List Of Drugs That Required Cold Storage (Cold Chain)

Every drug has a shelf life. The shelf life changes the very moment it is opened. But for each to survive throughout the shelf life, it must be stored according to the manufacturer's instructions before and after opening.

Storing drugs in fridge

For most drugs, they can be stored at controlled room temperature before and after opening. This is not the case with some. They require cool temperature (cold storage) to survive the duration of shelf life.

A cold chain is a temperature-controlled supply chain. An unbroken cold chain is an uninterrupted series of refrigerated production, storage and distribution activities and associated equipment which maintain a given low-temperature range. It is used to preserve and to extend the shelf life of products such as fresh agricultural produce, seafood, photographic film, chemicals, pharmaceutical drugs and other medical and biological agents.

List Of Drugs Stored In Freezer

Some require a fridge while others a refrigerator. Medications requiring frozen storage conditions include:

# anthrax immune globulin

# carmustine wafer

# cholera (live) vaccine

# dinoprostone vaginal insert

# dinoprostone vaginal suppository

# varicella vaccine

# Varivax III can be stored in the refrigerator or freezer)

# zoster vaccine

# Zostavax II can be stored in the refrigerator or freezer.

List Of Drugs Stored In Refrigerator

The list below is a list of  medications requiring a refrigerator. The list can never be exhaustive. Each product will need a fridge. But there are certain conditions attached which are explained when necessary. Some drugs can survive for a month after opening and do well under room condition. This cannot be said of many others:

Read Also: Storage conditions of different drugs

# Abaloparatide: Once open, may store at room temperature (RT) 20°C to 25°C for up to 30 days.

# Abatacept

# Abciximab

# AbobotulinumtoxinA

# Adalimumab: May store Humira pens or prefilled syringes at RT 25°C for up to 14 days.

# Albiglutide and Eperzan: May store at RT up to 30°C for up to 4 weeks.

Alirocumab: May store at RT 25°C for up to 30 days

# Ado-trastuzumab emtansine

# Aflibercept: May store at RT 25°C for up to 24 hours

# Alglucosidase alfa Myozyme

# Alprostadil injection (Caverject 40 mcg, Prostin VR): May store Caverject 40 mcg at RT for up to 3 months (U.S. labeling). U.S. Caverject strengths 5 mcg, 10 mcg, and 20 mcg along with all Canadian strengths do not require refrigeration. Caverject Impulse (U.S.) does not require refrigeration.

# Alprostadil suppositories: May store at RT up to 30°C for up to 14 days.

# Alteplase

# Amphotericin B

# Anakinra

# Anidulafungin: May store at RT up to 25°C for up to 96 hours.

# Antivenin, black widow (U.S.)

# Antivenin, coral snake (U.S.)

# Anti-thymocyte globulin, rabbit

# Aprepitant injection

# Arformoterol: may store at RT up to 25°C for up to 6 weeks

# Atezolizumab

# Atracurium besylate

# Avelumab

# Azithromycin ophthalmic: Once open, may store at RT up to 25°C for up to 14 days

# Aztreonam: After dispensing, may store at RT up to 25°C for up to 28 days

# Bacitracin powder for injection 

# Basiliximab

# Becaplermin

# Belatacept

# Bendamustine: Treanda (Canada) does not require refrigeration.

# Benzoyl peroxide/clindamycin gel: After dispensing, store at RT up to 25°C for up to 60 days.

# Benzylpenicilloyl polylysine injection: May store at RT up to 25°C for up to 24 hours.

# Beractant

# Bevacizumab

# Bezlotoxumab

# Bleomycin injection

# Brodalumab: May store prefilled syringes at RT up to 25°C for up to 14 days.

# Bupivacaine liposomal: May store at RT up to 25°C for up to 30 days.

# Busulfan injection

# Calcitonin injection

# Calcimar: May store Calcimar at RT up to 30°C for up to 2 weeks.

# Calcitonin nasal spray: Once open, may store at RT up to 25°C for up to 30 days (2 mL) or 35 days (3.7 mL)

# Canakinumab

# Carboprost

# Carfilzomib

# Carmustine

# Certolizumab pegol

# Cetuximab

# Chlorambucil

# Ciprofloxacin 6% otic

# Cisatracurium: Use within 21 days of removing from the refrigerator, even if re-refrigerated.

# Cladribine

# Conjugated estrogen injection

# Corticorelin

# Dacarbazine

# Daclizumab: May store at RT 30°C for up to 30 days.

# Daptomycin

# Daratumumab

# Darbepoetin alfa

# Desmopressin: May store DDAVP Rhinal Tube at RT up to 25°C for up to 3 weeks.

# Desmopressin injection

# Digoxin immune Fab

# DigiFab: May store Digibind at RT up to 30°C for up to 30 days.

# Diltiazem injection: May store at RT for up to 1 month

# Dinoprostone vaginal gel

# Dinoprostone (tablets)

# Dinutuximab

# Dornase alfa

# Doxorubicin

# Doxorubicin liposomal

# Dronabinol capsules: May store between temperatures of 8°C and 15°C, if not refrigerated.

# Dronabinol solution: Once open, may store at RT up to 25°C for up to 28 days.

# Durvalumab

# Ecallantide: May store at RT up to 30°C for up to 14 days.

# Echothiophate iodide

# Elosulfase alfa

# Elotuzumab

# Emtricitabine oral solution: May store at RT up to 25°C with excursions up to 30°C for up to 3 months

# Enalapril oral solution: May store at RT up to 25°C for up to 60 days.

# Epirubicin

# Epoetin alfa

# Eptifibatide: May store at RT up to 25°C with excursions to 30°C for up to 2 months.

# Estradiol/norethindrone acetate patch: After dispensing, may store at RT up to 25°C for up to 6 months

# Estradiol; May store between 2°C and 30°C

# Estramustine: may store between 2°C and 25°C

# Etanercept: May store at RT up to 25°C for up to 14 days; o Enbrel single-dose prefilled syringes, prefilled SureClick, and multi-use vials may be stored up to 27°C for up to60 days; o Brenzys may be stored up to 27°C for up to 60 days; o Multi-dose vial after reconstitution may be stored at RT up to 25°C for up to 14 days.

# Etonogestrel/ethinyl estradiol vaginal ring: After dispensing, may store at RT up to 25°C with excursions up to 30°C for up to 4 months.

# Etoposide powder for injection

# Evolocumab: May store at RT up to 25°C with excursions up to 30°C for up to 30 days.

# Exenatide: Once open, may store Bydureon at RT up to 25°C for up to 4 weeks: Once open, may store Byetta at RT up to 25°C for up to 30 days

# Famotidine injection

# Filgrastim: May store at RT for up to 24 hours up to 30°C for 14 days.

# Formoterol: After dispensing, may store at 2°C to 25°C for up to 3 months.

# Fosphenytoin: May store at RT for up to 48 hours.

# Gabapentin oral solution

# Galsulfase

# Gemtuzumab ozogamicin

# Glatiramer acetate: May store at RT 15°C to 30°C for up to 1 month

# Glucarpidase 

# Golimumab

# Granisetron extended-release oral solution: May store at RT up to 25°C for up to 7 days.

# Human chorionic gonadotropin: After dispensing, may store at RT up to 25°C for up to 30 days.

# Hyaluronate/chondroitin

# Idarubicin

# Idarucizumab: May store at RT up to 25°C for no more than 48 hours (protected from light) or 6 hours (not protected from light).

# Idursulfase

# Immune Globulin

# Infliximab: Remicade may store for no more than 6 months at RT up to 30°C

# Interferon alfa-2b: May store at RT up to 25°C

# Lyophilized powder: up to 4 weeks

# Ready-to-use solution: up to 7 days# Reconstituted Antibiotics: - once reconstituted most need to be discarded after 1 to 2 weeks. E.g. Amoxicillin, Erythromycin, Augmentin

# Multi-dose pens: up to 48 hours over a four-week period

# Interferon beta-1a: May store lyophilized powder at RT up to 25°C for a total of 30 days; May store prefilled syringes and pens at RT up to 25°C per U.S. labeling, up to 30°C per Canadian labeling for up to 7 days.

# Interferon beta-1a: May store at RT up to 25°C for up to 30 days.

# Interferon beta-1a: May store at RT up to 25°C for up to 30 days

# Insulin

# Interferon gamma-1b: May store at RT up to 25°C for up to 12 hours.

# Ipilimumab

# Irinotecan liposome

# Isavuconazonium injection

# Ixabepilone

# Ixekizumab

# Laronidase

# Latanoprost: Once open, may store at RT up to 25°C for up to 6 weeks

# Latanoprost/timolol: Once open, may store at RT up to 25°C for up to 10 weeks

# Liotrix tablets

# Lopinavir/ritonavir oral solution: After dispensing, may store at RT 25°C for up to 2 months (U.S. labeling); 42 days (Canadian labeling).

# Lorazepam injection

# Lorazepam oral concentrate

# Lymphocyte immune globulin

# Melphalan tablets

# Methylergonovine injection

# Metreleptin

# Mipomersen: May store at RT up to 30°C for up to 14 days

# Natalizumab

# Necitumumab

# Neomycin/polymyxin B urinary irrigant

# Nivolumab

# Nusinersen: May store at RT up to 30°C for up to 14 days

# Obinutuzumab

# Ocrelizumab

# Octostim

# Octreotide (Sandostatin, Sandostatin LAR): May store Sandostatin multidose vials at  RT up to 30°C for up to 14 days; May store Sandostatin LAR at RT for 30 to 60 minutes prior to reconstitution (U.S.labeling) or the day of injection (Canadian labeling)

# Ofatumumab

# Olaratumab

# Omalizumab

# OnabotulinumtoxinA: May store frozen at or below -5°C

# Palifermin

# Palivizumab

# Pancuronium

# Parathyroid hormone

# Patiromer: May be stored at RT up to 27°C for up to 3 months.

# Pegademase

# Pegfilgrastim: May store at RT for up to 48 hours (U.S. labeling) or 72 hours (Canadian labeling)

# Peginterferon alfa-2a: May store at RT for up to 24 hours

# Peginterferon alfa-2b: Prefilled pens should be refrigerated, vials may be stored at RT.

# Peginterferon alfa-2b/ribavirin

# Pegloticase

# Pembrolizumab

# Penicillin G benzathine: May store at RT up to 30°C for up to 7 days

# Penicillin G benzathine/penicillin G procaine

# Pertuzumab

# Posaconazole injection

# Pralatrexate: May store at RT for up to 72 hours.

# Pramlintide: Once open, may store at RT up to 30°C for up to 30 days.

# Promethazine rectal suppositories

# Proparacaine ophthalmic solution

# Proparacaine/fluorescein: May store at RT for up to 1 month.

# Quinupristin-dalfopristin

# Rabies immune globulin

# Ramucirumab

# Ranibizumab: Prior to use, may store at RT up to 25°C for up to 24 hours

# Reslizumab

# RhoGAM immune globulin

# RimabotulinumtoxinB

# Risperidone long-acting injection: May store at RT up to 25°C for up to 7 days

# Ritonavir capsules: After dispensing, may store at RT up to 25°C for up to 30 days

# Rituximab

# Rituximab/hyaluronidase

# Rocuronium: May store unopened at RT up to 25°C for up to 60 days (U.S. labeling) and 86°F (30°C) for up to 90 days (Canadian labeling): Once open, at RT up to 25°C must be used within 30 days. 

# Romiplostim

# Sacrosidase

# Sargramostim

# Sarilumab

# Secukinumab

# Sinecatechins: After dispensing, patients may store at RT up to 25°C (U.S. labeling); May store between 5°C and 25°C (Canadian labeling)

# Sirolimus oral solution: May store open bottles at RT up to 25°C for up to 15 days (U.S. labeling); May store open bottles at RT up to 30°C for up to 5 days (Canadian labeling)

Read Also: Ideal water temperature for bathing

# Somatropin

# Somatropin: Once open, may store at RT up to 25°C for up to 3 weeks

# Somatropin: The 3.33 mg vials should be stored in the refrigerator, but the 5 mg vials should be stored at RT (Canadian labeling); All autoinjector cartridge strengths should be stored in the refrigerator (Canadian labeling); All strengths may be stored at RT (up to 30°C; U.S. labeling)

# Somatropin: May store Genotropin GoQuick at RT (up to 25°C) for up to 4 weeks (Canadian labeling); May store Genotropin MiniQuick at RT (up to 25°C) for up to 3 months (U.S. labeling) and 6 months (Canadian labeling)

# Streptozocin

# Succinylcholine: May store at RT for up to 14 days.

# Tafluprost: May store at RT (up to 25°C] for up to 30 days.

# Taliglucerase alfa

# Telavancin: Excursions up to 25°C are acceptable, but no time limit given

# Temozolomide injection

# Temsirolimus

# Teniposide: May store at RT and does not require refrigeration (Canadian labeling).

# Teriparatide

# Thiotepa

# Tipranavir capsules: Once opened, may store at RT 25°C with excursions up to 30°C for up to 60 days

# Tobramycin inhalation solution: May store in opened or unopened foil pouches at RT up to 25°C for up to 28 days.

# Tocilizumab

# Topotecan capsules

# Trametinib: Once open, may store at RT 30°C for up to 30 days

# Trastuzumab

# Trastuzumab emtansine

# Trifluridine

# Ustekinumab

# Valrubicin

# Vaccines (most): Some may require storage in the freezer. 

# Vedolizumab

# Velaglucerase alfa

# Vinblastine injection

# Vinorelbine: May store at RT (up to 25°C for up to 72 hours

Vitamin A palmitate injection

# Ziv-aflibercept

Adapted from: Clinical Resource, Medications Stored in the Refrigerator. Pharmacist’s Letter/Prescriber’s Letter. September 2017