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Each medicinal product should be stored as recommended by the manufacturer, following stability tests done to the product at different temperatures for certain periods of time. There are medications that have to be kept frozen; others can be stored at room temperature while some need to be stored in the refrigerator.
Some medications are stored in the refrigerator while kept at the pharmacy but can be stored at room temperature by the patient. There are also medications that must be maintained kept in the refrigerator even after taking them home. Interestingly, there are medications that were originally stored in room temperature but should be kept refrigerated during use.
This article explains tips on proper storage of medications in the refrigerator, handling of refrigerated medications while travelling, and the importance of complying to temperature requirements during medication storage.
Tips on Knowing Medications’ Storage Conditions
How to know the right storage conditions of medications? You can follow these tips:
Medications’ storage instructions are usually stated on the box or on the original packaging of the medication.
Medications’ storage instructions can be found in the package insert under the heading “storage”.
The pharmacist may paste a sticker with storage instructions on the medication container.
You can ask directly to the pharmacist who dispense the medication.
Medications to be Kept Refrigerated
If the instructions on the medication packaging says “keep refrigerated” or “store at 2 – 8°C”, it means you have to keep the medication in the refrigerator.
Refrigerators in the pharmacy are equipped with devices that can display the current temperature inside the refrigerator. However, most domestic refrigerators do not display the current temperature. Therefore, the following steps are recommended for storage of medications in a domestic refrigerator:
Keep medications in the middle of the refrigerator shelves and space them away from other stuffs in the refrigerator.
Keep medications away from the freezer compartment and away from the air vents to avoid formation of ice crystals that can damage the medications.
Do not store medications at the refrigerator door because they will be exposed to uneven temperature every time the refrigerator door is opened.
Please ensure that medications are not easily accessible to children.
These are some examples of refrigerated medications in the pharmacy that need to be kept refrigerated at home:
Insulin injections (unused)
Erythropoietin injections (for example: Eprex® and Recormon®)
Some interferon injections (for example: Pegasys®)
Filgrastim injections (for example: Neupogen®)
Eye drops (for example: latanoprost (Xalatan®) and chloramphenicol)
Ear drops (for example: chloramphenicol)
Synthetic salmon calcitonin nasal sprays (for example: Miacalcic®)
Alfacalcidol oral drops (for example: One-Alpha®)
Ritonavir capsules (for example: Norvir®)
In addition, some medicinal preparations that are compounded or diluted in the healthcare facility also need to be stored in the refrigerator. These preparations usually have shorter expiry dates. Examples are:
Mixtures such as omeprazole suspension and spironolactone syrup
Eye drops such as cyclosporin dan sodium chloride 3%
Ear drops such as sodium bicarbonate 5%
Antibiotic syrups / suspensions which are compounded from powder such as amoxycillin supension
Medications to be Kept Frozen
Medications to be kept frozen means medications that should be stored below freezing temperature of -10 to -20°C. Certain types of vaccines and pessaries should be kept frozen in the healthcare facility and only be placed at room temperature just before use
The Need for Maintaining Storage Temperature
Three main reasons why medications need to be stored in the refrigerator:
To maintain the medication’s effectiveness.
Medications that need to be kept cold will lose their effectiveness when placed outside the recommended temperature range after a certain period of time. The period of stability is dependent on the type of medication and is usually specified in the package insert.
To maintain the medication’s sterility.
Sterile means medications are free from microorganisms such as bacteria. Some medications especially eye drops or ear drops that are compounded at healthcare facilities aseptically (free from germ) and without preservatives should always be kept in cold conditions to slow the growth of bacteria.
To maintain the physical form of medication.
Some medications in suppository form need to be stored in the refrigerator so that they do not melt before use.
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