Prescription drugs that needs to be refrigerated?

[boomtown]

Planning my first Camino here, and I have somewhat of a problem with my Rx drug.

I have ankylosing spondylitis and every two weeks I administer myself with a self-injection pen of Humira, much the same way a diabetic does but with a pen that's only used once and then disposed of.

Thing is, it has got to be kept refrigerated. I do understand that's impossible on the Camino, but as I see it I have two options:

- When taken out of the fridge it can be kept in room temperature for two weeks, but no warmer than 25°C. I'm ready to bet heavy on the fact that it will probably be hotter than that inside my backpack, especially since I'm planning for august-september, so that doesn't really feel like an option.

- Finding it in Spain. Now, Humira is hugely expensive, even in (when it comes to drugs) moderately cheap Sweden, but a double pack costs just shy of €1000 around here (yeah, you read that right) and isn't available everywhere. Sweden's high cost protection system means I pay far from full price, but I seriously doubt that system will work in Spain...

There is one more option and that is to shrug and keep walking.
I have given this a lot of thought, but my condition sits in my lower back and I feel that area will take enough of a beating anyway and giving up on the meds that literally keeps me walking without limping, and also lets me sleep properly? Well...

Any ideas..? It sure would be appreciated!

 

[C clearly]

I haven't had to do this, but I think you could keep it cool (under 25C) if you came prepared and were diligent.

An important question to understand would be: What happens if the cooling requirements are not fully met? Does it just become gradually/suddenly less effective? or does it spoil and become a direct hazard?

 

[natefaith]

Hi boomtown and welcome to the Forum. I've also not had to do this before, but this thread may give you some helpful advice: https://www.caminodesantiago.me/com...n-cold-chain-on-the-camino.16639/#post-119200

Seems like keeping your medication next to your water bladder may be a good tip...except that was during an April Camino. Hmmm....

 

[natefaith]

This thread my also be helpful, and there are a couple of other links within the thread as well. https://www.caminodesantiago.me/com...k-how-to-keep-insulin-cool.24523/#post-189880

Regarding pricing in Spain - medication prices in Spain are also pretty low, but you're right, you probably can't count on that and you may not be able to find Humira everywhere you need it. So the wisest thing may be to bring what you need ahead of time unless you can do some research and know for sure there are certain pharmacies in certain towns that will carry it.

 

[Stephen]

Could you put it in a wide necked thermos flssk with ice?

 

[Deleted member 67185]

Planning my first Camino here, and I have somewhat of a problem with my Rx drug.

I have ankylosing spondylitis and every two weeks I administer myself with a self-injection pen of Humira, much the same way a diabetic does but with a pen that's only used once and then disposed of.

Thing is, it has got to be kept refrigerated. I do understand that's impossible on the Camino, but as I see it I have two options:

- When taken out of the fridge it can be kept in room temperature for two weeks, but no warmer than 25°C. I'm ready to bet heavy on the fact that it will probably be hotter than that inside my backpack, especially since I'm planning for august-september, so that doesn't really feel like an option.

- Finding it in Spain. Now, Humira is hugely expensive, even in (when it comes to drugs) moderately cheap Sweden, but a double pack costs just shy of €1000 around here (yeah, you read that right) and isn't available everywhere. Sweden's high cost protection system means I pay far from full price, but I seriously doubt that system will work in Spain...

There is one more option and that is to shrug and keep walking.
I have given this a lot of thought, but my condition sits in my lower back and I feel that area will take enough of a beating anyway and giving up on the meds that literally keeps me walking without limping, and also lets me sleep properly? Well...

Any ideas..? It sure would be appreciated!

Here are a couple of ideas.

http://www.simpleoutdoorstore.com/escape_pod_cooler.html

http://www.instructables.com/id/Backpacking-Cooler/

 

[Rick of Rick and Peg]

I have no experience with anything like this but here is something I found that may be of use to you:
The website http://www.ibdpassport.com/travelling-ibd/travelling-with-medication
mentions https://friouk.com/

 

[JohnCP43]

Boomtown - you are to be commended for keeping active - not only for joint health but general health as well. Some suggestions I would not try are placing in the refrigerator where you stay overnight. While most pilgrims are honest, the temptation of unattended syringes containing anything might be too great to resist. I would also not want to depend on a system that requires it to be refrozen each night. Trying to get relatively esoteric meds in any foreign country could be problematic. (No, I'm not implying medical care there is not up to standard - just that it would add another level of complication to your camino. ) The suggestion by Steven of using a wide mouthed cooler flask makes good sense.A light weight plastic one with styrofoam insulation, holding your meds sealed in a "baggie" with ice to be replaced each day should work well keeping things in the 2 - 8 degree range. I don't know how long you intend to walk but if for example you were only going to be gone only 4 weeks you'd really need to carry only one dose. Been camino and good health!! We all wish you well.

 

[boomtown]

Thanks for all the replies, sure pointed me in the right direction!

The idea of a icefilled thermos sounded both likely to keep the temperature and relatively easy to maintain - until I saw Ricks link to Frio. Bingo! Less than five minutes to activate and reactivate, immediate cooling effect and holds for 45 hours in surrounding temperatures of over 35°C! Now that's tech working for you!

I haven't had to do this, but I think you could keep it cool (under 25C) if you came prepared and were diligent.

An important question to understand would be: What happens if the cooling requirements are not fully met? Does it just become gradually/suddenly less effective? or does it spoil and become a direct hazard?

As I understand it, Humira isn't manufactured in a factory, it's grown in laboratories - part of the big prizetag I assume. But that also implies that it's filled with friendly little germs and these fellas die if the temperature gets too high.
So I don't know if it turns hazardous when too warm but it definitely spoils it.

My doc at the hospital gave me very clear instructions regarding the care of it: keep it in the fridge, if warm it lasts two weeks, once warm don't put it back in the fridge and don't let it get warmer than 25 degrees...

 

[boomtown]

Some suggestions I would not try are placing in the refrigerator where you stay overnight. While most pilgrims are honest, the temptation of unattended syringes containing anything might be too great to resist.

Haha, noooo way I'm gonna leave it unattended! I look over my shoulder just walking home from the pharmacy...

 

[HedaP]

Just in case you need a backup for the frio, in my experience there was a greater chance of municipal albergues having a fridge than any other type of albergue.
Wishing you a healthy and buen camino.

 

[GettingThere]

Planning my first Camino here, and I have somewhat of a problem with my Rx drug.

I have ankylosing spondylitis and every two weeks I administer myself with a self-injection pen of Humira, much the same way a diabetic does but with a pen that's only used once and then disposed of.

Thing is, it has got to be kept refrigerated. I do understand that's impossible on the Camino, but as I see it I have two options:

- When taken out of the fridge it can be kept in room temperature for two weeks, but no warmer than 25°C. I'm ready to bet heavy on the fact that it will probably be hotter than that inside my backpack, especially since I'm planning for august-september, so that doesn't really feel like an option.

- Finding it in Spain. Now, Humira is hugely expensive, even in (when it comes to drugs) moderately cheap Sweden, but a double pack costs just shy of €1000 around here (yeah, you read that right) and isn't available everywhere. Sweden's high cost protection system means I pay far from full price, but I seriously doubt that system will work in Spain...

There is one more option and that is to shrug and keep walking.
I have given this a lot of thought, but my condition sits in my lower back and I feel that area will take enough of a beating anyway and giving up on the meds that literally keeps me walking without limping, and also lets me sleep properly? Well...

Any ideas..? It sure would be appreciated!

This 2016 thread about Humira might be helpful: https://www.caminodesantiago.me/com...ira-on-the-camino-frances-is-it-doable.40073/

 

[cher99840]

Have you discussed this with your doctor? Perhaps he would suggest a substitute for your injection(s) while on Camino, or even skipping.

 

[DirtAmy]

If it lasts two weeks once warm, it could survive posting???? Could you have a friend pop into your fridge at home and post it to you? I think there's plenty of threads on here about sending gear to Post Offices. And if the postage was Next Day, you'd only need to know where you were going to be in the next day or so. If not a Post Office, you could pre-book the next night's accommodation in a place that would accept a package. Maybe....

 

[Rick of Rick and Peg]

Have you discussed this with your doctor? Perhaps he would suggest a substitute for your injection(s) while on Camino, or even skipping.

Or ask about taking it a bit early instead of late. If you can have a small period of time without after a scheduled shot or take a shot a few days earlier then you may be able to do a more convenient schedule such as went you are in a larger town where the drug is available or shippable to you. Check anyway just in case something bad happens along the way like losing the drug. It will ease any stress you may have in trying to recover from a potential disaster.

 

[boomtown]

I don't think posting it would do the trick, it's all too easy to go wrong. Because it's live biologics it can't be frozen (I don't trust cargo holds in airplanes) and once warm it can't be re-refridgerated - you simply don't know what happens to it during transit.

Since AS is an inflammatory disease Humira keeps the inflammation in my back at bay for two weeks. I take the shot every second monday and sometimes my back starts to ache the weekend before "shot monday", that's when Humira wears off.

I haven't seen my doc for a while and I'm going to bring up the question next time, especially if there's a pill of some sort that can be used during that period.

But for now, Frio wins the day.

 

[Del Falkowsky]

Planning my first Camino here, and I have somewhat of a problem with my Rx drug.

I have ankylosing spondylitis and every two weeks I administer myself with a self-injection pen of Humira, much the same way a diabetic does but with a pen that's only used once and then disposed of.

Thing is, it has got to be kept refrigerated. I do understand that's impossible on the Camino, but as I see it I have two options:

- When taken out of the fridge it can be kept in room temperature for two weeks, but no warmer than 25°C. I'm ready to bet heavy on the fact that it will probably be hotter than that inside my backpack, especially since I'm planning for august-september, so that doesn't really feel like an option.

- Finding it in Spain. Now, Humira is hugely expensive, even in (when it comes to drugs) moderately cheap Sweden, but a double pack costs just shy of €1000 around here (yeah, you read that right) and isn't available everywhere. Sweden's high cost protection system means I pay far from full price, but I seriously doubt that system will work in Spain...

There is one more option and that is to shrug and keep walking.
I have given this a lot of thought, but my condition sits in my lower back and I feel that area will take enough of a beating anyway and giving up on the meds that literally keeps me walking without limping, and also lets me sleep properly? Well...

Any ideas..? It sure would be appreciated!

My husband and i did a walk in August and he is Diabetic. He bought 2 Frio bags from the internet which use water for cooling and they worked amazing even in 30 degrees. He never had a problem with his insulin. Check them out they work.

 

[Marilyn Canada]

I don't think posting it would do the trick, it's all too easy to go wrong. Because it's live biologics it can't be frozen (I don't trust cargo holds in airplanes) and once warm it can't be re-refridgerated - you simply don't know what happens to it during transit.

Since AS is an inflammatory disease Humira keeps the inflammation in my back at bay for two weeks. I take the shot every second monday and sometimes my back starts to ache the weekend before "shot monday", that's when Humira wears off.

I haven't seen my doc for a while and I'm going to bring up the question next time, especially if there's a pill of some sort that can be used during that period.

But for now, Frio wins the day.

I have used the Frio on my Camino.... being an insulin dependent Diabetic.....it worked perfectly.....and I highly recommend them....I now use them on all my travels.....be sure to get the right size to fit your Humira injector .....

Also be aware that there will be some “sweating” through the outer sleeve so try to find the right place in your pack....