Yes, you can fly with biologics!
According to TSA regulations, you can pack “medically necessary liquids, medications, and creams”, as well as syringes, ice packs, and other medical supplies, in your carry-on luggage. For these items, you do not need to follow the 3-1-1 liquids rules that are required for products like shampoo and perfume. However, when going through airport security, be sure to package your medications in a separate bag (or a separate container within your carry-on bag), as the security agent will screen them separately. If possible, when going through airport security, make sure your ice-packs are frozen solid. When carrying biologics, partially frozen ice-packs are still considered medically necessary, but some patients have reported a delay at security when their ice packs are slushy or leaking.1-3
Working with airport security
When going through airport security, tell the security agent about your medications before they start screening your bags. If you’re going through airport security, it’s important to let the security agent know that you’re traveling with medications. If you’re nervous about explaining your medications to a security agent, TSA recommends handing the agent a ‘TSA Notification Card’, which allows passengers with medical needs to disclose this information. On this card, consider writing something like, “I am traveling with medication syringes, ice-packs to keep my medications cold, and a sharps container”. If you have questions or concerns about taking your biologics through airport security, you can also contact TSA before your flight.1-3
Call your pharmacy
Contact your specialty pharmacy or mail order service BEFORE your trip. When traveling, you’ll need enough syringes to last the entire trip. If you are traveling for an extended period, this may require contacting your specialty pharmacy or mail order service to receive your next syringes early. Be sure to call well in advance, so your medications arrive before you leave! Similarly, if your biologics are automatically shipped to you, you may need to alert the shipper that you will be traveling.
Make sure your medications are clearly labeled, and keep your syringes in the original box or packaging. To expedite airport screening, TSA recommends that all medications are contained in the original packaging. If possible, keep the original prescription labels on the packaging, so that the security agents will know the medications that you’re carrying were indeed prescribed for you. If you’re traveling internationally, prescription labels on your medications may also limit any delays at customs and immigration.1-3
Always bring a letter from your doctor.
To minimize problems at airport security, border patrol, or customs and immigration, always travel with a letter from your doctor. This letter should explain the need for your medications (and that they need to be kept in your carry-on!), and how they need to be stored/kept cold. Especially when traveling with syringes and ice-packs, a letter from your doctor may reduce any delays at security checkpoints.1
Bring copies of all prescriptions
In addition to clearly labeled medications and a letter from your doctor, always travel with written copies of your prescriptions. If your biologics become damaged or overheated, you may need a copy of your prescription to pick up replacement syringes nearby.
Carry a biological therapy alert card.
In addition to copies of your prescriptions, when traveling, always carry a biological therapy alert card. You should consider keeping this alert card in your wallet when not traveling! If you ever need emergency medical treatment, your alert card will help your healthcare providers to be aware of any increased risk of infection, as well as avoid drug interactions.1
Know the rules!
Different medications are allowed (and not allowed) in different countries. When traveling internationally, be sure to check the country’s laws and customs regulations to ensure that you can bring your biologics on your trip. For more information about traveling internationally and what medications you can bring, consider visiting the US State Department website, or contact the US Embassy for the country you’re visiting.1
Keep (your medications) cool.
When traveling with biologics, be sure to plan how you will keep your medications cold during travel, and how you will store them when you arrive at your destination. For air, train, bus, or car travel, consider purchasing a medication travel bag that is designed to keep your medications cool (or ask if you can order one for free from the manufacturer). Especially for long trips, it may not be possible to control the temperature of your medications in a normal backpack or suitcase. Some medication travel bags even have a built-in temperature display, but you can also purchase a small thermometer to bring with you. When packing, be sure to put your biologics in your carry-on luggage.1
While taking your medications through airport security may seem difficult, the checked baggage compartment on a plane (or bus or train!) is not temperature-safe for medications. Additionally, if your checked bag is lost, stolen, delayed, or misplaced, your medications may be damaged (or no longer cold) by the time you get your bag. When planning your trip, also be sure that your destination or hotel has a refrigerator for your medications. If you’re staying at a hotel, be sure to call ahead to confirm that there is a mini-fridge available, and double-check the temperature when you arrive. If your destination does not have a refrigerator, you may also consider bringing extra plastic bags, in case you need to get ice from a local restaurant or convenience store to keep your medications cold when you arrive.
Pack a sharps disposal container.
To dispose of used syringes, be sure to pack a sharps disposal container or another safe alternative. If possible, dispose of used syringes before going through the airport, to limit extra searches at security. However, if you are flying with used syringes, be sure to pack your sharps container in your carry-on bag, as your checked bag may be hand-searched if the sharps container is detected on the X-ray. Again, be sure to tell the security agents that you are traveling with used medical syringes.
Plan for extra time at security.
When traveling with biologics, especially through an airport, you should allow extra time for security screening, as going through your medications may take longer than a typical security screening. According to TSA regulations, you can ask for your medications to be hand-searched if you do not want them to go through the X-ray screening or opened. To make sure that your medications are handled properly during security, you can request to be present when your medications are searched, and will probably be asked to display and repackage your items yourself.2,3