Storage of medications
Importance of proper storage of medication :
Inorder to maintain the medicine stability through out its shelf
life period
Where you store your medicine affects how
well it works.
Tips to store your medicines safely:
1
•Store away from heat, air, light, and moisture as it may damage your
medicine.
2
•Store your medicines in a cool, dry place. For example, store it in
your dresser drawer or a kitchen cabinet away from the stove, sink,
and any hot appliances. You can also store medicine in a storage box,
on a shelf, in a closet.
3
•Don’t store your medicine in a bathroom cabinet as the heat and
moisture from your shower, bath, and sink may damage your
medicine. Your medicines can become less potent before the
expiration date.
4
5
•Pills and capsules are easily damaged by heat and moisture.eg:
Aspirin pills break down into vinegar and salicylic acid. This irritates
the stomach.
•Always keep medicine in its original container
•Take the cotton ball out of the medicine bottle. The cotton ball pulls
moisture into the bottle.
Always store your
medicine out of
reach and out of
sight of children in a
cabinet with a lock.
Put medicines and
vitamins up and away
out of reach and out
of sight.
Children are curious
and put all sorts of
things in their mouths.
Even if you turn your
back for less than a
minute.
Never leave your
medicines or vitamins
that you use daily on
a kitchen counter or at
a sick child's bedside,
even if you have to
give the medicine
again in a few hours.
Always relock the cap on a medicine
bottle. If the bottle has a locking cap
that turns, twist it until you hear the
click even though many medicines
have safety caps, children may be
able to open them. Therefore it
must be stored up and away and out
of children's reach and sight.
Teach your children what medicine is
and why you must be the one to give
it to them. Never tell children
medicine is candy to get them to
take it, even if your child doesn't like
to take his or her medicine.
To avoid undesirable effects due to defects in
medicines :
DOGet rid of the pills that has changed color, texture, or smell, even if it has not
expired.
DON’T take Pills that stick together, pills that are harder or softer than normal, or
are cracked or chipped.
DO always Check the expiration date on your medicine. Throw out medicines that
are out of date as they can cause harm to the patient .
To get rid of the medicines safely and promptly:
DON’Tflush your medicine down the toilet. This is bad for the water supply.
DO throw away your medicine in the trash
- first mix your medicine with something that ruins it, such as coffee grounds or
kitty litter and,
- put the entire mixture in a sealed plastic bag.
DO Throw the empty container in your household trash
DO
remember to scratch out all information on the prescription label to make it
unreadable
Purchase of medicines :
Medicines must be purchased from pharmaceutical distributers,
wholesalers and pharmacies licensed by the health science
authority.
There should be an adequate supply of medicines
The nursing home should not over stock medicines (not more
than 3 months supply of medicines)
Storage of medications
For Medicines requiring refrigeration :
The refrigerator
should be set at an
appropriate
temperature ,i.e +2
to +8
A thermometer
should be placed
in the refrigerator
to record and
monitor the
temperature daily
at the start and the
end of the day
The refrigerator
should only be
used for storing
medicines
Commonly used medicines that require
refrigeration are :
-desmopressin nasal spray ,
-erythropoietin,
-haloperidol oral drops,
- insulin
-latanoprost eye drops
-miacalcic nasal spray ,
-morphine syrup (after opening)
-chloramphenicol eye drops and
-vaccines
-all refrigerated medicines for residents should be clearly labelled with each resident’s
name ,NRIC number,ward number and bed number
-For medicines which are given to residents over a period of time such as insulin and
cough syrups ,the dates on which the vials or containers are first opened should be
written down and any remaining medicines should be discarded after the storage
period recommended by the manufacturers
Medicines for external use :
Antiseptics and
disinfectants should
be stored separately
from medicines for
internal use and
stocks of medicines
should be stored
separately from
medicines for
individual residents .
Medicines should be
locked up in a
designated area
that is not accessible
to the residents and
members of the
public
Medicines should be kept in locked
in a clean cupboard/trolley and
should be arranged in a systemic
manner to minimise mix-ups
The emergency trolley should be
checked regularly to ensure that all
essential medicines are available
and not expired .
The nursing home should maintain a system for checking
regularly at least once a month .the stock level ,expiry dates
and the quality of medicines eg :change in colour ,smell and
appearance of the medicine ,should be checked.
Packaging of medicines
-Individualised medication should be used where it can be in the form of medication
box at residents bedside or a medicine trolley which is clearly labelled with
resident’s names and MRN numbers
-The individual containers used to store the dispensed medicines should be clearly
labelled with appropriate information .
the label should not be altered or removed
Don’t use medicines which are no longer
required for a resident for other residents
Disposal of medications
medicines should be disposed of prompltly if :
-they have expired or when there is doubt about expiry date .
-they show signs of deterioration
-
The treatment is discontinued and the medicines is no longer required by the
resident
- - the patient is no longer residing in the nursing home
After opening ,discard by date should be observed for:
- Eyedrops/eye ointments,eardrops and ointment
- Multidose injection vials
Generic name (Brand Name)
Recommended Storage
Stability at Room
Temperature
Adalimumab (Humira)
Refrigerate at 36º to 46ºF (2º Not stable
to 8ºC)
Alprostadil injection
(Caverject solution
Refrigerate 40 mcg strength After dispensing 40 mcg
at 36º to 46º F (2º to 8ºC)
strength: Three months at or
until dispensed. (Store the
below 25°C .
5, 10, and 20 mcg strengths
at or below 77°F [25°C]).
Alprostadil urethral
suppository (Muse)
Refrigerate at 36º to 46º F
(2º to 8ºC).
Stable for 14 days.
Amphotericin B (Amphocin,
others)
Refrigerate at (2º to 8ºC)
before reconstitution
(lyophilized powder).. After
reconstitution, refrigerate
solution(stable for one
week)
Reconstituted solution
stable for 24 hrs
Azithromycin ophthalmic
(Azasite)
Refrigerate at 36º to 46º F
(2º to 8ºC).
for opened bottle , store at
2° to 25°for up to 14 days .
Becaplermin (Regranex)
Refrigerate at 36º to 46ºF (2º unopened bottles are stable
to 8ºC). Do not freeze.
(up to 30ºC) for up to six
days
Generic name
Recommended Storage
Stability at Room
Temperature
Benzoyl
peroxide/clindamycin
Refrigerate at (2º to 8ºC). Do 60 days
not freeze
Calcitonin injectable
(Miacalcin)
Refrigerate unopened bottle
at (2º to 8ºC).
Not stable
Chlorambucil (Leukeran)
Refrigerate at 36º to 46º F (2º
to 8ºC).
stable when maintained at
up to (30C) for up to one
week
Darbepoetin alfa (Aranesp)
Refrigerate at 36º to 46ºF (2º
to 8ºC).
Not stable
Desmopressin
Refrigerate at 36º to 46º F (2º
to 8ºC)
Up to three weeks.
Dinoprostone cervical gel
Refrigerate at 36º to 46º F (2º
to 8ºC).
stable for 24 hours.
Dornase alfa (Pulmozyme)
Refrigerate at 36º to 46º F (2º
to 8ºC)
stable for up to 48 hours at
a (30C).
Dronabinol (Marinol)
Refrigerate at (2º to 8ºC) or
store in a cool environment
between (8°C to 15°C).
stable at room temperature
(25C) for 24 months.
Epoetin alfa (Epogen)
Refrigerate at 36º to 46ºF (2º
Not stable
Generic name
Recommended Storage
Stability at Room
Temperature
Exenatide (Byetta)
Prior to first use, refrigerate
at 36º to 46º F (2º to 8ºC). Do
not freeze.
After first use, store at a
room temperature not to
exceed 77°F (25°C). Discard
after 30 days
Formoterol (Foradil)
Prior to dispensing,
refrigerate at 36º to 46º F (2º
to 8ºC)
Store at room temperature
(20° to 25°C). stable for up
to 6 months.
Gabapentin oral suspension
(Neurontin)
Refrigerate at 36º to 46º F (2º
to 8ºC).
indicates oral solution stable
for seven days at temps up
to (30oC)
Glatiramer acetate injection
(Copaxone)
Refrigerate at 36º to 46º F (2º
to 8ºC).
One month at room
temperature (15 to 30C).
Interferon alfacon-1
(Infergen)
Refrigerate at 36º to 46ºF (2º
to 8ºC).
Interferon beta-1a (Avonex)
Refrigerate un reconstituted
vial of lyophilized powder at
(2º to 8ºC).
Lyophilized powder vial – 30
days. Prefilled syringes –
seven days.
Interferon beta-1a (Rebif)
Refrigerate at (2º to 8ºC).
30 days.
Generic name
Recommended Storage
Stability at Room
Temperature
Interferon gamma1b (Actimmune)
Refrigerate at (2º to 8ºC) immediately
upon receipt to ensure optimal
retention of physical and biochemical
integrity. Do not freeze
Unopened vial should not be
left at room temperature for
a total time exceeding 12
hours prior to use.
Lopinavir/ritonavir
solution (Kaletra)
Refrigerate at (2º to 8ºC) until
dispensed. Stable until expiration date
if stored in refrigerator
Two months
Lorazepam intensol
oral concentrate
Refrigerate at 36º to 46º F (2º to 8ºC).
when maintained at
temperature (25oC) for 30
days.
Tobramycin for oral
inhalation (Tobi)
Refrigerate at 36º to 46º F (2º to 8ºC).
Opened or unopened
pouches may be stored at
(25ºC) for up to 28 days
Peginterferon alfa2a (Pegasys)
Refrigerate at 36º to 46º F (2º to 8ºC).
24 hours
Peginterferon alfa2b (PegIntron)
PegIntron vials and PegIntron Redipen
After reconstitution, the solution
should be used immediately, but may
PegIntron vials - Store at25ºC
PegIntron Redipen
unreconstituted is stable
Pediatric Oral Antibiotic Suspensions .
generic
Recommended Storage
Stability at Room
Temperature
amoxicillin
14 days
7 days
Amoxicillin/clavulanate
7 days
Not stable
Azithromycin
10 days
10 days
cefaclor
14 days
Not stable
Cefixime
14 days
14 days
cefprozil
14 days
Stable for only 24 hours only
Tips for storage of insulin
-do not store your insulin near extreme heat or extreme cold.
-Never store insulin in the freezer, direct sunlight, or in the glove
compartment of a car.
-Check the expiration date before using, and don't use any insulin beyond its
expiration date.
-Examine the bottle closely to make sure the insulin looks normal before you
draw the insulin into the syringe.
-Unopened, not-in-use insulin should be stored in a refrigerator at a
temperature of 2-8 C.
-Opened, in-use insulin should be stored at room temperature below 25C.
- -Inspect insulin prior to each use. Any insulin that has clumps or solid white
particles should not be used. Insulin that is supposed to be clear should not have
any cloudy appearance
Insulin vials
Room temperature opened
and unopened(15-30c)
Refrigerated
opened(2-8c)
Refrigerated unopened
Humulin R
28 days
Until Expiration Date Stamp
Humulin N
28 days
Until Expiration Date Stamp
28 days
Humulin L
28 days
Until Expiration Date Stamp
28 days
Humulin U
28 days
Until Expiration Date Stamp
28 days
Humulin 70/30
28 days
Until Expiration Date Stamp
28 days
Humalog
28 days
Until Expiration Date Stamp
28 days
Humalog 75/25
28 days
Until Expiration Date Stamp
28 days
28 days
Insulin vials
Refrigerated
opened(2-8c)
Refrigerated
unopened
Room temperature opened
and unopened(15-30)
Humulin 50/50
28 days
Until Expiration
Date Stamp
28 days
Novolin R
30 days
Until Expiration
Date Stamp
30 days
Novolin N
30 days
Until Expiration
Date Stamp
30 days
Novolin L
30 days
Until Expiration
Date Stamp
30 days
Novolin 70/30
30 days
Until Expiration
Date Stamp
30 days
Novolog
28 days
Until Expiration
Date Stamp
28 days
Insulin flex pens
Refrigerated
opened(2-8c)
Refrigerated
unopened
Room temperature opened
and unopened(15-30c)
Humulin N
Do not Refrigerate
Until Expiration Date
Stamp
14 days
Humulin 70/30
Do not Refrigerate
Until Expiration Date
Stamp
10 days
Humalog
Do not Refrigerate
Until Expiration Date
Stamp
28 days
Humalog 75/25
Do not Refrigerate
Until Expiration Date
Stamp
10days
Novolin R I .5 ml
Do not Refrigerate
Until Expiration Date
Stamp
30 days
Novolin R 3 ml
Do not Refrigerate
Until Expiration Date
Stamp
28 days
Insulin flex pens
Refrigerated
opened(2-8c)
Refrigerated
unopened
Room temperature opened
and unopened(15-30c)
Novolin N 1.5 ml
Do not Refrigerate
Until Expiration Date
Stamp
7 days
Novolin N 3 ml
Do not Refrigerate
Until Expiration Date
Stamp
14 days
Do not Refrigerate
Until Expiration Date
Stamp
7 days
Novolin 70/30 3 ml
Do not Refrigerate
Until Expiration Date
Stamp
10 days
Novolog 3 ml
Do not Refrigerate
Until Expiration Date
Stamp
28 days
Novolin R Prefilled
Do not Refrigerate
Until Expiration Date
Stamp
30 days
Novolin N Prefilled
Do not Refrigerate
Until Expiration Date
Stamp
7 days
Novolin 70/30
Prefilled
Do not Refrigerate
Until Expiration Date
Stamp
7 days
Novolin 70/30 1.5 m
Insulin cartridges
Refrigerated
opened(2-8c)
Refrigerated
unopened(2-8)
Room temperature opened
and unopened(15-30c)
Humalog 1.5 ml
28 days
Until Expiration Date
Stamp
28 days
Humalog 3 ml
28 days
Until Expiration Date
Stamp
28 days
Novolin R 1.5 ml
Do not Refrigerate
Until Expiration Date
Stamp
30 days
Novolin R 3 ml
Do not Refrigerate
Until Expiration Date
Stamp
28 days
Novolin N 1.5 ml
Do not Refrigerate
Until Expiration Date
Stamp
7 days
Novolin N 3 ml
Do not Refrigerate
Until Expiration Date
Stamp
14 days
Novolin 70/30 1.5ml
Do not Refrigerate
Until Expiration Date
Stamp
7days
Novolin 70/30 3ml
Do not Refrigerate
Until Expiration Date
Stamp
14 days
Novolog 3 ml
Do not Refrigerate
Until Expiration Date
Stamp
28 days