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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:
How to safe your children from
medicine ?
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 Throw out medicines that are out of date as they can cause harm to the patient .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 avoid undesirable effects due to defects in medicines :
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
Storage of medication in
nursing home
Purchase of medicines :
Storage of medications
For Medicines requiring refrigeration :
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 :
-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
Packaging of medicines
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 to 8ºC)
Not stable
Alprostadil injection (Caverject solution
Refrigerate 40 mcg strength at 36º to 46º F (2º to 8ºC) until dispensed. (Store the 5, 10, and 20 mcg strengths at or below 77°F [25°C]).
After dispensing 40 mcg strength: Three months at or below 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 to 8ºC). Do not freeze.
unopened bottles are stable (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 not freeze
60 days
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 to 8ºC).
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 gamma-1b (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 alfa-2a (Pegasys)
Refrigerate at 36º to 46º F (2º to 8ºC).
24 hours
Peginterferon alfa-2b (PegIntron)
PegIntron vials and PegIntron Redipen After reconstitution, the solution should be used immediately, but may be stored up to 24 hours at (2° to 8°C).
PegIntron vials - Store at25ºCPegIntron Redipen unreconstituted is stable when maintained up to (30C) for one day.
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
Pediatric Oral Antibiotic Suspensions .
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
Refrigerated opened(2-8c)
Refrigerated unopened Room temperature opened and unopened(15-30c)
Humulin R 28 days Until Expiration Date Stamp 28 days
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
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
Novolin 70/30 1.5 m 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 70/30Prefilled Do not Refrigerate Until Expiration Date
Stamp7 days
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
