Ensuring medications are stored appropriately is essential for their effectiveness and safety. Follow these steps to maintain optimal conditions for medications in your clinic and when advising clients.
In the Clinic
- Store Medications in Original Containers
- Always keep medications in their original packaging and store them under the conditions specified by the manufacturer. If you engage in any compounding, be sure to refer to USP beyond-use-date guidelines and storage conditions or the specific monograph for the compound.
- Temperature and Humidity Guidelines
- Controlled Room Temperature Medications: Store in a dry area with an average humidity not exceeding 40% at 20°C (68°F). The temperature should remain between 20°C and 25°C (68°F–77°F), with excursions permitted between 15°C and 30°C (59°F–86°F).
- Refrigerated Medications: Maintain temperatures between 2°C and 8°C (36°F-46°F). The use of medical grade refrigerators is highly recommended.
- Frozen Medications: Store at temperatures between -25°C and -10°C (-13°F to 14°F) unless otherwise specified by the manufacturer. The use of medical grade freezers is highly recommended.
- Vaccine-Specific Recommendations
- The use of medical grade freezers is highly recommended.
- Check and record refrigerator temperatures at the start of each day.
- If the temperature monitoring device lacks a min/max display, record the current temperature at both the start and end of the work day.
- Maintain a detailed temperature log, including minimum/maximum readings (or current temperature), date, time, and actions taken if excursions occur.
- Incorrect Storage
- If you discover that a medication has been stored improperly, refer to the package insert for information on acceptable temperature variations. If no details are provided, reach out to the manufacturer to inquire about any available data. If you are unsure if a medication is still okay to use, it is best to dispose of it.
For Clients at Home
- Proper Storage
- Advise clients to keep room-temperature medications in their original containers or those provided by the clinic or pharmacy.
- Most medications should be stored in a cool, dry place, away from direct sunlight, heat sources, and humidity (avoid storing medications in bathrooms and kitchens).
- Advise clients not to store medications in the door of the refrigerator as the appropriate temperature may not be maintained as well as in the body of the refrigerator.
- Containers should be kept sealed when not in use.
- Counsel owners on the appropriate storage of insulin. Some types of insulin may be left out of the refrigerator once they have been used for the first time. Check the package insert or with a pharmacist for more information.
- Keep all medications securely out of reach of children and pets.
- Tablet Splitting
- Avoid pre-cutting tablets for clients unless absolutely necessary as this exposes the medication to air and moisture. Discourage clients from splitting tablets ahead of time.
- Ensure that medications are safe to split before prescribing. In general, sustained-release or extended-release tablets should not be cut.
Storage and Shipping of Medications
Medications can be affected by temperature, light, and humidity. When ordering online or when shipping medications to clients:
- Ensure shipping conditions are suitable to prevent heat or cold damage or shaking (e.g., for proteins like insulin).
- Note that degraded medications may not show visible signs of damage.
- Recommend clients pay for expedited shipping to minimize risks during transit.
- Avoid shipping medications during extreme temperatures.
By Lauralei Fisher-Cronkhite, PharmD, DICVP, FSVHP, Clinical Staff Pharmacist
