sign in sign up
<<
Home , Basiliximab, Belatacept, Corticorelin, Idarucizumab, Idursulfase, Metreleptin

−This Clinical Resource gives subscribers additional insight related to the Recommendations published in−

September 2017 ~ Resource #330909

Medications Stored in the Refrigerator (Information below comes from current U.S. and Canadian product labeling and is current as of date of publication)

Proper storage is important to ensure medication shelf life until the manufacturer expiration date and to reduce waste. Many meds are recommended to be stored at controlled-room temperature. However, several meds require storage in the refrigerator or freezer to ensure stability. See our toolbox, Medication Storage: Maintaining the Cold Chain, for helpful storage tips and other resources. Though most meds requiring storage at temperatures colder than room temperature should be stored in the refrigerator, expect to see a few meds require storage in the freezer. Some examples of requiring frozen storage conditions include: anthrax immune globulin (Anthrasil [U.S. only]), carmustine wafer (Gliadel [U.S. only]), cholera (live) vaccine (Vaxchora), dinoprostone vaginal insert (Cervidil), dinoprostone vaginal suppository (Prostin E2 [U.S.]), varicella vaccine (Varivax [U.S.]; Varivax III [Canada] can be stored in the refrigerator or freezer), zoster vaccine (Zostavax [U.S.]; Zostavax II [Canada] can be stored in the refrigerator or freezer). Use the list below to help identify medications requiring refrigerator storage and become familiar with acceptable temperature excursions from recommended storage conditions.

Abbreviations: RT = room temperature

Abaloparatide (Tymlos [U.S.]) (Eylea) Amphotericin B (Abelcet, Fungizone) • Once open, may store at RT (68°F to 77°F • May store at RT (77°F [25°C]) for up to (Kineret) [20°C to 25°C]) for up to 30 days. 24 hours (Canadian labeling). Anidulafungin (Eraxis) (Orencia) (Lumizyme [U.S.]; • May store at RT (up to 77°F [25°C]) for up (ReoPro) Myozyme [Canada]) to 96 hours. AbobotulinumtoxinA (Dysport) Alprostadil (Caverject 40 mcg, Antivenin, black widow (U.S.) (Humira) Prostin VR) Antivenin, coral snake (U.S.) • May store Humira pens or prefilled • May store Caverject 40 mcg at RT for up Anti-thymocyte globulin, rabbit at RT (up to 77°F [25°C]) for up to 3 months (U.S. labeling). (Thymoglobulin) to 14 days. • U.S. Caverject strengths 5 mcg, 10 mcg, Aprepitant injection (Emend) (Tanzeum [U.S.], Eperzan and 20 mcg along with all Canadian Arformoterol (Brovana [U.S.]) [Canada]) strengths do not require refrigeration. • May store at RT (up to 77°F [25°C]) for up • May store at RT (up to 86°F [30°C]) for up • Caverject Impulse (U.S.) does not require to 6 weeks. to 4 weeks. refrigeration. (Tecentriq) (Praluent) Alprostadil suppositories (Muse) Atracurium besylate • May store at RT (up to 77°F [25°C]) for up • May store at RT (up to 86°F [30°C]) for up (Bavencio [U.S.]) to 30 days (U.S. labeling). to 14 days. Azithromycin ophthalmic (Azasite [U.S.]) Ado- emtansine (Kadcyla [U.S.]) Alteplase (Cathflo Activase [U.S.]; Cathflo • Once open, may store at RT (up to 77°F [Canada]) [25°C]) for up to 14 days. More. . . Copyright © 2017 by Therapeutic Research Center 3120 W. March Lane, Stockton, CA 95219 ~ Phone: 209-472-2240 ~ Fax: 209-472-2249 PharmacistsLetter.com ~ PrescribersLetter.com ~ PharmacyTechniciansLetter.com ~ NursesLetter.com (Clinical Resource #330909: Page 2 of 6)

Aztreonam (Cayston) (generics [U.S.]) Diltiazem injection • After dispensing, may store at RT (up to • Once open, may store at RT (up to 77°F • May store at RT for up to 1 month. 77°F [25°C]) for up to 28 days. [25°C]) for up to 30 days (2 mL) or Dinoprostone vaginal (Prepidil, Prostin E2 Bacitracin for injection 35 days (3.7 mL). Vaginal Gel [Canada]) (Simulect) (Ilaris) Dinoprostone (Prostin E2 tablets [Canada]) (Regranex [U.S.]) Carboprost (Hemabate) Dinutuximab (Unituxin [U.S.]) (Nulojix [U.S.]) Carfilzomib (Kyprolis) Dornase alfa (Pulmozyme) Bendamustine (Bendeka [U.S.]) Carmustine (BiCNU) Doxorubicin (Adriamycin) • Treanda (Canada) does not require (Cimzia) Doxorubicin liposomal (Doxil [U.S.], Lipodox refrigeration. (Erbitux) [U.S.]; Caelyx [Canada]) Benzoyl peroxide/ gel (Duac Chlorambucil (Leukeran) Dronabinol capsules (Marinol [U.S.]) [U.S.], Neuac [U.S.]; Clindoxyl [Canada], Ciprofloxacin 6% otic (Otiprio [U.S.]) • May store between temperatures of 46°F Clindoxyl ADV [Canada]) Cisatracurium (Nimbex [U.S.]) and 59°F (8°C and 15°C), if not • After dispensing, store at RT (up to 77°F • Use within 21 days of removing from refrigerated. [25°C]) for up to 60 days. refrigerator, even if re-refrigerated. Dronabinol (Syndros [U.S.]) Benzylpenicilloyl polylysine injection • Once open, may store at RT (up to 77°F (Pre-Pen) Conjugated injection (Premarin [25°C]) for up to 28 days. • May store at RT (up to 77°F [25°C]) for up Intravenous) (Imfinzi [U.S.]) to 24 hours. (Acthrel [U.S.]) Ecallantide (Kalbitor [U.S.]) Beractant (Survanta) Dacarbazine • May store at RT (up to 86°F [30°C]) for up (Avastin) (Zinbryta [U.S.]) to 14 days. Bezlotoxumab (Zinplava [U.S.]) • May store at RT (up to 86°F [30°C]) for up Echothiophate iodide (U.S.) Bleomycin injection to 30 days. Elosulfase alfa (Vimizim) (Siliq [U.S.]) Daptomycin (Cubicin) Elotuzumab (Empliciti [U.S.]) • May store prefilled syringes at RT (up to Daratumumab (Darzalex) Emtricitabine oral solution (Emtriva [U.S.]) 77°F [25°C]) for up to 14 days. Darbepoetin alfa (Aranesp) • May store at RT (up to 77°F [25°C], with Bupivacaine liposomal (Exparel [U.S.]) Desmopressin (DDAVP Rhinal Tube [U.S.]; excursions up to 80°F [30°C]) for up to • May store at RT (up to 77°F [25°C]) for up DDAVP Rhinyle [Canada]) 3 months. to 30 days. • May store DDAVP Rhinal Tube at RT (up Enalapril oral solution (Epaned [U.S.]) Busulfan injection (Busulfex) to 77°F [25°C]) for up to 3 weeks. • May store at RT (up to 77°F [25°C]) for up Calcitonin injection (Miacalcin [U.S.]; Desmopressin injection (DDAVP [U.S.]; to 60 days. Calcimar [Canada]) Octostim [Canada]) Epirubicin (Ellence) • May store Calcimar at RT (up to 86°F (Digibind [U.S.]; Epoetin alfa (Epogen [U.S.], Procrit [U.S.]; [30°C]) for up to 2 weeks. DigiFab [Canada]) Eprex [Canada]) • May store Digibind at RT (up to 86°F [30°C]) for up to 30 days.

More. . . Copyright © 2017 by Therapeutic Research Center 3120 W. March Lane, Stockton, CA 95219 ~ Phone: 209-472-2240 ~ Fax: 209-472-2249 PharmacistsLetter.com ~ PrescribersLetter.com ~ PharmacyTechniciansLetter.com ~ NursesLetter.com

(Clinical Resource #330909: Page 3 of 6)

Eptifibatide (Integrilin) (Repatha) Hyaluronate/chondroitin (DuoVisc [U.S.]) • May store at RT (up to 77°F [25°C] with • May store at RT (up to 77°F [25°C] with Idarubicin (Idamycin PFS) excursions to 86°F [30°C]) for up to excursions up to 86° [30°C]) for up to Idarucizumab (Praxbind) 2 months. 30 days. • May store at RT (up to 77°F [25°C]) for no /norethindrone acetate patch (Byetta, Bydureon) more than 48 hours (protected from light) (CombiPatch [U.S.]; Estalis [Canada]) • Once open, may store Bydureon at RT (up or 6 hours (not protected from light). • After dispensing, may store at RT (up to to 77°F [25°C]) for up to 4 weeks. (Elaprase) 77°F [25°C]) for up to 6 months. • Once open, may store Byetta at RT (up to Immune Globulin (GamaSTAN S/D) Estradiol (Estradot [Canada] 77°F [25°C]) for up to 30 days. (Inflectra, Remicade, Remsima • May store between 2°C and 30°C Famotidine injection [Canada]) (Canadian labeling). (Neupogen) • Remicade may store for no more than 6 Estramustine (Emcyt) • May store at RT for up to 24 hours (up to months at RT (up to 86°F [30°C]). • May store between 2°C and 25°C 86°F [30°C] for 14 days [Canadian alfa-2b (Intron A) (Canadian labeling). labeling]). • May store at RT (up to 77°F [25°C], per (Enbrel, Brenzys [Canada]) Filgrastim (Grastofil [Canada]) Canadian labeling only) • May store at RT (up to 77°F [25°C]) for up Filgrastim-sndz (Zarxio [U.S.]) o Lyophilized powder: up to 4 weeks to 14 days (U.S. labeling) Formoterol (Perforomist [U.S.]) o Ready-to-use solution: up to 7 days • Per Canadian labeling • After dispensing, may store at 36°F to o Multi-dose pens: up to 48 hours over a o Enbrel single-dose prefilled syringes, 77°F (2°C to 25°C) for up to 3 months. four-week period prefilled SureClick, and multi-use vials Fosphenytoin (Cerebyx) Interferon beta-1a (Avonex) may be stored up to 27°C for up to • May store at RT for up to 48 hours. • May store lyophilized powder at RT (up to 60 days. Gabapentin oral solution (Neurontin [U.S.]) 77°F [25°C]) for a total of 30 days (U.S. o Brenzys may be stored up to 27°C for Galsulfase (Naglazyme) labeling). up to 60 days. Gemtuzumab ozogamicin (Mylotarg [U.S.]) • May store prefilled syringes and pens at o Multi-dose vial after reconstitution may Glatiramer acetate (Copaxone, Glatopa RT (up to 77°F [25°C] per U.S. labeling, be stored at RT (up to 77°F [25°C]) for [U.S.]) up to 86° [30°C] per Canadian labeling) up to 14 days. • May store at RT (59°F to 86°F [15°C to for up to 7 days. Etonogestrel/ethinyl estradiol vaginal ring 30°C]) for up to 1 month. Interferon beta-1a (Plegridy) (NuvaRing) Glucarpidase (Voraxaze [U.S.]) • May store at RT (up to 77°F [25°C]) for up • After dispensing, may store at RT (up to (Simponi, Simponi Aria [U.S.]) to 30 days. 77°F [25°C] with excursions up to 86° Granisetron extended-release oral solution Interferon beta-1a (Rebif) [30°C]) for up to 4 months. (Sustol [U.S.]) • May store at RT (up to 77°F [25°C]) for up Etoposide powder for injection (Etopophos • May store at RT (up to 77°F [25°C]) for up to 30 days. [U.S.]) to 7 days. (U.S. subscribers; Canadian Human chorionic gonadotropin (Ovidrel) subscribers) • After dispensing, may store at RT (up to 77°F [25°C]) for up to 30 days. More. . . Copyright © 2017 by Therapeutic Research Center 3120 W. March Lane, Stockton, CA 95219 ~ Phone: 209-472-2240 ~ Fax: 209-472-2249 PharmacistsLetter.com ~ PrescribersLetter.com ~ PharmacyTechniciansLetter.com ~ NursesLetter.com

(Clinical Resource #330909: Page 4 of 6)

Interferon gamma-1b (Actimmune [U.S.]) (Gazyva) Penicillin G benzathine (Bicillin L-A) • May store at RT (up to 77°F [25°C]) for up (Ocrevus [U.S.]) • May store at RT (up to 86°F [30°C]) for up to 12 hours. Octreotide (Sandostatin, Sandostatin LAR) to 7 days (Canadian labeling). (Yervoy) • May store Sandostatin multidose vials at Penicillin G benzathine/penicillin G procaine Irinotecan (Onivyde [U.S.]) RT (up to 86°F [30°C]) for up to 14 days. (Bicillin C-R [U.S.]) Isavuconazonium injection (Cresemba [U.S.]) • May store Sandostatin LAR at RT for 30 to (Perjeta) Ixabepilone (Ixempra [U.S.]) 60 minutes prior to reconstitution (U.S. Posaconazole injection (Noxafil [U.S.]; (Taltz) labeling) or the day of injection (Canadian Posanol [Canada]) Laronidase (Aldurazyme) labeling). Pralatrexate (Folotyn [U.S.]) Latanoprost (Xalatan) Ofatumumab (Arzerra) • May store at RT for up to 72 hours. • Once open, may store at RT (up to 77°F (Lartruvo [U.S.]) (Symlin [U.S.]) [25°C]) for up to 6 weeks. (Xolair) • Once open, may store at RT (up to 86°F Latanoprost/timolol (Xalacom [Canada]) OnabotulinumtoxinA (Botox) [30°C]) for up to 30 days. • Once open, may store at RT (up to 77°F • May store frozen (at or below 23°F rectal suppositories [25°C]) for up to 10 weeks. [-5°C] per Canadian labeling) (Promethegan [U.S.]) Liotrix tablets (Thyrolar [U.S.]) Palifermin (Kepivance [U.S.]) Proparacaine ophthalmic solution (U.S.) Lopinavir/ritonavir oral solution (Kaletra) Palivizumab (Synagis) Proparacaine/fluorescein (Flucaine [U.S.]) • After dispensing, may store at RT 77°F Pancuronium • May store at RT for up to 1 month. (25°C) for up to 2 months (U.S. labeling); (Natpara [U.S.]) Quinupristin-dalfopristin (Synercid [U.S.]) 42 days (Canadian labeling). Patiromer (Veltassa [U.S.]) Rabies immune globulin (HyperRAB S/D, Lorazepam injection • May be stored at RT (up to 81°F [27°C]) Imogam Rabies) Lorazepam oral concentrate (U.S.) for up to 3 months. (Cyramza) Lymphocyte immune globulin (Atgam) Pegademase (Adagen [U.S.]) (Lucentis) Melphalan tablets (Alkeran) (Neulasta) • Prior to use, may store at RT (up to 77°F Methylergonovine injection (U.S.) • May store at RT for up to 48 hours (U.S. [25°C]) for up to 24 hours (Canadian (Myalept [U.S.]) labeling) or 72 hours (Canadian labeling). labeling only). Mipomersen (Kynamro [U.S.]) Peginterferon alfa-2a (Pegasys) (Cinqair) • May store at RT (up to 86°F [30°C]) for up • May store at RT for up to 24 hours (U.S. RhoGAM immune globulin (HyperRHO to 14 days. labeling). [U.S.], MICRhoGAM [U.S.]; RhoGAM [U.S.]; (Tysabri) Peginterferon alfa-2b (PegIntron [U.S.]) WinRho S/D [Canada]) (Portrazza [U.S.]) • Prefilled pens should be refrigerated, vials RimabotulinumtoxinB (Myobloc [U.S.]) Neomycin/polymyxin B urinary irrigant may be stored at RT. long-acting injection (Risperdal (Neosporin G.U.) Peginterferon alfa-2b/ribavirin (Pegetron Consta) (Opdivo) [Canada]) • May store at RT (up to 77°F (25°C) for up Nusinersen (Spinraza [U.S.]) Pegloticase (Krystexxa [U.S.]) to 7 days. • May store at RT (up to 86°F [30°C]) for up (Keytruda) to 14 days.

More. . . Copyright © 2017 by Therapeutic Research Center 3120 W. March Lane, Stockton, CA 95219 ~ Phone: 209-472-2240 ~ Fax: 209-472-2249 PharmacistsLetter.com ~ PrescribersLetter.com ~ PharmacyTechniciansLetter.com ~ NursesLetter.com

(Clinical Resource #330909: Page 5 of 6)

Ritonavir capsules (Norvir [U.S.]) Somatropin (Saizen) Tipranavir capsules (Aptivus) • After dispensing, may store at RT (up to • The 3.33 mg vials should be stored in the • Once opened, may store at RT (77°F 77°F [25°C]) for up to 30 days. refrigerator, but the 5 mg vials should be [25°C] with excursions up to 86°F [30°C]) (Rituxan) stored at RT (Canadian labeling). for up to 60 days. Rituximab/ (Rituxan Hycela • All cartridge strengths should Tobramycin solution (Bethkis [U.S.]) be stored in the refrigerator (Canadian [U.S.]; Tobi) Rocuronium (Zemuron) labeling). • May store in opened or unopened foil • May store unopened at RT (up to 77°F • All strengths may be stored at RT (up to pouches at RT (up to 77°F [25°C]) for up [25°C] for up to 60 days (U.S. labeling) 86°F [30°C]; U.S. labeling). to 28 days. and 86°F (30°C) for up to 90 days Somatropin (Genotropin) (Actemra) (Canadian labeling). • May store Genotropin GoQuick at RT (up Topotecan capsules (Hycamtin [U.S.]) • Once open, at RT (up to 77°F [25°C]) to 77°F [25°C]) for up to 4 weeks (Mekinist) must use within 30 days. (Canadian labeling). • Once open, may store at RT (up to 86°F Romiplostim (Nplate) • May store Genotropin MiniQuick at RT [30°C]) for up to 30 days (Canadian (Sucraid [U.S.]) (up to 77°F [25°C]) for up to 3 months labeling) (Leukine [U.S.]) (U.S. labeling) and 6 months (Canadian Trastuzumab (Herceptin) (Kevzara) labeling). (Kadcyla [Canada]) (Cosentyx) Streptozocin (Zanosar) Trifluridine (Viroptic) Sinecatechins (Veregen) Succinylcholine (Quelicin) (Stelara) • After dispensing, patients may store at RT • May store at RT for up to 14 days. Valrubicin (Valstar [U.S.]; Valtaxin [Canada]) (up to 77°F [25°C]; U.S. labeling). Tafluprost (Zioptan [U.S.]) Vaccines (most) • May store between 41°F and 77°F (5°C • May store at RT (up to 77°F [25°C] for up • Some may require storage in the freezer. and 25°C; Canadian labeling). to 30 days. For more information and specifics, see oral solution (Rapamune) (Elelyso) our toolbox, Medication Storage: • May store open bottles at RT (up to 77°F Telavancin (Vibativ) Maintaining the Cold Chain, and product [25°C]) for up to 15 days (U.S. labeling). • Excursions up to 77°F (25°C) are labeling. • May store open bottles at RT (up to 86°F acceptable, but no time limit given, (U.S. (Entyvio) [30°C]) for up to 5 days (Canadian labeling). (Vpriv) labeling). Temozolomide injection (Temodar [U.S.]) Vinblastine injection Somatropin (Humatrope, Nutropin AQ, (Torisel) Vinorelbine (Navelbine) Omnitrope) Teniposide (Vumon) • May store at RT (up to 77°F (25°C) for up Somatropin (Norditropin) • May store at RT and does not require to 72 hours (U.S. labeling). • Once open, may store at RT (up to 77°F refrigeration (Canadian labeling). palmitate injection (Aquasol A [25°C]) for up to 3 weeks. (Forteo) [U.S.]) Thiotepa (Tepadina [U.S.]) Ziv-aflibercept (Zaltrap [U.S.])

More. . . Copyright © 2017 by Therapeutic Research Center 3120 W. March Lane, Stockton, CA 95219 ~ Phone: 209-472-2240 ~ Fax: 209-472-2249 PharmacistsLetter.com ~ PrescribersLetter.com ~ PharmacyTechniciansLetter.com ~ NursesLetter.com

(Clinical Resource #330909: Page 6 of 6)

Users of this resource are cautioned to use their own Project Leader in preparation of this clinical professional judgment and consult any other necessary resource (330909): Beth Bryant, Pharm.D., BCPS, or appropriate sources prior to making clinical Assistant Editor judgments based on the content of this document. Our editors have researched the information with input from experts, government agencies, and national organizations. Information and internet links in this article were current as of the date of publication.

Cite this document as follows: Clinical Resource, Medications Stored in the Refrigerator. Pharmacist’s Letter/Prescriber’s Letter. September 2017.

Evidence and Recommendations You Can Trust…

3120 West March Lane, Stockton, CA 95219 ~ TEL (209) 472-2240 ~ FAX (209) 472-2249 Copyright  2017 by Therapeutic Research Center

Subscribers to the Letter can get clinical resources, like this one, on any topic covered in any issue by going to PharmacistsLetter.com, PrescribersLetter.com, PharmacyTechniciansLetter.com, or NursesLetter.com