Flying with Epinephrine Auto-Injectors
5 min readSources checked
Airline and government rules change. Check your airline's current rules before you travel.
Quick answer
Keep prescribed epinephrine auto-injectors in your carry-on and within reach. Do not put the only devices in a checked bag, or in an overhead bin you cannot get to quickly.
Epinephrine is only useful if it is within reach of the person who needs it. That makes this mostly a packing and access question, with two separate processes around it: what a screening authority allows through a checkpoint, and what an airline will arrange as an accommodation. They are decided by different people and one does not imply the other.
Scope: Packing, Canadian screening and keeping prescribed epinephrine accessible during air travel. This guide does not replace an allergy action plan or medical advice, and it does not choose how many devices you should carry.
Part of: Flying with Allergies, Flying with Medical Equipment
What changes by airline
- Security rules for medication and needles from country to country
- Whether the airline asks for advance notice or medical documentation
- What accommodation the airline will arrange, and how it confirms it
- What emergency equipment the aircraft carries
General advice: applies wherever you fly
Within reach means within reach
Carry the devices together in a protective case that opens quickly, and keep the pharmacy label or prescription information with them. During the flight, keep them in the personal item under the seat or somewhere else you can get to without waiting for the seatbelt sign to go off.
Do not bury them under a laptop, a winter coat or several zipped pouches. Tell a travel companion where the devices are and how your action plan works.
Food Allergy Canada advises travellers at risk of anaphylaxis to carry at least two devices for the flight, and not to rely on an airline having stock epinephrine.
General advice: applies wherever you fly
Before you leave
Check the expiry date and the condition of each device. Follow the storage instructions supplied with your own medication, and ask a pharmacist how to handle the temperature conditions you expect on the trip.
Do not leave an auto-injector in a hot car, a checked baggage hold or anywhere else outside the manufacturer's storage directions. If a device has been exposed to an unsuitable temperature, damaged or used, ask a pharmacist or clinician whether it must be replaced.
Add a copy of the allergy action plan and emergency contact details. A translated card can help on an international trip, and it should name the exact allergen and the action to take rather than a vague phrase such as allergic to food.
Official rules: Canada
Canada: at the screening checkpoint
CATSA permits jet injectors and epinephrine auto-injectors in carry-on and checked baggage when they are for personal medical use and the needle guard is in place. CATSA does not require medical documentation for the screening itself, although a supporting document can make the medical need easier to explain.
Essential prescription and non-prescription medication is permitted through Canadian screening, including medically required liquids above the ordinary 100 millilitre limit when they are declared for inspection. Present the medication in an orderly way and tell the screening officer if sterile packaging should not be opened.
Official rules: Canada
Canada: asking the airline for an accommodation
The medication and the request for an airline accommodation are two separate things. A security authority may allow the auto-injector without a letter while the airline still asks for supporting information before it arranges a particular service.
For covered travel in Canada, the Canadian Transportation Agency says a passenger with a disability due to a severe allergy should normally request assistance at least 48 hours before departure. The carrier may need more time if it asks for supporting documents.
The Agency also warns passengers not to assume that an airline carries epinephrine for them. Cabin emergency equipment varies, and your own devices are the plan.
General advice: applies wherever you fly
At the gate and on board
Confirm the accommodation at the gate, and ask to pre-board if you need time to clean the seating area. Tell the flight attendant about the allergy without handing over responsibility for your medication.
Worth knowing: crew change between flights on the same itinerary, so a briefing given on the first leg does not carry to the second.
General advice: applies wherever you fly
If symptoms begin
Follow the action plan your clinician gave you, and tell the crew immediately. Do not move to a lavatory or another isolated place to see whether the reaction settles. The crew needs to know where you are, what happened and what medication has been used so it can coordinate a response and contact medical support.
After an auto-injector is used, emergency medical assessment is still important. The aircraft may need to land or arrange medical help on arrival, and that decision belongs to the operating crew and their medical support.
General advice: applies wherever you fly
Checklist
Checklist
- Carry the number of auto-injectors your clinician recommends
- Check each expiry date and the condition of each device
- Keep the medication in carry-on and within immediate reach
- Follow the product's storage instructions
- Carry the pharmacy label, the action plan and emergency contacts
- Tell a companion where the medication is
- Request an airline accommodation early when you need one
- Confirm the request at the gate
- Tell the flight attendant before departure
- Follow the action plan and alert the crew immediately if symptoms begin
General advice: applies wherever you fly
Next step
Put the auto-injectors, the action plan and the pharmacy information together now, then check the airline's accommodation deadline.
Official sources
Rules and amounts change. Before you rely on anything marked as an official rule, check the source. These are the official pages we used.
- Jet Injectors and Epipens · Canadian Air Transport Security Authority (CATSA)
- Medication and Medical Items · Canadian Air Transport Security Authority (CATSA)
- Severe Allergies: A Guide · Canadian Transportation Agency
- Travel · Food Allergy Canada
Next step
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