−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 medication 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 medications 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.]) Aflibercept (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 Anakinra (Kineret) [20°C to 25°C]) for up to 30 days. 24 hours (Canadian labeling). Anidulafungin (Eraxis) Abatacept (Orencia) Alglucosidase alfa (Lumizyme [U.S.]; • May store at RT (up to 77°F [25°C]) for up Abciximab (ReoPro) Myozyme [Canada]) to 96 hours. AbobotulinumtoxinA (Dysport) Alprostadil injection (Caverject 40 mcg, Antivenin, black widow (U.S.) Adalimumab (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 syringes 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) Albiglutide (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. Atezolizumab (Tecentriq) Alirocumab (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 Avelumab (Bavencio [U.S.]) to 30 days (U.S. labeling). to 14 days. Azithromycin ophthalmic (Azasite [U.S.]) Ado-trastuzumab 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) Calcitonin nasal spray (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 gel (Prepidil, Prostin E2 Bacitracin powder for injection 35 days (3.7 mL). Vaginal Gel [Canada]) Basiliximab (Simulect) Canakinumab (Ilaris) Dinoprostone (Prostin E2 tablets [Canada]) Becaplermin (Regranex [U.S.]) Carboprost (Hemabate) Dinutuximab (Unituxin [U.S.]) Belatacept (Nulojix [U.S.]) Carfilzomib (Kyprolis) Dornase alfa (Pulmozyme) Bendamustine (Bendeka [U.S.]) Carmustine (BiCNU) Doxorubicin (Adriamycin) • Treanda (Canada) does not require Certolizumab pegol (Cimzia) Doxorubicin liposomal (Doxil [U.S.], Lipodox refrigeration. Cetuximab (Erbitux) [U.S.]; Caelyx [Canada]) Benzoyl peroxide/clindamycin 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 solution (Syndros [U.S.]) Benzylpenicilloyl polylysine injection Cladribine • Once open, may store at RT (up to 77°F (Pre-Pen) Conjugated estrogen injection (Premarin [25°C]) for up to 28 days. • May store at RT (up to 77°F [25°C]) for up Intravenous) Durvalumab (Imfinzi [U.S.]) to 24 hours. Corticorelin (Acthrel [U.S.]) Ecallantide (Kalbitor [U.S.]) Beractant (Survanta) Dacarbazine • May store at RT (up to 86°F [30°C]) for up Bevacizumab (Avastin) Daclizumab (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) Brodalumab (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 Digoxin immune Fab (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) Evolocumab (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 Estradiol/norethindrone acetate patch Exenatide (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. Idursulfase (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. Infliximab (Inflectra, Remicade, Remsima • May store between 2°C and 30°C Famotidine injection [Canada]) (Canadian labeling). Filgrastim (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 Interferon alfa-2b (Intron A) (Canadian labeling). labeling]). • May store at RT (up to 77°F [25°C], per Etanercept (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.