Keeping biologics (Amgevita/Humira) cold

[kiwikid]

How have people managed keeping their biologics (I'm on Amgevita, which is the same drug as Humira) cold for so long? I've used Frio pouches when I travel for my insulin, but I'm newly on a biologic for Crohn's and I don't think they would keep it cold enough... Any other people's experiences would be hugely helpful!

 

[J Willhaus]

Difficult. This is an option, but kind of heavy.
All Family Nomad cooler.

I have the one that plugs in as a mini refrigerator also with the gel cooler. You would have to have a place to refreeze the gel so would need help from hospitaleros.

Have a back up plan such as go to a doctor in Spain to see if you can get a script for this there and then get from a Spanish pharmacy. May have to order it a few days before you reach a town.

You may need to pay and then get reimbursement from your insurance carrier upon return home.

Fragile meds are a pain, but they keep us going. Don't give up!

.

 

[montyhiker]

How have people managed keeping their biologics (I'm on Amgevita, which is the same drug as Humira) cold for so long? I've used Frio pouches when I travel for my insulin, but I'm newly on a biologic for Crohn's and I don't think they would keep it cold enough... Any other people's experiences would be hugely helpful!

I used to be on Humira. Had to inject every 2 weeks. The Pens were always shipped to me packed in Dry Ice (from the other side of the country). I wonder if packing it in Dry Ice is an option.

 

[kiwikid]

I used to be on Humira. Had to inject every 2 weeks. The Pens were always shipped to me packed in Dry Ice (from the other side of the country). I wonder if packing it in Dry Ice is an option.

Unfortunately it isn't legal to have medication shipped into Spain.

 

[montyhiker]

Unfortunately it isn't legal to have medication shipped into Spain.

No, I wasn’t talking about shipping anything. I was explaining that Dry Ice is used to keep it cold even from across the US. In the heat of summer, no less. My suggestion was to see if the OP could pack their medicine in Dry Ice while hiking.

 

[Xali1970]

Jammed between 2 ice packs in a thermal pouch.
Roll your sleeping bag or quilt around it. I'd be surprised if it wouldn't keep at temperature.
Something worth trying with a thermometer before.

 

[Jill PetersGee]

How have people managed keeping their biologics (I'm on Amgevita, which is the same drug as Humira) cold for so long? I've used Frio pouches when I travel for my insulin, but I'm newly on a biologic for Crohn's and I don't think they would keep it cold enough... Any other people's experiences would be hugely helpful!

How have people managed keeping their biologics (I'm on Amgevita, which is the same drug as Humira) cold for so long? I've used Frio pouches when I travel for my insulin, but I'm newly on a biologic for Crohn's and I don't think they would keep it cold enough... Any other people's experiences would be hugely helpful!

4ALLFAMILY EXPLORER 72 Hours 7 Pen Medical Insulin Cooler Travel CASE USB Charger + BIOGEL Ideal Diabetic Medicine Portable Insulina Carrying Bag TSA Approved Medication Bottle Diabetes Storage Vial
https://www.amazon.com/dp/B07SYZ22GS?tag=casaivar02-20. There are carriers that can charge with USB. Stay cold up to 72 hours and hold 7 pens. Can get on amazon

 

[jayree]

A friend used the Frio cooling pack on her Camino Frances and reported that it worked well.

https://www.amazon.com/Insulin-Cooling-Reusable-Evaporative-Medication/dp/B0002262IK?tag=casaivar02-20

 

[J Willhaus]

4ALLFAMILY EXPLORER 72 Hours 7 Pen Medical Insulin Cooler Travel CASE USB Charger + BIOGEL Ideal Diabetic Medicine Portable Insulina Carrying Bag TSA Approved Medication Bottle Diabetes Storage Vial
https://www.amazon.com/dp/B07SYZ22GS?tag=casaivar02-20. There are carriers that can charge with USB. Stay cold up to 72 hours and hold 7 pens. Can get on amazon

Yes, I have this. Kind of heavy, but if you need it, you need it.

 

[J Willhaus]

A friend used the Frio cooling pack on her Camino Frances and reported that it worked well.

https://www.amazon.com/Insulin-Cooling-Reusable-Evaporative-Medication/dp/B0002262IK?tag=casaivar02-20

Also have a frio, but it does not keep meds at refrigerator temps.

 

[CorinneH]

How have people managed keeping their biologics (I'm on Amgevita, which is the same drug as Humira) cold for so long? I've used Frio pouches when I travel for my insulin, but I'm newly on a biologic for Crohn's and I don't think they would keep it cold enough... Any other people's experiences would be hugely helpful!

I have had the same problem on two Caminos. I had to have friends post my Humira every second week to a hotel. The first time, it worked pretty well. I packed 3 injections in 3 separate boxes and left them in the refrigerator at a friend's place in Barcelona. They couriered a package, with a regular, frozen ice pack in it, to me, the day before I was to arrive in a specific hotel. From within Spain, that worked well.

The second time, my friends were not in Spain anymore, and I had to have a friend in France courier my Humeira to me. That didn't work quite as well as the time for delivery was a little erratic. On one occasion, I had to wait an extra day for my injection to turn up, and once, I had to have it taken to me in a taxi, once it finally turned up, two days late. It wasn't ideal, but I managed. FYI, years ago, Humeira had to be kept cold all the time, right up until use. Over recent years, it was determined to be fine at room temperature for up to a week, just as long as it was used within that time. Do you know anyone in Spain at all?

If you speak Spanish, you could try calling hotels or kind, helpful, private albergues to ask if they would mind storing a dose of your medication in their fridge for 1, 2, 3, or 4 weeks, until you arrive there. You could land in Spain and freeze your ice packs overnight before couriering one dose, packed in ice, to each of those places. They will receive them overnight (as long as you pick bigger places to send them to), and the receiver could put them straight in the fridge, upon receipt, to await your arrival.

Good luck, and have a great trip!

 

[SandraZ]

How have people managed keeping their biologics (I'm on Amgevita, which is the same drug as Humira) cold for so long? I've used Frio pouches when I travel for my insulin, but I'm newly on a biologic for Crohn's and I don't think they would keep it cold enough... Any other people's experiences would be hugely helpful!

Hi Kiwikid, I also have a biologic to think about for travel this year 2024, it is Enbrel for Rheumatoid arthritis. Pre-filled syringes which I take weekly. I have a travel pack that is frozen before-hand but will probably be defrosted between leaving Sydney and arriving in Spain. Information states that the medication can be kept unrefrigerated for up to 30 days, I take it weekly so hopefully by the 4th week the last injection will still be OK. Not sure if the medication could easily be obtained in a chemist in Spain. I'm just starting my planning and many enquiries now so if I find out any further information I'll let you know. Sandra

 

[kiwikid]

Hi Kiwikid, I also have a biologic to think about for travel this year 2024, it is Enbrel for Rheumatoid arthritis. Pre-filled syringes which I take weekly. I have a travel pack that is frozen before-hand but will probably be defrosted between leaving Sydney and arriving in Spain. Information states that the medication can be kept unrefrigerated for up to 30 days, I take it weekly so hopefully by the 4th week the last injection will still be OK. Not sure if the medication could easily be obtained in a chemist in Spain. I'm just starting my planning and many enquiries now so if I find out any further information I'll let you know. Sandra

Hey Sandra, That’s awesome that yours can be unrefrigerated that long. If it helps, I’ve heard some airlines are willing to refrigerate meds / provide ice / freeze ice packs if needed. Unfortunately mine can only be at room temp for a maximum of 14 days, so won’t last as long... I looked up buying it in Spain, but it’s approximately €500 per dose!! Will def be looking into the other suggestions being made in this thread - they’ll add weight to my pack, but probably worth it!
Good luck for your Camino, and definitely keep me updated with anything you find out, if there’s other options out there I’d love to hear about them!
Emily

 

[WalkingLester]

When are you going on the Camino? My wife and I walked on the Frances in late October to late November. No problem keeping the medicine below 77degrees for two weeks before she used her dose.

Also, there are biosimilar medications in Spain that are essentially the same as Humira but much cheaper than in the USA. I don’t know how expensive Humira is in New Zealand, but in the USA it costs, I believe, $1000 a dose without insurance. I think you may have a reasonable chance of getting a pharmacist to give you a dose if worse came to worse. It would be good to take some documentation such as your prescription, typed, not in illegible doctor handwriting. I have found that pharmacists will be sympathetic to pilgrims having problems with medication. Compared to the US, Spanish pharmacists have more autonomy, and many times I have obtained prescription meds in Spain without a doctors prescription. It doesn’t always work at every pharmacy. I should note that I am a physician and I speak Spanish so maybe it’s easier for me to make this work. You may have to go to a Spanish doctor and ask for a prescription.
If your dosing schedule doesn’t work with keeping one dose at less than 25 degrees Centigrade for two weeks then you will need some kind of cooler. I think trying to keep cold packs properly cooled or to obtain ice regularly would be stressful and difficult. I think your best bet then would be the Family Nomad Cooler mentioned in an above post. They have a model that is basically a small, thermos sized refrigerator with a digital temperature read out. It will add approximately 5 lbs of weight. Good luck y buen camino!

 

[SandraZ]

Thanks for your reply.

 

[CorinneH]

As I mentioned before , I walked the Camino Frances in 2016 and 300km on the Vezeley route followed by the Camino Frances in 2018, and both times I needed Adalimumab (Humeira) every 2 weeks. I asked my Auckland-based rheumatologist about writing a prescription for me to have filled in Spain, and he told me that a pharmacist in Spain will be unable to fill a Humeira prescription for me. NZ physicians do not have prescription privileges in Spain. He told me that I would have to try to get an appointment with a rheumatologist in Spain or bring my own (kept in ice on my flight over) and make my own arrangements to have someone store it in a fridge and courier it from within Spain to me at planned destinations where I could collect it, or drop it in person at planned destinations prior to starting my hike. This is what I did, and it meant I got my meds with no uncertainty. There is no way I would take a chance on getting some pharmacist to potentially contravene their dispensing laws to provide an expensive and specialised medication like Humeira for me. As I struggled to walk and even dress myself without it, I had to be certain I would get it. I would suggest you take responsibility yourself for ensuring you have made the arrangements you need before you leave NZ. Best of luck and have a great Camino!

 

[SandraZ]

Hey Sandra, That’s awesome that yours can be unrefrigerated that long. If it helps, I’ve heard some airlines are willing to refrigerate meds / provide ice / freeze ice packs if needed. Unfortunately mine can only be at room temp for a maximum of 14 days, so won’t last as long... I looked up buying it in Spain, but it’s approximately €500 per dose!! Will def be looking into the other suggestions being made in this thread - they’ll add weight to my pack, but probably worth it!
Good luck for your Camino, and definitely keep me updated with anything you find out, if there’s other options out there I’d love to hear about them!
Emily

Hi Emily, after searching and reading many items of information, I have decided to buy either the Voyager or the Explorer cooler from 4allthefamily. I would rather be sure my meds stay cool than take a chance of the temp going over 25degs. Good luck with your plans. Sandra

 

[walkingagain]

Yes, I have this. Kind of heavy, but if you need it, you need it.

Hi J - have you walked the Camino carrying the 4ALLFAMILY VOYAGER (USB LID battery charged model) ? I am starting the CF on Friday and am worried about how I will realistically keep it from getting wet and breaking in the rain. Any tips would be greatly appreciated!!

 

[J Willhaus]

No, actually I have not used mine yet. The doctor changed my prescription and the injectors for the new medication are now too large to put more than one or two in the container along with the cooling element. My medication is for diabetes and the shelf life at room temp is 21 days. Its one of those that are also being prescribed off label for weight loss and as a result there are shortages and I had to switch to something that is more regularly in stock (although it is also getting harder to refill due to shortages!)This winter it was fine because I was not in Spain longer than the room temp shelf life so I just carried it in the box it comes in. My provider and I will have to reconsider next year what to do. I may have to ask to be changed back to a different medication with a longer shelf life or pay for it out of pocket in Spain or both since I want to be there about 3 months.

You might put the cooler in a large ziplock bag and maybe even double bag it if you are thinking it will be too rainy. You can also put it in a drybag which should give you protection against weather. I would put it inside my backpack with some other things wrapped around it to cushion it.

 

[walkingagain]

I'm trying bring a similar medication - Ozempic. The manufacturer says after first use a pen can be stored at room temp (59°F to 86°F) for up to 56 days. But I too want to be there 3 months - so would need to keep my 2nd pen refrigerated at 36°F to 46°F until I first use it. I was at REI when I saw your reply so I got an dry bag large enough to fit the cooler - thanks for the idea! Back to packing

 

[J Willhaus]

Yes, Ozempic has a longer shelf-life, but unfortunately the pharmacies here could not get it and I needed to stay on something for my type 2 diabetes so they switched me to Mounjaro which is one pen a week with a really big injector packaging that won't fit more than 2 in the USB cooler/ portable frig thing. Now it is getting in short supply, too. I may have to go to an oral medication which might be convenient, but may not work as well for my blood sugar control. Its hell getting old!

Incidently, Wegovy which is the same medication as Ozempic , but marketed for weight loss does not have as long a shelf life as Ozempic. I am thinking it has something to do with the packaging since Wegovy is also packaged in individual injectors (not as bulky as Mounjaro though...)