How to Travel with Insulin, Biologics and Refrigerated Medicines

Travelling with insulin, biologics, & refrigerated meds

An insulin pen in use needs no fridge on holiday: EU and US labels allow 4 to 8 weeks below 30°C. Several labels even say not to refrigerate it once started, and the bigger threats are freezing, heat and paperwork. This guide gives the official out-of-fridge limits for 39 temperature-sensitive medicines, then shows how to pack, fly and store them.

This guide is general information, not medical advice. Rules change; check with the destination's embassy or health ministry and your prescriber before you travel.

How long can insulin be out of the fridge?

Most insulin pens and vials can stay out of the fridge for 28 days to 8 weeks, as long as they stay below 30°C. Humalog^[3] and Lantus^[35] allow 28 days, Toujeo^[7] allows 6 weeks in the EU, and Tresiba^[8] allows 8 weeks.

Unopened stock belongs in a fridge at 2°C to 8°C, but many labels give spares the same allowance as the pen in use. The EU label for NovoRapid^[1] covers pens "in use or when carried as a spare" for 4 weeks below 30°C. The US label for Humalog^[34] counts unopened and opened room-temperature time together, to a total of 28 days.

Three rules apply to almost every product. The clock runs once and does not reset in a fridge, and the temperature ceiling is a hard limit. Every insulin label says do not freeze, and NovoLog^[33] says not to use it if it has been frozen.

Out-of-fridge limits for 39 temperature-sensitive medicines

Each row below comes from an official label: the EU or UK Summary of Product Characteristics (SmPC), or US prescribing information on DailyMed. Where the EU and US labels differ, both are shown. Always check the leaflet in your own box, because pack sizes, devices and regions vary.

"Single period" means once the product is out of the fridge it must not go back. "After first use" means the clock starts at the first injection. Unless a row says otherwise, the medicine must not be frozen.

Insulins

GLP-1 and GIP/GLP-1 medicines

See our dedicated travel guides for common GLP-1 brands: Ozempic and its fridge-free window, Wegovy pen storage, and travelling with Mounjaro.

Biologics for inflammatory, skin and allergic conditions

Read our dedicated product guides: adalimumab and infliximab and biologic asthma medication.

Migraine (CGRP) and cholesterol (PCSK9) injections

Our CGRP migraine biologics guide contains detailed information on cold chain management.

Fertility, glucagon and eye drops

Read more on eye drops in our glaucoma eye drops travel guide.

Label sources for the tables, by group:

• Insulins: NovoRapid (EU)^[1], NovoLog (US)^[33], Fiasp^[2], Humalog (EU)^[3], Humalog (US)^[34], Lyumjev^[4], Lantus (EU)^[5], Lantus (US)^[35], Abasaglar^[6], Toujeo (EU)^[7], Toujeo (US)^[36], Tresiba (EU)^[8], Tresiba (US)^[37], Levemir^[9].
• GLP-1s: Ozempic (EU)^[10], Ozempic (US)^[38], Wegovy (EU)^[11], Wegovy (US)^[39], Mounjaro (EU)^[12], Mounjaro (US)^[40], Zepbound^[41], Saxenda (EU)^[13], Saxenda (US)^[42], Victoza (EU)^[14], Victoza (US)^[43], Trulicity (EU)^[15], Trulicity (US)^[44].
• Biologics: Humira (EU)^[16], Humira (US)^[45], Dupixent (EU)^[17], Dupixent (US)^[46], Enbrel (EU)^[18], Enbrel (US)^[47], Cosentyx (EU)^[19], Cosentyx (US)^[48], Taltz (EU)^[20], Taltz (US)^[49], Stelara (EU)^[21], Stelara (US)^[50], Skyrizi (EU)^[22], Skyrizi (US)^[51], Xolair (EU)^[23], Xolair (US)^[52].
• CGRP and PCSK9: Aimovig (EU)^[24], Aimovig (US)^[53], Emgality (EU)^[25], Emgality (US)^[54], Ajovy (EU)^[26], Ajovy (US)^[55], Repatha (EU)^[27], Repatha (US)^[56], Praluent (EU)^[28], Praluent (US)^[57].
• Fertility, glucagon and eye drops: GONAL-f (EU)^[29], Gonal-f (US)^[58], Ovitrelle (EU)^[30], Ovidrel (US)^[59], Menopur 150 IU (UK)^[67], Menopur 1200 IU (UK)^[66], Menopur (US)^[60], GlucaGen (UK)^[65], Ogluo (EU)^[31], Gvoke (US)^[61], Baqsimi (EU)^[32], Baqsimi (US)^[62], Xalatan (UK)^[64], Xalatan (US)^[63].

Where EU and US labels disagree

The same brand can carry different storage rules on each side of the Atlantic. Follow the label in your box, which matches the product you were dispensed.

• Toujeo: 6 weeks below 30°C in the EU^[7], 56 days in the US^[36].
• Ozempic pens: 6 or 8 weeks after first use in the EU^[10], 56 days in the US^[38]. Neither label gives an unopened pen a room-temperature allowance.
• Wegovy FlexTouch: 6 weeks after first use in the EU^[11], 56 days in the US^[39]. The single-dose pens match at 28 days.
• Skyrizi: the EU label^[22] allows 24 hours out of the fridge up to 25°C. The US label^[51] only mentions 15 to 90 minutes of warming before the injection.
• Enbrel: 4 weeks up to 25°C in the EU^[18], 30 days at 20°C to 25°C in the US^[47] for syringes, pens and cartridges. The US multi-dose vial tray is limited to 14 days.
• Xalatan: the UK SmPC^[64] only says do not store above 25°C and use within 4 weeks of opening. The US label^[63] requires refrigeration until opened, then allows 6 weeks up to 25°C.

The real danger is freezing, not heat

Every label in the tables above says do not freeze, and several warn about the exact objects travellers pack. Lantus^[5] says do not place it "next to the freezer compartment or a freezer pack". Fiasp^[2] says keep it away from the freezing element.

Fridges are less reliable than people assume. In a study presented at the 2018 European diabetes congress (EASD), insulin in home fridges sat outside the recommended range about 11% of the time^[77]. Around 17% of the sensors recorded temperatures below 0°C.

The gel pack against the pen. A pack straight from the freezer sits below 0°C, and a pen pressed against it can freeze. Wrap packs in a cloth or use a case with a divider, and never let a pen touch ice.

The hold bag. The American Diabetes Association^[72] says not to check insulin in, as pressure and temperature changes could damage it. Lost bags are the other risk, so every dose and spare travels in the cabin.

The hotel minibar. Minibars are built for drinks, not medicines, and the coldest shelf may sit near a freezing plate. Test any hotel fridge with a thermometer before trusting it, as the EASD study lead^[77] advised for home fridges.

The ski day. Sub-zero air will freeze a pen in an outer pocket or a car. Carry it in an inside pocket close to your body, as covered in our guide to sub-zero medication storage on the mountain.

Heat matters too, but the margins are wider. Most insulins and GLP-1s tolerate 30°C, while many antibodies stop at 25°C. A parked car, a sunny beach bag or a heatwave can pass both, so read our guide to travelling during a heatwave with medication.

Choosing a travel cooler for medication

Match the cooler to the label. If your medicine tolerates 25°C or 30°C for the length of the trip, you need protection from extremes, not a fridge. If it must stay at 2°C to 8°C, you need active or ice-based cooling and a way to check it.

Evaporative cooling wallets (FRIO)

A FRIO wallet holds crystals that swell into a gel when soaked in water, and cools as that water evaporates. The maker says it keeps in-use insulin at 18°C to 26°C for at least 45 hours^[76], even in 37.8°C heat. Soaking it again reactivates it.

That range suits medicines allowed at room temperature, such as in-use insulin pens and most GLP-1 pens. It is not a 2°C to 8°C fridge, and 26°C is above the 25°C ceiling on labels such as Humira and Aimovig. Evaporation also slows in humid air, so test it before a tropical trip.

Insulated cases with gel or ice packs

Insulated bags with frozen gel packs can hold 2°C to 8°C for several hours, which suits a door-to-door flight day. The trade-off is freezing risk and packs that warm through, so carry a thermometer and keep pens separated from the packs.

Active and USB coolers

Battery or USB coolers use a small electric cooler to hold a set temperature, and some pair a USB-powered lid with a gel pack. Check the maker's tested temperature range and duration against your label before you rely on one.

Check the battery before you fly. The FAA^[75] allows personal lithium batteries under 100 Wh, while 101 to 160 Wh batteries need airline approval, and spares must travel in the cabin.

Thermometers and temperature loggers

A cheap digital minimum and maximum thermometer tells you whether a fridge or case dipped below 0°C overnight. Bluetooth temperature loggers can send alerts to your phone, so check the maker still supports the app before you buy. A single-use freeze indicator in the case is a simple backstop.

Ice packs at airport security: TSA, UK and EU rules

In the US, the TSA^[68] allows medically necessary gel ice packs in reasonable quantities whether they are frozen, slushy or melted. Ordinary frozen items must be frozen solid. Tell the officer, and place insulin and other medical liquids in a separate bin^[69] for X-ray screening.

In the UK, GOV.UK^[70] lists cooling gel packs as allowed in hand luggage, but says to contact the airport about ice packs. Liquid medicines over 100 ml need proof they are prescribed to you, such as a prescription copy or doctor's letter.

Across the EU, medicines needed for the journey are exempt from the 100 ml limit but may get extra screening. Eindhoven Airport^[71], for example, asks passengers to take larger medicine containers out and present them separately, with a doctor's note as proof.

The ADA^[72] says insulin can usually pass through X-ray machines, and you can request a visual inspection instead. For more on liquids and documents, see liquid medication on a plane and flying with prescription medication.

On the plane: crew fridges, dry ice and long-haul timing

Do not plan on the galley fridge. ANA^[73] states that its cabin attendants are not allowed to look after or refrigerate passengers' medication, and asks travellers to bring a cooling box. Other airlines set their own policies, so ask in advance but pack as if the answer is no.

Keep the cooler under the seat in front, where you can reach it and check the thermometer. If crew offer ice, bag it twice and keep a cloth between ice and pens.

Under the dangerous goods rules published by Qantas^[74], passengers may carry up to 2.5 kg of dry ice with airline approval. It must be in vented packaging and declared at check-in. Dry ice is far below freezing, so it must never touch medication, and few travellers need it.

Work out your door-to-door time, including connections, delays and the drive to your hotel. Compare that total with your label allowance, and pick the cooler from the table above. Skyrizi's 24-hour EU allowance, for example, is shorter than many long-haul journeys.

At your destination: hotel fridges and power

1. ·
   Ask for a fridge when you book, and say it is for medicine. Test it with a thermometer for a few hours before moving medication in. Keep everything away from the back wall and any freezer plate.
2. ·
   If the room has no fridge, ask whether reception can store it in a staff fridge in a labelled bag. In some hotels the room power, minibar included, switches off when you remove the key card, which is another reason to check temperatures.
3. ·
   Check that the adapter accepts 100 to 240 volts, or run a USB cooler from a power bank. Active coolers need the right plug and voltage. Where no fridge exists, an evaporative wallet keeps in-use pens within range while you wait.

Customs: why refrigerated injectables draw questions

Customs rules apply to the medicine, not the cooler, and some countries cap injectables by supply. Japan's health ministry^[78] allows injectable drugs and their syringes up to a one-month supply, pre-filled or self-injection kits only. Above that you need import confirmation before you leave.

Singapore's Health Sciences Authority^[79] allows up to three months' supply of non-controlled medication without approval. Travellers must carry a copy of a valid prescription or doctor's letter from their country of residence.

GLP-1 medicines draw extra attention because of shortages and counterfeits. Regional guides: GLP-1 customs approval worldwide, GLP-1 import rules in Europe, GLP-1s in the Gulf, GLP-1s in Southeast Asia and GLP-1s in Latin America.

For the Middle East, see UAE and Gulf medication import rules, and for Japan, Japan medication rules. Carry a letter naming each medicine by its INN (generic name), the dose, the quantity and the need for needles. Our medication import rules glossary entry explains the terms.

Weekly and daily injections across time zones

Weekly injections are forgiving if you know the window. Use the rule on your own label, and ask your prescriber before shifting a schedule.

• Ozempic: if missed, inject within 5 days. You can move the weekly day if doses stay at least 3 days apart (EU^[10]) or 2 days apart (US^[38]).
• Wegovy: the EU label^[11] says inject within 5 days of a missed dose. The US label^[39] says inject if the next dose is more than 2 days away.
• Mounjaro: inject within 4 days (96 hours) of a missed dose, keeping at least 3 days between doses (EU^[12], US^[40]).
• Trulicity: give a missed dose only if at least 3 days remain before the next one (EU^[15]).

Daily basal insulin and mealtime doses need a plan for eastbound and westbound flights, worked out with your diabetes team. For GLP-1 specifics, read GLP-1 pen dose timing and whether to skip Wegovy or Mounjaro on holiday.

If your medicine froze or overheated

Do not use a medicine that has frozen, even if it looks normal after thawing. Labels such as Lantus^[35] and Mounjaro^[40] say not to use it.

If a product went past its temperature ceiling or allowance, call the manufacturer's medical information line or a local pharmacist. Several labels, including Stelara^[21] and Ajovy^[26], say not to return the product to the fridge once it has been at room temperature.

Replacement abroad is easier with the generic name and a record of your doses. Our guide to replacing lost or stolen medication abroad covers prescriptions and pharmacy access if your supply is compromised.

Country guides for insulin, GLP-1s and diabetes

Rules on bringing in, packing, buying, and refilling these medicines vary by country. Start with the guide for your destination.

• Insulin: Japan, Thailand, Spain, Mexico, India, Indonesia.
• Semaglutide: Japan, Thailand, France, Germany, Portugal, Spain, Mexico, Indonesia.
• Brand pages: Ozempic in Spain, Ozempic in Mexico, Wegovy in Spain, Mounjaro in Spain, tirzepatide in Japan, tirzepatide in Spain.
• Diabetes travel guides: United States, United Kingdom, Japan, Thailand, UAE, Spain, Mexico, Indonesia, Australia, Turkey.
• Biologic conditions: rheumatoid arthritis in Germany, Crohn's disease in Spain, IBD in India, migraine in Spain, multiple sclerosis in Italy.

Related guides

• Immunosuppressants abroad, for anyone on a biologic with an infection risk.
• IBD travel tips and checklist, for Crohn's and colitis treatment plans.
• Vitamins and supplements on a plane and abroad, the fourth guide in this series.

Frequently asked questions

Sources

1. [1] EMA: NovoRapid (insulin aspart) product information (SmPC)
2. [2] EMA: Fiasp (insulin aspart) product information
3. [3] EMA: Humalog (insulin lispro) product information
4. [4] EMA: Lyumjev (insulin lispro) product information
5. [5] EMA: Lantus (insulin glargine) product information
6. [6] EMA: Abasaglar (insulin glargine) product information
7. [7] EMA: Toujeo (insulin glargine 300 units/ml) product information
8. [8] EMA: Tresiba (insulin degludec) product information
9. [9] EMA: Levemir (insulin detemir) product information
10. [10] EMA: Ozempic (semaglutide) product information
11. [11] EMA: Wegovy (semaglutide) product information
12. [12] EMA: Mounjaro (tirzepatide) product information
13. [13] EMA: Saxenda (liraglutide) product information
14. [14] EMA: Victoza (liraglutide) product information
15. [15] EMA: Trulicity (dulaglutide) product information
16. [16] EMA: Humira (adalimumab) product information
17. [17] EMA: Dupixent (dupilumab) product information
18. [18] EMA: Enbrel (etanercept) product information
19. [19] EMA: Cosentyx (secukinumab) product information
20. [20] EMA: Taltz (ixekizumab) product information
21. [21] EMA: Stelara (ustekinumab) product information
22. [22] EMA: Skyrizi (risankizumab) product information
23. [23] EMA: Xolair (omalizumab) product information
24. [24] EMA: Aimovig (erenumab) product information
25. [25] EMA: Emgality (galcanezumab) product information
26. [26] EMA: Ajovy (fremanezumab) product information
27. [27] EMA: Repatha (evolocumab) product information
28. [28] EMA: Praluent (alirocumab) product information
29. [29] EMA: GONAL-f (follitropin alfa) product information
30. [30] EMA: Ovitrelle (choriogonadotropin alfa) product information
31. [31] EMA: Ogluo (glucagon) product information
32. [32] EMA: Baqsimi (nasal glucagon) product information
33. [33] DailyMed: US prescribing information, NovoLog (insulin aspart)
34. [34] DailyMed: US prescribing information, Humalog (insulin lispro)
35. [35] DailyMed: US prescribing information, Lantus (insulin glargine)
36. [36] DailyMed: US prescribing information, Toujeo (insulin glargine U-300)
37. [37] DailyMed: US prescribing information, Tresiba (insulin degludec)
38. [38] DailyMed: US prescribing information, Ozempic (semaglutide)
39. [39] DailyMed: US prescribing information, Wegovy (semaglutide)
40. [40] DailyMed: US prescribing information, Mounjaro (tirzepatide)
41. [41] DailyMed: US prescribing information, Zepbound (tirzepatide)
42. [42] DailyMed: US prescribing information, Saxenda (liraglutide)
43. [43] DailyMed: US prescribing information, Victoza (liraglutide)
44. [44] DailyMed: US prescribing information, Trulicity (dulaglutide)
45. [45] DailyMed: US prescribing information, Humira (adalimumab)
46. [46] DailyMed: US prescribing information, Dupixent (dupilumab)
47. [47] DailyMed: US prescribing information, Enbrel (etanercept)
48. [48] DailyMed: US prescribing information, Cosentyx (secukinumab)
49. [49] DailyMed: US prescribing information, Taltz (ixekizumab)
50. [50] DailyMed: US prescribing information, Stelara (ustekinumab)
51. [51] DailyMed: US prescribing information, Skyrizi (risankizumab-rzaa)
52. [52] DailyMed: US prescribing information, Xolair (omalizumab)
53. [53] DailyMed: US prescribing information, Aimovig (erenumab-aooe)
54. [54] DailyMed: US prescribing information, Emgality (galcanezumab-gnlm)
55. [55] DailyMed: US prescribing information, Ajovy (fremanezumab-vfrm)
56. [56] DailyMed: US prescribing information, Repatha (evolocumab)
57. [57] DailyMed: US prescribing information, Praluent (alirocumab)
58. [58] DailyMed: US prescribing information, Gonal-f RFF Redi-ject (follitropin alfa)
59. [59] DailyMed: US prescribing information, Ovidrel (choriogonadotropin alfa)
60. [60] DailyMed: US prescribing information, Menopur (menotropins)
61. [61] DailyMed: US prescribing information, Gvoke (glucagon injection)
62. [62] DailyMed: US prescribing information, Baqsimi (nasal glucagon)
63. [63] DailyMed: US prescribing information, Xalatan (latanoprost)
64. [64] emc: Xalatan 50 micrograms/ml eye drops, UK SmPC
65. [65] emc: GlucaGen HypoKit 1 mg, UK SmPC
66. [66] emc: Menopur 1200 IU, UK SmPC
67. [67] emc: Menopur 150 IU, UK SmPC
68. [68] TSA: What Can I Bring? Gel ice packs
69. [69] TSA: What Can I Bring? Insulin
70. [70] GOV.UK: Hand luggage restrictions, essential medicines and medical equipment
71. [71] Eindhoven Airport: Everything about liquids in your hand luggage
72. [72] American Diabetes Association: What can I bring with me on the plane?
73. [73] ANA: Customers using autoinjectors and portable medical devices
74. [74] Qantas: Other dangerous goods items (dry ice)
75. [75] FAA PackSafe: Airline passengers and batteries
76. [76] FRIO UK: How a FRIO works
77. [77] Medical News Today: Insulin stored in home fridges often outside the recommended range (EASD 2018, Braune et al.)
78. [78] MHLW Japan: Information for those bringing medicines for personal use into Japan
79. [79] HSA Singapore: Travelling with medications to Singapore

Topics

• TopicDiabetes & Travel
• TopicPrescriptions Abroad
• TopicPharmacy Guide

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