Contributor: Dr. Staci-Marie Norman, PharmD, DCES
It's summer, and I bet you're thinking about vacation! During my shifts at the pharmacy, summer always brings questions about how to deal with medications while traveling, especially if the medications are refrigerated. Here are answers to some of the most common questions I get so you are ready for your summer vacation:
Can I keep my insulin out of the refrigerator while I'm traveling?
The easy answer is it depends! Not helpful, but it really does depend on the insulin (or GLP-1), the device, your individual dose, and the length of your trip. In general, insulin in a vial or pen is good until the printed expiration date on the packaging while stored in the refrigerator. Once opened or removed from the refrigerator, the expiration dates range from 10 to 56 days, depending on the insulin. The downloadable charts at the end of this article lists expiration dates for insulin (in pens and vials) and GLP-1 pens. The chart is from June 2021 and is up to date currently, but medications seem to be coming to the market quickly. If you don't see your current medication on the list, look to the manufacturer's product insert for expirations.
One key point you may miss is that once you start using insulin pens, the pen needs to stay at room temperature until it is empty. (The exception is the Tresiba pen, which can go back and forth or stay at room temperature.) Pens must be left at room temperature once opened to ensure the device's "pressurization" is stable, so your dose is accurate. The expansion and contraction of warming and cooling can throw the dosing off, so please don't do it. But be sure to put a box of pens that you just picked up at the pharmacy into the refrigerator and take one pen out at a time because some pens, like Regular or NPH insulin, are only good for ten days once at room temperature. A box of five NPH pens equals 1,500 units of insulin, so you need to use 150 units per day to use all five pens in 10 days. Since each pen only has 300 units, if you take 30 units or more daily, you will finish one pen within the 10-day expiration.
How much medication should I pack for my trip?
First, determine how much medication you will need over the length of your vacation, and then how many pens or vials are needed. If the vial or pen is good unrefrigerated for the length of your vacation, you are good to go. Don't leave it in a hot car or a beach bag in the sand. Instead, put it into an insulated bag inside a cooler, so you don't accidentally freeze the medication.
Always pack all your medications in your carry-on bag if you are flying. Never (especially during the summer) pack medications in your checked luggage! If your medication does need to stay refrigerated, you can pack it in a small, insulated bag. I did a quick search on Amazon for insulated insulin travel cases and found hundreds of travel cooler packs that are relatively small and fairly inexpensive. Once you get to your destination, most hotels have small in-room refrigerators, and you can always request one when making your reservation. Most hotels are extremely accommodating if you let them know you have medication that needs refrigeration. Also, don't forget to pack all the other supplies you need, such as pen needles, syringes, alcohol pads, etc.
What else should I pack for my trip?
Once you have your medications packed, it's time to pack your blood glucose meter, strips, and lancets (or your sensors and transmitters if you use a continuous glucose monitor). Be aware that blood glucose strips are also temperature sensitive. They do not like extreme temperatures, so if you take them to the beach, add them to your insulated bag. If you forget and the strips are exposed to really hot (or very cold) temperatures, check them for accuracy using that control solution. If you don't have a control solution, really question levels that may not be consistent with how you feel. If you think the strips were ruined, it's best to replace them.
With a bit of planning, your vacation can be lots of fun with no stress regarding your medications. Happy traveling.
Click each chart to enlarge and download.
References: Clinical Pharmacology Home (clinicalkey.com). Monographs. Accessed 5/18/21.
Expirations are all per manufacturer recommendation*
Dr. Staci-Marie Norman, PharmD, DCES received her bachelors from Purdue University (’94) and her Doctor of Pharmacy from the University of Oklahoma (’96). In 2000 Dr. Norman added to her credentials by becoming a Certified Diabetes Care and Education Specialist. She is currently the Clinical Coordinator and staff pharmacist for Martin’s Pharmacy. Dr. Norman is a national faculty member for the American Pharmacist Association, teaching certificate programs in both diabetes and cardiovascular disease. She serves on the advisory board that oversees development and revision of these programs. Along with teaching and development responsibilities for APhA, Dr. Norman serves as a peer reviewer for research grants and publication submission. Dr. Norman has also spoken for Abbott, Bayer, Lilly, Mannkind, and Lifescan as a diabetes specialist.