Appropriate storage of medicines is necessary to confirm their effectiveness, potency along with physical integrity. Most of the medicines are required to be stored in a cool, dry place, away from sunlight and moisture. While some medicines necessitate special storage as in the refrigerator, or even the freezer. Medicines can expire/deteriorate rapidly on improper storage decreasing their effectiveness and also produces poisonous substances. The key points related to proper storage of medicines can be described as follows:

1. General Instructions for adequate storage of medicines:

It is always necessary to ask the pharmacist / health professional about special storage condition requirement, while taking medicine to home from hospital/drug store house. It is advised not to carry the medicines in the glove compartment of the car or scooter dickey, particularly during the day time, as it could have raised temperature.

The  storage  instructions printed on the packing of medicines should be followed. Majority of the medicines are required to stored away from direct sunlight at room temperature, in a dry place.

Medicine should be placed in an ice-packet and take it to home at the earliest, if the same is to be stored between 2° to 8°C. It should also be quickly transferred to a refrigerator (but not to the freezer compartment).

In home, medicines should be placed in a cupboard, where properly labelled different boxes could be used for a different family members. Common medicines can be stored in a separate box. Medicines for external use ( not to be taken orally) should be placed aside.

Different storage conditions are described on the label of medicines. It is necessary for common man to know their meaning for proper storage of medicines (Table 1 and 2). 

Table 1 : Storage conditions on the label and their meaning

S. No.	Storage condition(s)	Details of storage condition(s)
1	Store in a freezer	- 2° to -18°C.
2	Store in a deep freezer	below -18°C.
3	Store in a COOL place.	Store at a temperature between 8° to 30°C.
4	Store in a COLD place. Do not freeze.	Store at a temperature between 2° to 8°C (in the refrigerator, but not in the freezer compartment)
5	Store in a dry place.	Do not keep in a place with excess moisture (e.g. kitchen, bathroom). Keep in the original container.
6	Store away from light.	Do not expose to light or sunlight.
7	If no storage condition is mentioned on the label.	Keep in a cool, dry place, away from exposure to direct sunlight so that medicine could be protected from moisture, freezing, and excessive heat.

 

 

Table 2: Type of Medicine and their required storage condition(s)

S. No.	Type of Medicine	Storage condition(s)
1	Tablet, Capsule	Temperature not exceeding 30o C
2	Creams	< 25o C unless specified, Do not freeze.
3	Oral powder	Protect from moisture
4	Ointment, Gel	< 30o C unless specified, Do not freeze.
5	Nasal powder	Protect from light & moisture
6	Oral liquid, Pessaries, Suppositories	Well closed contained
7	Insulin Preparation	Unless specific, store at 2° to 8°C, should not be frozen, protect from light.
8	Inhalations	Avoid extremes of temp & large variation in temperature.

 

It is always advised to read the drug labels first at the time of purchasing/using medicine as there are always some exceptions. For example, most types of insulin requires to be refrigerated prior to opening. Once opened, insulin may be kept unrefrigerated as long as it is kept far from heat and light. The period for storage of unrefrigerated insulin depends on the type of insulin.

For safety reasons, it is better to store medicines only in their original containers. Some drugs, for example nitrate (a heart medication) should never be put in another container. On doing so they get exposed to oxygen resulting in evaporation of nitrate and remaining them of no use.

It is also advised that do not fully pack the refrigerator with medicines as it results in blockage of air circulation between stored medicines leading to inconsistent temperature inside refrigerator.

2. Children and storage of medicines

As per Centre for Disease Control and Prevention data, about 60,000 young children die in hospitals every year as they consumed medicines when no adult was looking them at home. out of these around, 30% of children's deaths from medication are due to iron-containing vitamins/supplements. These deaths could be avoided by always storing medicine away and beyond children’s reach and sight every time we use it.

Never leave medicine at dining table, kitchen platform or other low height open places reachable to children. Do not leave the medicine at an ill child’s bedside, even if it is to be given several times a day.

It should always be confirmed that safety cap of medicine bottle is properly locked during its storage. Always relock the cap of medicine bottle after its use. Sometimes, there might be chances that children could open the cap of medicine bottle, so medicines should be stored up and beyond the reach to children preferably in a locked cabinet.

2. Carrying medicines while travelling

During travelling, medicines should be packed in a carry-on bag to be kept closer. The regularly used medicines should be carried with an extra amount as there might be chances of delayed return or sometimes, the particular brands of medicines being taken may not be available in the destination place.

If it is required to carry medicines which require storage between 2° to 8° C, an ice-bag or thermocol box with ice  should be used during transit.

During international travel, medicines should be stored in a carry-on bag instead of a checked-in luggage. The later is stored in cargo compartment during flight which may be too hot or cold, making it unsuitable for storage of medicines. Always carry your doctor's prescription with you as it might be asked to produce the same at the airport/customs. Only freshly issued prescription should be carried during travel. It would also be useful to know the generic name/s of the prescribed medicines, if needed to purchase the medicines in abroad.

3. Clearing your medicine cabinet

Every house, after some time ends up with a lot of unused medicines, thus to get rid of expired medicines and medicines that are of no longer use should be checked in storage cabinet at least once in 6 months. Medicines with changed colour, odour, texture, consistency regardless of their expiration date should also be discarded. The capsules or tablets that fuse together, are harder or softer than normal, or cracked or flaked should be thrown out.

4. Safe disposal of medicines

The burning of the expired or unused medicines as part of waste material in an open containers should not be done as it results in release of toxic pollutants to the air. 

In general, label of medicines does not any instructions about safe disposal of unwanted or expired medicines, making it a major problem. Most of the medicines, if disposed off in domestic waste basket can be harmful. In India, we do not have any proper systems for safe disposal of medicines.  In several other countries, it is recommended that medicines should neither be thrown into domestic waste basket, nor flushed down the toilet, as this may pollute the environment. In these countries, pharmacies or specific agencies accept unused or expired medicines and manage for their safe disposal.

Conclusion

All the medication has its own recommended storage condition varying from room temperature, to refrigeration, to freezing, or others. Patients are advised to read the labels of medicines carefully at the time of purchase or before storing their medicines at home.