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Travel out of country on meds?

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Ulcerative Colitis
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Posted 8/20/2022 5:22 PM (GMT 0)
Hi, I’m wondering if anyone's had experience of traveling outside of their own country while on U.C meds (other than mesalamine tablets) and what the issues / solutions were? I’m retired and in Canada. In the past when we’ve done months-long roadtrips to the U.S. I’ve simply brought along an adequate supply of my mesalamine tablets for the time we’re away, no problems there. But, I’ve progressed to daily mesalamine enemas since we last traveled, and my doctor has mentioned biologics as a strong possibility in the near future. The enema packaging is huge so a 10 week supply for example would be really awkward to cart around, protect from the weather etc. As for biologic treatment…. No idea how that would work (I’ve only a sketchy idea of how that while process works yet anyway). Does anyone have any experience that might help me figure out the feasibility of this kind of travel?
Thanks in advance.
Posted 8/20/2022 6:10 PM (GMT 0)
Hi if you end up on biologics they are mostly either self-injection every 2 weeks at home, or infusion at a clinic every 4 to 8 weeks. With the infusions you just have to plan your travel around your infusions (assuming you're not planning to travel longer than 8 weeks at a time). It's ok to shift appointments by a few days. If you end up on biologics and they work for you, you can likely drop the enemas so that would solve that problem. I'm not sure how it works if you want to do really long trips (> 2 months)... maybe someone else on here has experience of that? If you're on the injectable biologics then you can simply take the required supply with you.
Posted 8/20/2022 8:28 PM (GMT 0)
Interesting, thanks! How do docs decide which biologic med is used for which patient? I wonder if I’ve got a preferred delivery method that could influence the decision? Sorry, I’m sure these are very naive questions.
Posted 8/20/2022 9:56 PM (GMT 0)
Here in the U.S. the insurance plan usually drives the choice of biologics. Not sure how it works in Canada.

Sometimes it’s the dr personal experience with other patients You should be able to investigate and be a deciding factor.

Entyvio is probably the safest profile as it is supposed to work only on the gut and not affect the whole body immune system. It’s a short infusion time (30 min) but can take 3-4 months for complete remission

Remicade has the longest history of being used. It’s a 3 hr infusion typically as it’s weight based. Can also take 3 months or so for complete relief.

Humira is self inject.

Xeljanz is a pill and several here found remission on it when all else had failed. It’s fairly quick acting.

There’s also stelara, and rinvoq which is fairly new.
Posted 8/21/2022 1:22 AM (GMT 0)

Midge22 said...
Interesting, thanks! How do docs decide which biologic med is used for which patient? I wonder if I’ve got a preferred delivery method that could influence the decision? Sorry, I’m sure these are very naive questions.

Hi I think it depends a lot where you live... hopefully someone in Canada can answer that. I'm in Europe and at least where i live the order in which to try the different options was based largely on costs as well as how long a drug had been around for (more data on safety and efficacy with the older drugs).

I think a good doctor would discuss options and let you have input in the decision, as long as there is flexibility with regards to health insurance or national protocols.

In addition to biologics there are some newer drugs that are tablets, including xeljanz, rinvoq, jyseleca and zeposia. These are not biologics and have a different mechanism of working, although the degree of immunosuppression is comparable. I am on xeljanz which is 2 tablets a day but I know my dr doesn't like to prescribe it for over 60s because it is associated with increased risk of blood clots.

Biologics are always via infusion or injection.
Posted 8/21/2022 5:40 PM (GMT 0)
Thanks very much Poopydoop and Flowersgal - this is very helpful information.
Posted 8/21/2022 7:36 PM (GMT 0)
Welcome Midge,...sorry you have to deal with those enemas. I am also a retired Canadian, and we do like to travel. A few years ago i went into a bad flare and was prescribed the enemas. I packed 2 boxes into my carry on, and was flagged at an airport after going through the xray. They opened my case up and asked if they were for medical reasons. I said yes, and that was it. I think they must have seen these many times already. Just bring your prescription with you.

Lucky for me, I only needed them for about 3 weeks, until this year. I still had several cases left that expired in a month. I noticed the color was off, and only one was still ok. So know that they will expire. I can't help on the biologics, as I've not needed to move past the 5 ASA meds.

Good luck, and happy travels. Don't let this disease stop you from your travel bucket list!
Posted 8/22/2022 8:07 PM (GMT 0)
Thanks Sassysback, good to know its possible to get through the airport without a big hassle at security.
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