Air travel with Humira or Enbrel

I’ll be visiting Arizona next week during the time when I’ll need to take Humira, so, of course, one of the first things I’ll have to think about when packing is how I’m transporting it. This will be the second time I’m taking Humira or Enbrel on a plane, so it doesn’t feel like that big of a deal (no bigger than the whole TSA fiasco normally is).

The first time, though, I was very confused about what I would have to do bring my Humira through the airport (or my sister her Enbrel). This post contains everything you might want to know about flying with Humira or Enbrel. To find the key points, look for the bolded words or click a link below.

Edit: This is my most popular post, but I know it can be a little long. Check out this list of the important points!

Keeping the medication the right temperature

Humira or Enbrel and airport x-ray machines

Injectable medication and the TSA screening process

What about documentation?

I’m not a medical professional, an employee of the maker of either Humira or Enbrel, or an employee of the TSA. The information contained here is information obtained from my own experience, from the drug makers’ websites, and from the TSA website. As always, if you have questions, contact a healthcare professional.

Keeping Humira or Enbrel the right temperature

If you’re faced with traveling with a biologic the first thing you need to think about is what temperature it will be. If kept at or below 77 degrees Fahrenheit (and out of the light), both Humira and Enbrel can be kept unrefrigerated for up to 14 days. It’s not ideal storage, but both the manufacturers consider it perfectly acceptable. This was fine for me last time I flew, because I was traveling between Chicago and Florida in the winter. No chance of it overheating there.

This time, though, I’m traveling between Chicago and Phoenix in the middle of summer. Overheating could definitely be a problem. The good news is, the makers of both Humira and Enbrel offer free travel kits that contain freezer packs and storage space for you medicine to make traveling easier. Make sure to order your travel kit in advance, as they can take some time to arrive.

Humira’s travel kit is available through the Humira Complete program, and Enbrel’s travel pack is available through Enbrel Support. Especially with Humira, you have to sign up for their program to receive a call from your nurse ambassador, who can then help you order the travel kit, so allow time. Enbrel’s process looks more straightforward, although I’ve never done it myself.

(Also, remember to freeze the freezer packs prior to travel.  And think about how it will be stored at your destination. For long flights, ask the staff to put your medication in their fridge, and don’t forget it!)

Humira or Enbrel and airport x-ray machines

Definitely travel with your Humira or Enbrel as a carry-on, because you can’t be sure what conditions it will be subjected to as checked baggage. Also, if your checked baggage is lost, you’ll be without important medication (important thousand-dollar medication).

The biggest question I had when I traveled by plane with Humira for the first time was: Can Humira go through the x-ray screener? It took me far too long to find the answer, but the makers of Humira say that Humira is able to go through the x-ray machine. This support page contains a video with more information.

Unfortunately, users of Enbrel don’t get an answer that is quite so straightforward. I was unable to find the answer to the question directly from Amgen, so we had to make the decision ourselves. We made the personal decision to send my sister’s Enbrel through the x-ray scanner due to:

1. The overwhelming number of people in forums and blogs saying that they noticed no ill effects after their Enbrel went through the x-ray scanner.

2. The fact that Humira is able to go through the scanner. The two are not the same medication, but their storage requirements are similar.

3. The difficulty involved with keeping the medication from being x-ray scanned. Passengers who forego x-ray examination are subject to additional screening.

Indeed, my sister noticed no problems after using the Enbrel that went through the x-ray scanner. However, this was the decision we came to after much discussion and consideration of the outcomes. It’s really best to talk to your healthcare professional for additional advice. (This was not an option for us, because my sister didn’t think about this being a problem until we were on the way to the airport.) And if any of this makes you uncomfortable, you can always request hand-screening for any of your belongings, to stay on the safe side.

(Why this may be a concern: Light is known to promote degradation of the molecules that make Humira and Enbrel work, so a worry may be that x-rays will have a similar effect. From what I understand, the makers of Enbrel have not tested the effect of x-rays on Enbrel, so this is why consulting your healthcare professional is important if you’re unsure what to do.)

Injectable medication and the screening process

The TSA makes different allowances for medications, so it doesn’t have to follow their 3-1-1 liquids, gels, and aerosols rule. The freezer packs needed to keep the medication at the right temperature are also exempt.

When I flew with Humira, my mom and I (randomly) had TSA precheck (to get it every time, you have to apply). This meant we were pre-approved to go through an abbreviated screening process. We didn’t have to remove our shoes or take liquids, laptops, and other things out of our carry-ons, like would normally be done. This made it incredibly easy to travel with the medications. My mom had my sister’s medication in her bag, and I had my medication in my own, and because of TSA precheck we were able to just leave the medication in the bags and send them through the scanner. No problems at all. The security officers didn’t even mention it.

When it comes to going through the standard security, the TSA requests that you take the medication out and declare it, but this may not be necessary in most cases. My family has been traveling with medically necessary aerosols (read: inhalers) for years, and usually, putting the medication in the tray beside your other belongings is enough. In the event that the officers need to know more, they will tell you. It may be visually inspecting the equipment or swabbing the medication containers for traces of dangerous materials.

If you have decided not to send your medication through the scanner, of course, you can request that the medication be examined by hand at this point.

What about documentation?

I know a lot of sites and forums, including sites by the makers of the medication, advise bringing copies of prescriptions and doctor’s orders with your medication, but I’ve found no indication from the TSA that this is necessary (so if you don’t have documentation, don’t panic). It may make the process easier, and they do advise that medications are, at the very least, labeled for easy identification. For me, keeping the Humira syringe in its box means keeping the prescription right with it. Also, if you are traveling internationally, documentation requirements may be different.

However, having the doctor’s note does not exempt you from further examination if the security officers feel that it’s needed. This is because, as they explain here, anyone with a doctor’s note would be able to smuggle dangerous materials onto a plane. Still, if you’re keen on hitting as few snags as possible, you can definitely present medical documentation to make the process smoother. The TSA also provides a printable medical notification card that you can present to security officers at the airport.

Even if you or your medication are selected for additional screening, there are a number of options to make sure you’re the most comfortable, including options that allow you to sit, if that is necessary for you. When it comes to mobility issues, clearly identifying your needs is important. My sister had to go through airport security with a cane one time, and when she notified the security officers of this, they provided her with a cane she could use when going through the detector so that she didn’t set it off. And of course, her cane was subjected to further screening, since it couldn’t be scanned traditionally.

I hope this was able to answer any pressing questions you had about traveling with Enbrel or Humira. If I didn’t cover something you’d like to know, please ask about it in the comments!

My post about staying comfortable when standing might also give you important things to consider during your travels. I’m also working on an upcoming article about important things for packing. Sign up for the email list to get it delivered straight to your email!

-Bri

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