University of Texas - College of Pharmacy - Drug Information Alert: Medication Storage Tips

Drug Information Alert

Medication Storage Tips

Tina Bhakta, PharmD Intern; Nathan Raemsch, PharmD Intern;
Courtney Schoessow, PharmD Intern; Jennifer Seltzer, PharmD

August 29, 2011

Medications
Proper storage of medications is always an important consideration during periods of extreme heat or cold. Heat exposure during the grueling summer months of south Texas is a cause for concern.

If no specific instructions are provided regarding medication storage, the recommended conditions include storage at controlled room temperature (15°C to 30°C, or 59°F to 86°F), protection from moisture, and protection from light.¹

Important considerations to remember include^{2, 3}:

Store medications in their original container.
Store all medications in the same location.
Avoid leaving medications in heat and sunlight for a prolonged period of time.
Avoid kitchens and bathrooms because heat and humidity can damage the medication.
Avoid leaving medications in vehicles for a prolonged period of time.
Know which medications need to be refrigerated or kept at room temperature. Make sure medications do not freeze in the refrigerator.
Discard outdated or expired medications.

Travel tips:
CAR: If you travel by car, do not store medications in the trunk. Keep medications in the car with you.⁴A British study found that temperatures in vehicle trunks during a heat wave were well beyond the recommended controlled room temperature range, spanning from 27.5°C to 43.5°C (81.5°F to 110.3°F).⁶ Do not leave medications in the car for extended periods. For medications that need to be refrigerated, use a refrigerator or freezer gel pack for the duration of the trip.⁴

AIR: Keep medications in their original, labeled containers and in carry-on luggage during flights to prevent exposure to the extreme temperatures in the baggage compartment and prevent complications from possible loss of luggage. ^4,5 Keep in mind that airport security may require further inspection of medication.⁵

Insulin
Unopened insulin vials, cartridges, and prefilled pens should be stored in the refrigerator between 2°C and 8°C (36°F to 46°F) until the expiration date. Once punctured and used, these products may be stored under refrigeration or at room temperature [<30°C (<86°F)] and must be used within 28 days.⁷ The only exception is insulin detemir (Levemir®), which is stable under refrigeration or room temperature for up to 42 days.⁷ High temperatures and light exposure increase insulin degradation and may cause loss of potency. However, brief exposure to extreme temperatures does not necessarily reduce insulin efficacy.⁸ If travelling with insulin, consider the use of refrigerator gel packs for short trips or freezer gel packs for trips of longer duration.

Important shipping information for some insulin products is listed below:

Humalog® (Eli Lilly and Company): Must be shipped overnight with frozen packs during summer months. Mail order pharmacies must ship insulin at 2°C to 9°C (36°F to 48°F). [Telephone communication with Mimi. Eli Lilly and Company, 1-800-545-5979. (August 8, 2011)]

Novolog® (Novo Nordisk Inc.): During summer months insulin is shipped as next day delivery with frozen packs. [Telephone communication with Lorie. Novo Nordisk, Inc., 1-800-727-6500. (August 8, 2011)]

Lantus® (Sanofi-Aventis U.S.): Always keep this product refrigerated between 2°C and 8°C (36°F and 46°F). [Telephone communication with Rita. Sanofi-Aventis U.S., 1-800-633-1610. (August 8, 2011)]

REFERENCES

United States Pharmacopeia. General notices. USP-NF. Vol 26. Rockville, MD: USP; 2000. Available at: http://www.uspnf.com/uspnf/pub/index?usp=34&nf=29&s=1&officialOn=August 1, 2011. Accessed August 26, 2011.
United States Pharmacopeia. Just ask!...about proper medication use. Available at: www.usp.org/pdf/EN/patientSafety/justAskProperUse.pdf. Accessed August 24, 2011.
Dugdale DC, Zieve D. PubMed Health - Storing medicine safely, Medicine storage. Available at: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0004459/. Accessed August 24, 2011.
Traveling Safely with Medicines. American Society of Health-System Pharmacists¨. Available at: http://www.safemedication.com/safemed/MedicationTipsTools/
WhatYouShouldKnow/TravelingSafelywithMedicines.aspx. Accessed August 24, 2011
Transportation Security Administration. Hidden disabilities: travelers with disabilities and medical conditions. Available at: http://www.tsa.gov/travelers/airtravel/specialneeds/editorial_1374.shtm. Accessed August 24, 2011.
Crichton B. Keep in a cool place: exposure of medicines to high temperatures in general practice during a British heatwave. J R Soc Med. 2004;97:328-9.
Lexi-Drugs Online. Lexi-Comp Online [database online]. Hudson, OH: Lexi-Comp, Inc.; 2011. Available at: http://online.lexi.com. Accessed August 24, 2011.
Pryce R. Diabetic ketoacidosis caused by exposure of insulin pump to heat and sunlight. BMJ2009;338:a2218. Available at: http://www.bmj.com.libproxy.uthscsa.edu/content/338/
bmj.a2218.full?ijkey=e2de96f0ebd3018118bcebe557a5024
cc34e63b3&keytype2=tf_ipsecsha. Accessed August 26, 2011.

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Last Reviewed: August 30, 2011