Tocilizumab and travel

i have been using a medical travel bag but it uses ice packs to keep the injections cold, when I went through Heathrow airport a couple of weeks ago I was stopped because of this. I have a letter from the hospital but I still had to get special permission to be allowed to keep them. They said that as the ice packs where still frozen solid I could keep them this once. Anybody know of anything else I can use which will keep tocilizumab cold enough or will I have to leave my injections at home or just no fly anymore.

23 Replies

  • I got the disposable ice packs and a really good online insulated bag. I kept the packs in until I went through security. My injections were fine for the 3.20 minute flight. I don't know what the problem is about the ice packs. They specifically asked me this year.


  • I was told that they are checked the same as any other liquid and are over the limit. My flight was to see my daughter who is working in China. I have tried to find another way to keep the tocilizumab cool enough but although I found packs for insulin they didn't keep my drugs at the temperature required.

  • Well Ozzy I was going to check this myself apparently providing they are for medication and the letter says they have to be temp controlled then they are accepted. I suggest you email the airports customer services advising them what happened and ask them to clarify. They should then train their people. Mine wanted to take my toch injections away to swab. Told him he wasn't taking them anywhere. He then took the letter from doctor to his boss. This is first year my injections been questioned. I think they have taken extra staff who don't know the rules. Perhaps we should also be asking the NRAS to be raising this with Airport authorities. I had 5 months injections he asked why I couldn't keep one for the flight and put others in the hold. I pointed out the regs to him and my letter advising him he should read it properly. Healthcare at home sent a really good letter. I have to say the Bupa letter is garbage in comparison.

    I will contact NRAS asking them if they doing anything. If you want perhaps you could also ask them.


  • Just looked at the rules at Heathrow and it states the unless your need medicine during flight it has to go into the hold luggage. If needs to be temperature controlled you have to contact your airline directly and get them to place your medicine in the correct area of the Hold. My next flight is with Ryanair, as it's only for a week I think I will skip my next injection as I do not fancy handing my injecton over to just anybody who may not put the same level of important as me.

  • Hi....Shazbat....I wonder if you can you tell me if you had any problems with Private Medicine re going on Biologics? My Rheumy nurse reckoned my annual subscription would go through the roof if I had RTX privately. I'm waiting (& waiting) to get started on the NHS. As I'm full of steroids I'm not in too much pain, but I want to get on with things ...but don't want a huge increase in my already huge private medical insurance bill!

    Would appreciate your experience.

  • I agree 100% ...I used to be a trolley dolly & I wouldn't trust any meds being looked after by any airline.

    Keep them with you 100% of the time.

    As Shazbat says.....the people doing the scanning at airports are not well trained & certainly don't understand how vital it is to keep meds at the correct temperature.

    I do endorse contacting the airline & copying them your hospital/doctor's letter & asking them to arrange with airport security that you keep your meds with you at all times.

  • Thanks for your reply. My letter was from my rhumy at addenbrooks hospital and I took the injections in original packaging with the leaflet which has instructions on storing injections. I also noticed the label on the box from the pharmacy has the temperature to keep them in. I had to show all of it and still had trouble with security. The bag I use was my nieces which she was given to keep her drugs in from the drug company so it's marked with medical stamp. I will try to find out more as to rules on flying as this must effect a lot of people.

  • I was asked if I had not considered ice cubes. I just looked at the guy like he was a lunatic. I have emailed NRAS asking if anything is being done with the airports. I was also asked if I had considered epi pen for my diabetes until I pointed out I didn't have diabetes.


  • This is from Heathrow Airport web page.

    You can only carry an ice-pack or liquid / gas cooling bag if you are carrying essential medication required during the flight and you can provide proof that the medication must be kept cool. Please see the restrictions on the carriage of liquid medicines for further details.If your medication is not required during the flight but needs to be temperature controlled you must make arrangements with your airline to store the medicines and cool bag in an appropriate area of the hold.

  • Would small ice-packs (below 100ml) not get around this? I thought it was just the quantity of liquid in each separate container? May be wrong.

  • Yes that should can take 6x 100 ml bottles of cosmetic lotions can't you!

  • Hi all

    Thank you for raising this Ozzy, and thank you for emailing us and alerting us to the post Shazbat. We haven't been getting any helpline calls about this, so had not contacted airports/airlines etc. I have done some research on websites for some of the major UK airports. As Ozzy has said, Heathrow do state that:

    "If your medication is not required during the flight but needs to be temperature controlled you must make arrangements with your airline to store the medicines and cool bag in an appropriate area of the hold."

    None of the other sites I looked at went into this level of detail. They all seem to refer to only having medication in hand luggage that is 'essential' for the flight, but don't explain what happens when the medication has to be kept at a certain temperature.

    My concern with the above quote from Heathrow is that I wonder whether all the airlines are actually set up to have an 'appropriate area of the hold' as our understanding had always been that the hold would be too cold for this medication. You would certainly want some reassurance on this before handing the medication over to someone to entrust this with. It is also not clear at what point you would give it to a member of staff and how qualified that person would be to make sure the medication was safe.

    I can't tell whether the wording on these websites has always been that way or been changed/updated recently, but we will keep an ear out for other people having these problems, and I will see if there are organisations we can contact to get some clarity/reassurance. It might take a while to get responses on this, so please bare with me. I will update on here when I have anything, so that other people can see the thread.

    We always recommend that as well as carrying a letter from your doctor, as an added precaution it is worthwhile contacting the airline you will be travelling with to make them aware that you will be taking medication with you which must be temperature controlled.

    I notice that the Heathrow page doesn't say anything about 100ml allowance for the ice packs, just that they have to go in the hold. Can I just check Ozzy and Shazbat if you know what size yours were/whether they were over this amount, and how many ice packs you had for your medication?

    Many thanks


    (NRAS Helpline)

  • Hi Victoria mine were the small silver ones you can buy for a pound. I'm sure they are not more than 100mls. I have never had a problem travelled with injections for 6 years I go through Manchester and it was only this year the guy had no idea what to do. In the past they read the letter. Even when Enbrel said you can't scan they were fine. However the tone this year changed because it was short flight I didn't have the packs. The lady who searched my luggage initially said good no ice packs. Then I was passed onto a guy and spent 15 minutes while he went through every box, took my letter to a manager then swabbed them. But they seemed to be concerned about the ice packs.


  • Hi all

    It seems the more I delve into this the less clear it becomes, and I am struggling to find definitive answers or places to go for definitive answers. Most airport sites refer to people only carrying medication needed during the flight, and putting the rest of the medication in the hold. The problem with this for biologics is that they need to be kept at a controlled temperature, and the hold is generally too cold.

    Previously, a letter explaining the above has been sufficient. I am not sure if this has changed or if inexperienced/poorly trained staff have either been more rigid with guidelines than they used to be or haven't understood the guidelines.

    A suggestion to contact the airline you will be travelling with in advance keeps coming up, so I think that would be the best thing to do. If possible, ask them to put any requirements for travelling with medication in writing (email or post) to you. If they tell you that you only need a letter from your doctor or the company who provide your medication, having this in writing would be helpful.

    Here are some other suggestions from the research I have done today:

    As you will have seen, the major issue with carrying liquids is having more than 100ml. If you are using ice packs, ensure that they meet this requirement.

    You can buy special travel cases for traveling with medication that has to be kept at a certain temperature, for example: (I use this as an example because they specifically say that they can be used for biologics). However, it is worth contacting the company who provide your medication (e.g. Healthcare at Home or Bupa), as they may be able to provide you with a travel case. They may also have useful information about keeping your drug at temperature. For example, you may typically need to store it at 2-8 degrees, but it may be acceptable to allow it to go above this temperature, so long as it doesn't exceed 25 degrees. The exact temperatures and the number of times this can happen over a set period can vary, and guidance changes over time, so worth checking this.

    If you are told your medication will need to be kept in the hold, ask for details about when it will be handed to a staff member, what their level of training/understanding of treating your medication will be, and confirmation of the temperature of the hold area and how this would be monitored.

    I hope the above helps. Please let us know if any of you have continued problems with this.

    Kind regards


    (NRAS Helpline)

  • I am not sure what size my ice packs are as my son is using my bag to collect my next batch from the hospital. The bag I use is designed to keep injections at the ideal temperature between 2-8 degrees and was provided by a drug company. I have looked at insulin pouches but the temperature was not cool enough for tocilizumab. I have a letter from the hospital for travelling with also I kept the drugs in their packaging which has the temperature that it must be kept on it. I was eventually let through security after a manager was called but only because the ice packs were still frozen solid. I don't think they would let do it again. I don't know if gel packs would be the same.

  • Try using Frio bags which work by soaking a pouch filled with beads in cold water which then expand and stay cool for up to 48 hours. I use these for insulin when travelling and they are brilliant. When they get warm you simply soak again in cold water. I shall be using them for MTX injections on my trip to India in three weeks. Never had to have a letter. Insulin always travels with me and also a copy of my prescription

  • I looked at these but tocilizumab has to be kept between 2-8 degrees.

  • Oh! No! Due to travel on Easyjet in 2 weeks time - need to take 2 Methotrexate and 2 Humira pens with me. Stupidly I assumed cool bag and ice packs for Humira pens and the MTX pens in my hand luggage with a Consultants letter, drug packaging and info. , a Hospital at Home letter and current prescription documentation to be sufficient evidence and preparation. Seems like 'trouble ahead' !!! I have just emailed their customer services - but a reply will not be forthcoming for 4-5 working days!!!!! It has now become such a worry - the last thing any of us need - bad enough keeping the disease under control with everyday stresses and strains!! Any advice - new news will be much appreciated and I will update on outcome ..... It's been bad enough finding away to keep the Humira between 2-8C for 12 hours fridge to fridge!!!!!

  • It might just be Heathrow airport security. Can you ring customer services and look on airport website that your flying from. I had no problems with internal flights once I got to China .

  • Hi

    If you have a look on the Easyjet website they have a telephone number for passengers requiring special assistance. I contact them each time I fly with them as I have a wheelchair at the airport. I have always found them to be extremely helpful. I know medication is a different problem but I certainly think they are worth a try. Good luck.

  • Thank you thelmar - I will try that - I do want something in writing though to flash around at the airport and I guess they will need evidence (letters, prescriptions etc.) which I have added to my email - but a phone call certainly wouldn't go amiss!!!

  • I went through Edinburgh airport this year and had no problems taking injections on board and I had the small silver ice packs.

    In fact security said that the liquid in the injections would not be included in the total allowance for fluids.

    Glasgow airport the same last year.

    It might be good if all airports/airlines could agree to work to the same rules.

  • Another point with regards storing things in the hold - anyone ever got to their destination and been told their bag is in a different continent?

    I always split my medication between hand luggage and hold luggage and take enough in each to last the entire holiday. It might be overkill, but I personally wouldn't fancy having to track down a supplier of biologics, for example, in some parts of the world.

    Idk if it's partly the syringes that they are worried about, but I have never once had a problem with medication in my hand luggage.

    There's always a first time I guess....

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