Comments on: Mail order prescriptions and temperature

Question: Mail order prescriptions and temperature

jclovebrew — Wed, 26 Dec 2007 17:20:49 -0800

Does the cold temperature outside destroy my mail-order medication?

My asthma inhaler says Store between 15C and 25C (59F and 77F) on the box. It arrived in the mail today, and sat on the porch for a few hours at around 40F. So now what?

I'm pretty sure most drugs list some sort of storage temperature range, and I'm pretty sure that everyone, including me, ignores it.

How important is it, really, to keep the drugs in their specified range? And isn't it essentially impossible (depending on time of year and location) to send it over the mail and not expose it to temperatures outside of the specified range?

By: KokuRyu

KokuRyu — Wed, 26 Dec 2007 17:42:38 -0800

40F is not going to damage the contents of your inhaler. However, asthma medication has a shelf life, and obviously they would prefer it if you did not store it on your front porch for the entire time that you will be taking it. Probably the relative humidity at that temperature, for example, will affect the medication in some way **over an extended period of time**, not for four hours.

By: jessamyn

jessamyn — Wed, 26 Dec 2007 18:26:58 -0800

For a few hours, it's totally fine. You can also leave it in you car for a while when it's really hot and/or really cold. This New Zealand website seems to indicate that heat is more of an issue with asthma meds than cold.

Keep Flixotide Accuhaler in a dry place away from heat (store below 30°C).
Do not leave it in the car or on window sills.
Heat can destroy some medicines.

Accuhaler!

By: Quietgal

Quietgal — Wed, 26 Dec 2007 18:32:06 -0800

I work in biotech and have dealt with product stability tracking and testing for several different types of drugs. This is not medical/pharmaceutical advice, though, and may not apply to your specific product.

Generally speaking, higher temperatures are of more concern than lower temperatures (with the caveat that freezing certain products can be really bad for them - however, it doesn't look like your porch got down to freezing temperatures.) Here is a pretty good discussion of storage temperatures for pharmaceuticals as recommended by the US Pharmacopoeia.

When we test a product's stability, we test at the required storage temperature (whatever that might be), and one or two higher temperatures. We don't bother testing lower temperatures. With the caveat about freezing, it is pretty safe to assume that lower temperatures are better for most products (there are exceptions, but this is a good rule of thumb).

The required storage temperature is determined based on results of stability testing at several commonly-used temperatures: room temp, refrigerated, or frozen. Room temperature is always the preferred condition because of logistical concerns with shipping and storage space in hospital and pharmacy refrigerators. A drug would have to have a depressingly short shelf life at room T in order to get a "refrigerate" or "freeze" requirement.

However, the USP allows for brief (less than 24 hr) higher temperature spikes to accommodate the realities of shipping stuff around, provided that the manufacturer has stability data to support this. For this reason we do shipping studies too, sending out packages of drug product to various places at various times of the year, then having these packages sent back so we can analyze how well the product survived.

A whole lot of thought and effort went into those required storage conditions, and there's usually a pretty good safety margin built into them, but it is best to store the stuff for the long term where the manufacturer recommends it.