the bottle.  Having the cooler plugged into a battery pack (or whatever) would suffice.😊🎂

 

Have you actually used the cooler yet?  Would love a real honest review.  I don't distrust Amazon reviews, but would love to hear your thoughts on the following:

 

1) If you are not using the biogel bottle, and you unplug the unit, how long does it stay cool before needing to be plugged in again?

2) Will the unit actually freeze the biogel bottle on its own?  Doubt it... because if that were the case you would be in danger of freezing the medication.

 

We have battery backups that we travel with and I am sure that they would hold the cooler for many hours, perhaps even 24-48 hours.

 

 

[millybess]

21 minutes ago, CDNPolar said:

 

Have you actually used the cooler yet?  Would love a real honest review.  I don't distrust Amazon reviews, but would love to hear your thoughts on the following:

 

1) If you are not using the biogel bottle, and you unplug the unit, how long does it stay cool before needing to be plugged in again?

2) Will the unit actually freeze the biogel bottle on its own?  Doubt it... because if that were the case you would be in danger of freezing the medication.

 

We have battery backups that we travel with and I am sure that they would hold the cooler for many hours, perhaps even 24-48 hours.

 

 

No, we haven't used the cooler yet, but will be travelling with it next week and I will get back to you.

 

The bio gel bottle has to be frozen in the freezer and left out for several minutes so it can reach it's minimum temperature before inserting it in the cooler.

 

Regarding the unit itself, I think it would have to be powered the whole time there is medication stored in it.  It automatically shuts off at 2C and automatically turns on above that.

 

At temperatures above 40C (which feels like Toronto this week!) it's recommended to use the bio gel bottle as it can keep the temperature range for 28 hours.

[CDNPolar]

3 minutes ago, millybess said:

No, we haven't used the cooler yet, but will be travelling with it next week and I will get back to you.

 

The bio gel bottle has to be frozen in the freezer and left out for several minutes so it can reach it's minimum temperature before inserting it in the cooler.

 

Regarding the unit itself, I think it would have to be powered the whole time there is medication stored in it.  It automatically shuts off at 2C and automatically turns on above that.

 

At temperatures above 40C (which feels like Toronto this week!) it's recommended to use the bio gel bottle as it can keep the temperature range for 28 hours.

 

Thanks!  Hope all works well for you.  I know this has been discussed several times over the years, and will be nice to have a CC trusted review!

[longterm]

I bought a Voyager cooler, and just received it; a little info:

 

It's true that you can't use a USB-C to USB-C cable; why, I don't know. This meant that my Anker battery that I have, which has only a USB-C connection, wouldn't power up the Voyager.

So I tried using the supplied USB-A to USB-C cable, plugged it into a USB-A to USB-C adapter that I had, and then plugged that into my Anker battery. 

Works great! So if you have some smartphone backup batteries, as I do, you can use them with the Voyager, even if your battery has only a USB-C connection. Just use an adapter; you can find them on Amazon.

The Voyager has NO insulation, so if you were to cool the Voyager down, then unplug it and get on a plane, it's only going to stay cool about 15-20 minutes (according to the company rep I spoke to). So there are 2 solutions: 1) use the biogel pack; 2) have a battery available, and keep it powered up using a battery. 

[millybess]

2 hours ago, longterm said:

I bought a Voyager cooler, and just received it; a little info:

 

It's true that you can't use a USB-C to USB-C cable; why, I don't know. This meant that my Anker battery that I have, which has only a USB-C connection, wouldn't power up the Voyager.

So I tried using the supplied USB-A to USB-C cable, plugged it into a USB-A to USB-C adapter that I had, and then plugged that into my Anker battery. 

Works great! So if you have some smartphone backup batteries, as I do, you can use them with the Voyager, even if your battery has only a USB-C connection. Just use an adapter; you can find them on Amazon.

The Voyager has NO insulation, so if you were to cool the Voyager down, then unplug it and get on a plane, it's only going to stay cool about 15-20 minutes (according to the company rep I spoke to). So there are 2 solutions: 1) use the biogel pack; 2) have a battery available, and keep it powered up using a battery. 

Thanks!  I had an unanswered question above about the bio gel pack:  I have read that it needs to be frozen to pass TSA.  Have you used the bio gel yet to travel?

[Haqdeluxe]

1 hour ago, millybess said:

Thanks!  I had an unanswered question above about the bio gel pack:  I have read that it needs to be frozen to pass TSA.  Have you used the bio gel yet to travel?

All,

Just  got back to this thread...

Yes,  TSA expects gel packs to be frozen at the time you pass through an inspection. They tend to be reasonably flexible, as long as you're closer to frozen than not.

4AllFamily Voyager Canister - I traveled 22+ hours with my Voyager canister using a combination of the gel pack and the USB chiller lid. Ran the chiller lid on a battery or plugged into a A/C adapter, off and on,  for about 12 hours of those 22 hours. Content was still chilled to 48/50 F when moved to a fridge.

 

This  gel pack and chiller lid combo is my default solution. I then power the chiller lid anytime it's convenient. 

 

Have done 12 hours of travel on just the canister and a gel pack with the same or better results upon arrival. 

 

I recommend putting the Canister in the freezer without the lid for a few hours before use.

 

I also have the full USB insert for my canister that can hold the temperature at 36-46 for as long as it has power attached.  I tend to pack this insert as just in case option. 

 

Cheers

[millybess]

1 minute ago, Haqdeluxe said:

All,

Just  got back to this thread...

Yes,  TSA expects gel packs to be frozen at the time you pass through an inspection. They tend to be reasonably flexible, as long as you're closer to frozen than not.

4AllFamily Voyager Canister - I traveled 22+ hours with my Voyager canister using a combination of the gel pack and the USB chiller lid. Ran the chiller lid on a battery or plugged into a A/C adapter, off and on,  for about 12 hours of those 22 hours. Content was still chilled to 48/50 F when moved to a fridge.

 

This  gel pack and chiller lid combo is my default solution. I then power the chiller lid anytime it's convenient. 

 

Have done 12 hours of travel on just the canister and a gel pack with the same or better results upon arrival. 

 

I recommend putting the Canister in the freezer without the lid for a few hours before use.

 

I also have the full USB insert for my canister that can hold the temperature at 36-46 for as long as it has power attached.  I tend to pack this insert as just in case option. 

 

Cheers

Thanks much @Haqdeluxe.  Very helpful!

[longterm]

19 hours ago, millybess said:

Thanks!  I had an unanswered question above about the bio gel pack:  I have read that it needs to be frozen to pass TSA.  Have you used the bio gel yet to travel?

No, but I've used a travel pack before; it's a little sleeve that has a gel pack in it, and room for a couple of pens. I froze it solid, then put it in my suitcase, and went through security with no problems.

My understanding as well is that, in order to get the gel pack through TSA in your carryon, you definitely need to have it frozen solid, or else pack it in a checked bag.

We have a 16-day trip to Machu Pichu & the Galapagos coming up, where we'll be on internal flights a few times. My plan is to use batteries to keep the Voyager running while we're not in a hotel, and then plug it into hotel power when we're there, so I won't need to bring the biogel with me.

[millybess]

1 hour ago, longterm said:

No, but I've used a travel pack before; it's a little sleeve that has a gel pack in it, and room for a couple of pens. I froze it solid, then put it in my suitcase, and went through security with no problems.

My understanding as well is that, in order to get the gel pack through TSA in your carryon, you definitely need to have it frozen solid, or else pack it in a checked bag.

We have a 16-day trip to Machu Pichu & the Galapagos coming up, where we'll be on internal flights a few times. My plan is to use batteries to keep the Voyager running while we're not in a hotel, and then plug it into hotel power when we're there, so I won't need to bring the biogel with me.

Thanks Bob.  We'll be interested to know how that turns out if you are able to post back here.  Thanks again.

 

[rbslos18]

On 3/20/2024 at 9:58 AM, duquephart said:

14 days at room temp tops.

The problem is especially with long cruises. Mounjaro, for example, can be at room temperature for 21 days max. Other medications for less time.

Viking's position currently is to store the medicine in the room refrigerator (and pray the refrigerator maintains the proper temp.) They (according to "tellus") will not allow the medication to be stored in the Medical Center refrigerator. As someone posted earlier, a mishap with the cabin refrigerator can mean a loss greater than the cost of the cruise. A better policy would be to allow storage in the Med. Center and to have clear times when it can be accessed.

[CDNPolar]

22 hours ago, rbslos18 said:

The problem is especially with long cruises. Mounjaro, for example, can be at room temperature for 21 days max. Other medications for less time.

Viking's position currently is to store the medicine in the room refrigerator (and pray the refrigerator maintains the proper temp.) They (according to "tellus") will not allow the medication to be stored in the Medical Center refrigerator. As someone posted earlier, a mishap with the cabin refrigerator can mean a loss greater than the cost of the cruise. A better policy would be to allow storage in the Med. Center and to have clear times when it can be accessed.

 

We have to consider WHY Viking is not allowing this and it could be:

 

• Limited Space: The medical center on a cruise ship typically has limited refrigeration space, which must be reserved for emergency medical supplies and medications required for immediate treatment on board.

• Liability Concerns: Storing personal medication may raise liability issues if something goes wrong, such as improper storage leading to spoilage or loss. The cruise line may not want to assume responsibility for medications that are critical to a passenger's health.

• Security and Access Control: Medications need to be stored securely, and access must be controlled to prevent misuse or theft. Allowing passengers to store their medications in the medical center could complicate this process.

 

I firmly believe that Viking has its reasons for this and I do not believe that any cruise lines allow storage in their medical refrigeration units, and likely for the reasons above.

[longterm]

On 8/7/2024 at 3:01 PM, longterm said:

The Voyager has NO insulation, so if you were to cool the Voyager down, then unplug it and get on a plane, it's only going to stay cool about 15-20 minutes (according to the company rep I spoke to). 

OK, now that I looked at the container again, I see that it IS double-walled, which means it's got at least *some* insulating properties.

The Voyager has a thermometer on the cooling lid; I'm going to cool it down now, get it to its lowest temp, then I'll unplug it, leave it for a half-hour. Then I'll plug it back in, and see what the temperature setting is after a half-hour. Then I'll immediately unplug it again and wait another half-hour. Will report back.

[longterm]

OK, I ran an unscientific test with my Voyager bottle, which has nothing in it, by the way. I think these temps would be slightly lower if there were pens in it, because they would help to hold the cold. At any rate:

 

I plugged in the Voyager bottle; at 5:19, the Voyager bottle registered 39°. 

I then unplugged the battery; at 5:52 (33 minutes), I plugged the bottle in to see where the temperature was; the bottle registered 63°. I unplugged the bottle, and waited until 6:19, which was an hour after I first unplugged the battery.

 

At 6:19, the bottle registered 68°.

 

So this means that if you cool the Voyager down, while in an air-conditioned room (it's 76 in here), the bottle will lose 24 degrees of coolness in an hour.

I don't know whether this would work with insulin, but for Ozempic pens, it would be fine, according to my endocrinologist.

However, my plan, on our upcoming Machu Pichu/Galapagos trip, where we'll take several one-hour flights, is to keep the bottle on the battery the entire time; when we get to our hotels, I'll plug it into hotel power for the duration while there.

I hope this little test is useful to someone.

[CDNPolar]

I am very interested in these trials that you are running right now.  I have not purchased one yet and just watching from the sidelines.

 

For me at the moment, we are only travelling 2-3 weeks max at a time and the insulin I use (Tresiba) can be room temperature - up to 86F - for 56 days.

 

My concern is more when we are going on a self-guided land tour of China and Tibet next year, and we are moving cities frequently that I keep my pens under 86F.

 

Once I break open a new pen I never refrigerate it, as it just sits on my desk until it is empty. 

[longterm]

2 hours ago, CDNPolar said:

For me at the moment, we are only travelling 2-3 weeks max at a time and the insulin I use (Tresiba) can be room temperature - up to 86F - for 56 days.

In that case, you could probably get away with the Voyager; I too was told that Ozempic can be at room temperature, but not hotter; I interpret room temp to be around 70-78 degrees.
 

2 hours ago, CDNPolar said:

My concern is more when we are going on a self-guided land tour of China and Tibet next year, and we are moving cities frequently that I keep my pens under 86F.

That sounds similar to our upcoming Machu Pichu/Galapagos tour, which is with Odysseys; we'll be spending 2 nights in some of the hotels (longer in the Galapagos), so there will be some flights that will be an hour or so each. 

My plan is to leave the gel pack home, and rely on hotel power and battery power. I have a 22000 mAh battery, as well as several 10,000 mAh batteries; I should have no trouble keeping the cooler running for a few hours while traveling between hotels.

I forgot to mention that I had the Voyager sitting on the couch right next to me, and I couldn't hear it--it's really quiet, almost silent.

 

[millybess]

On 8/11/2024 at 12:28 PM, longterm said:

In that case, you could probably get away with the Voyager; I too was told that Ozempic can be at room temperature, but not hotter; I interpret room temp to be around 70-78 degrees.
 

That sounds similar to our upcoming Machu Pichu/Galapagos tour, which is with Odysseys; we'll be spending 2 nights in some of the hotels (longer in the Galapagos), so there will be some flights that will be an hour or so each. 

My plan is to leave the gel pack home, and rely on hotel power and battery power. I have a 22000 mAh battery, as well as several 10,000 mAh batteries; I should have no trouble keeping the cooler running for a few hours while traveling between hotels.

I forgot to mention that I had the Voyager sitting on the couch right next to me, and I couldn't hear it--it's really quiet, almost silent.

 

Our experience travelling to NS was very much like your experience.  

 

After attaching the Voyager to the battery pack, it took about 2 hours to get it to the required temperature.

 

It worked very well for our road trip.  However, I would be cautious about the connection, as it doesn't take much to knock it loose.  In our case, it was at room temperature the next morning.  That's when Breezy Pack came in very handy.  Thank you @CDNPolar @longterm and also to @Haqdeluxe for recommending the Voyager.  🙂