Several injectable medicines used in ITU during COVID-19 require storage in a refrigerator.  Where product licences require this, the text: “Store in a refrigerator (2°-8°C). Do not freeze. Store in outer packing to protect from light.” will usually be present on packaging.

During COVID-19, there may be circumstances where unopened and undiluted medicines are stored outside a refrigerator on ITU.  To support safe use of these medicines by nurses and pharmacists, we have collated stability information on a product-by-product basis and give recommendations on:

  • The maximum temperature that a given product can be stored at
  • The maximum duration that a given product can be stored at the new temperature
  • Whether the expiry date for the product needs reducing
  • Whether the product can be returned to the fridge after ambient storage

The decision to use products stored outside their licences is a clinical decision based on the available stability data. Our advice has been compiled to assist local risk assessments so health care professionals can make practical decisions about safe and effective medicines storage in clinical areas.  The advice aims to help avoid unnecessary waste and conserve stocks of these medicines; however, note that:

  • Products that have been stored outside the refrigerator should be used first
  • Products should be used within recommended timeframes or until expiry dates on pack are reached (whichever is earlier)
  • Where a change to expiry date is recommended, clearly label the container
  • This advice should not be used where products have had a previous temperature excursion

The information has been compiled with reference to extended stability data available from either product manufacturers or other sources. Our recommendations apply only to unopened and undiluted medicines, and do not cover medicines prepared in pharmacy aseptic units.  The table attached contains background information for all our recommendations.

Our individual recommendations currently cover UK licensed products and are available as follows:

Argipressin products: ambient stability during COVID-19

Atracurium products: ambient stability during COVID-19

Cisatracurium products: ambient stability during COVID-19

Lorazepam products: ambient stability during COVID-19

Pancuronium products: ambient stability during COVID-19

Phenylephrine products: ambient stability during COVID-19

Propofol products: ambient stability during COVID-19

Rocuronium products: ambient stability during COVID-19

Soluble Insulin products: ambient stability during COVID-19

Suxamethonium products: ambient stability during COVID-19

Terlipressin products: ambient stability during COVID-19

All these pages have been put together rapidly to help colleagues during the COVID-19 pandemic; if you spot anything that’s wrong or needs improving report a concern.

 

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