If you take any type of medication, it is important to understand how traveling may affect your medication schedule and the effects of the drugs. It is also helpful to take steps to ensure you stay on track the best you can. Travel across 6 or more time zones will almost certainly disrupt the exact timing of medications and alter the internal biological time of exposure, but the body is resilient enough in most instances to adapt.
Most pharmacy plans will allow extra medications to cover travel, if requested.
How air travel may affect your medication schedule
According to Dr. Robert Thomas, air travel can impact a medical condition you have and your medication schedule. “Three things usually happen when you travel. You lose sleep, develop a circadian mismatch, and your meals are often different,” said Dr. Thomas.
These factors can all affect a medical condition you have. For example, blood sugar may fluctuate during travel if you change the time you eat or what you eat. Your body may also experience stress when traveling and taking a flight. Changing time zones can alter your circadian rhythm and even leave you sleep-deprived.
Keep in mind, it is not necessarily the length of the flight. It is the change in time zones that may play a more significant role in sleep disruption or how the body handles medications (there can be important differences in effect based on when in body clock time a drug is taken).
Specific types of medications and air travel
Traveling may cause disruption to your medication use. So, before you go, it is best to talk to your healthcare provider and find out what is acceptable and what you should avoid. Usually, taking a medication an hour or two early or late is not a problem.
Different types of medications may require a few considerations when traveling by air. Consider the following:
Controlled drugs
These include opioids for pain, sedatives (including sleeping aids), stimulants (including those used for attention deficit disorder) and some special medications used for sleep disorders like Xyrem, Xywav, Wakix, as examples. Have clear documentation of use, ideally a letter from the prescribing physician, if traveling outside the USA. Some of these drugs are considered illegal or near-illegal to carry in several countries.
Immune system medications
Drugs like steroids need precision dosing. There are several new medications which impact immune system function, where individual doses cannot be missed. Speak to the prescribing specialist before major travel.
Cancer drugs
These days, having a cancer is not a contraindication by itself to travel. Patients with cancer want to have as normal a life as possible, but they may also be on complex oral or self-administered medications. Consulting with the cancer specialist is strongly recommended prior to travel. Many cancer drugs have limited availability outside the USA.
Respiratory medications
Respiratory medications include long-acting medications and fast-acting bronchodilators. Try to stick to the same interval between doses of your long-acting respiratory medications. Carry your rescue inhaler with you in your carry-on bag.
Pain medication
Sleep loss, which may occur with travel, can make it more difficult to deal with chronic pain. Also, sitting for extended periods on an airplane can become uncomfortable and also make pain worse. Talk with your doctor about adjustments in dosing before your trip. Do not try to skip these medications abruptly for a long flight.
Blood pressure
Sleep loss and stress to your circadian rhythm and eating different foods can affect your blood pressure. Certain blood pressure medications (diuretics) may also lead to increased trips to the bathroom. Most current blood pressure medications are long acting and are taken once a day, so a few hours delay is not going to have a large impact.
Insulin
Your meals and sleep may become disrupted during your flight. How much you eat may affect how much insulin you take. Talk to your physician, check your blood sugar level inflight as needed, and it safer to be slightly above ideal than below. Hypoglycemia at 30,000 feet is not a good thing!
Non-insulin diabetes medications are usually taken once a day and thus there is some flexibility of a few hours variability in time.
General tips
When traveling by air, there are some general tips for medications to keep in mind, such as:
Pack medication in carry-on bags instead of checked luggage. The American Lung Association recommends packing all inhalers in your carry-on bags. But that tip also goes for other types of medications. You do not want to go without medications if your luggage is delayed.
Be aware of restrictions. There are rules for taking liquids on board, but liquid medications are handled differently. According to the Transportation Security Administration, you can carry liquid medication onboard that is larger than 3.4 ounces. But just let the TSA officer know when you start the screening.
Bring information with you. Just in case you need it, have information with the name of the medication, strength, prescribing practitioner, and filling pharmacy. Keep in mind, some countries may require you to have the medication in the original bottle.
Set an alarm if needed. To keep your intervals the same between doses, set an alarm on your phone so you remember when to take your meds.
Have enough medication just in case your travel plans change. It is better to have a little extra medication with you so you do not have to search for a place to refill prescriptions.
References
TSA cares: What to expect when flying with medications. (2014). https://www.tsa.gov/blog/2017/11/14/tsa-cares-what-expect-when-flying-meds
COPD medication management tips. (2021). https://www.lung.org/lung-health-diseases/lung-disease-lookup/copd/treating/medication-management-tips
Pack smart. (2019). https://wwwnc.cdc.gov/travel/page/pack-smart
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