Ambient storage of refrigerated ITU medicines during COVID-19

Sheena Vithlani, Regional Medicines Information Manager, London Medicines Information ServicePublished Last updated See all updates

Information to support the storage of refrigerated ITU medicines outside a fridge in appropriate situations.

Several injectable medicines used in ITU during COVID-19 require storage in a refrigerator. During COVID-19, there may be circumstances where unopened and undiluted medicines are stored outside a refrigerator on ITU. Where the product licences require refrigerated storage, 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.

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.


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