EPO injections -safe storage : Does anyone have... - MPN Voice

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EPO injections -safe storage

Fika500 profile image
14 Replies

Does anyone have any tips on how keep the injections at fridge temperature when bringing them home from the pharmacy?

The advice given by the pharmacy seems almost impossible to adhere to:

-once out of the fridge for 30 mins., they are considered to be a room temperature and should NOT go back into the fridge

- once out of the fridge for 30 mins and therefore at room temperature , the injection must be used within seven days.

-the injections must not be frozen.

I bring an insulated bag with ice packs to the pharmacy but the temperature seems to be above fridge temperature in some parts of the bag and I’m not sure whether it’s okay to have the injections touching the ice packs (which have begun to warm up on the journey there)

I think most people would find it virtually impossible to get the injections back in the fridge within 30 mins of getting them from the pharmacy.

Are these ‘rules’ just ideal conditions and we should just do our best to keep them as cool as possible on the way home? Or are we compromising the treatment if we can’t adhere to these guidelines?

Any thoughts /advice would be greatly appreciated.

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Fika500 profile image
Fika500
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14 Replies
Miriammusic profile image
Miriammusic

Hi Joe. My Peg comes delivered to me in a refrigerated box so I’m not so familiar with all of those standards you are supposed to adhere to. Sounds like a lot to deal with. Previously on this site though, someone had mentioned that they bought a small bag to keep the medication chilled when traveling. I forgot what the name of it was but maybe someone will respond.

JSKly profile image
JSKly in reply to Miriammusic

Hello. Yes Frio works by evaporation but there’s an inner and outer pocket so meds’ dont get wet. Theres a good video that shows exactly how to use it. Search Frio. May also be on YouTube.

When you get where you are going

lay Frio out of carrying pouch so air can get to it. There’s also instructions on how to dry bag out, shake crystals and start again. Need crystals to be loose again. Not difficult but I forgot first time.

Miriammusic profile image
Miriammusic in reply to JSKly

Thanks so much! 😊

Fika500 profile image
Fika500 in reply to JSKly

Thank you

MPort profile image
MPort

Hi Joe,

All these guidelines would make it near impossible to achieve unless we were lucky enough to get it delivered in cool box as per other reply. That makes it very easy.

I have been collecting mine from a pharmacy that is 2 hours away from me for 10 years and as you can imagine it has been stored and kept cool or less cool, sometimes because I forget to bring cool bag. So in the real world I think there is some flexability, certainly the hospital pharmacy I deal with is relaxed, perhaps too much.

I bring a loaf size cool bag with me with ice block in side. I double wrap boxes and place them in it. Block has been out of freezer for about 4 hours so it is chilling the space. I feel this is best I can do. Sometimes I have forgot and then I buy a bag of frozen veg from Iceland and use that in a looser way. Your guidelines would say that is too cold but needs must. I have stopped worrying about it. Injections seem to work ok on this variable way.

The diabetes insulin injection bag I use for travelling is not suitable for pharmacy pick ups. This fits one box so the other injections have to be removed from their boxes. I prefer to keep them in original boxes when I am at home.

Hope this helps. It is trial and error and hoping some variation will be ok.

Mairead

hall2 profile image
hall2

I bring mine home from the hospital pharmacy in a normal bag no ice packs nothing. I put air con in the car on but takes me about an hour to get home never had any problems so far.

JSKly profile image
JSKly

Those fridge instructions from the pharmacist seem very extreme and by my experience are unnecessary. I think Pegasys needs to be cool, not overheated. I drive nearly an hour after I pick it up. If the day is hot I put Peg in cool bag in car boot or back seat.

My understanding is just cool! Not warm. In fridg I leave it in pharmacy bag or put it in plastic box in top of fridg.

The travelling bag is called Frio. I use it on long journeys. But not to and fro to pharmacy.

Don’t let pharmacist scare you.

Miriammusic profile image
Miriammusic in reply to JSKly

Hi. Question for you regarding the Frio bag. You put one vial in? My understanding is it works through expanding these crystals and evaporation, so does that mean it gets everything wet? If flying, do you put it in your carry on? Thanks for any info you can provide!

skipperL profile image
skipperL

Journey from hospital pharmacy to home was an hour or so - was just told to refrigerate the Epo when arrived home.

For flying abroad I used an M and S sandwich bag and several small freezer packs and had no problems. I hope this is useful!

Skipper L

Fika500 profile image
Fika500

Thank you for all thee replies -very helpful.

Purr-cat profile image
Purr-cat

Hi Joe500,

You are doing most things correctly. Freezer packs and insulated lunch boxes are great but can be made more beneficial by remembering the following:

1) Freeze the blocks overnight. They contain a substance which stays frozen much longer and at a different temperature than ice.

2) Heat rises and cold sinks. Therefore cover the top of your injections with freezer blocks first and use any extra for down the sides. Having some underneath helps it too, but less so. Carry it level.

3) Nothing heats anything as fast as circulating air. This is why the temperature seems to vary inside your lunch box and the solution is to eliminate as much air as you can from the inside. This means that you maximise the benefit of your freezer blocks if you can pack them and your injections as tightly as possible and have an excellent seal on the box. I know some only have Velcro strip but the ones that use clips and a rubber seal are more insulated.

4) You may find that swapping your current one for 2 medium or 2 or 3 smaller ones helps you achieve points 2 and 3. You could also consider once packed putting small/ medium/ large...etc. inside the next size up to achieve a double layer of insulating wall. It is like a three dimensional puzzle that only you can judge. The packing may seem time consuming at first but once you learn how best to fit things in your own equipment you will do it quickly.

3) If you go to a very busy clinic like me then one problem is that during the wait of 2-3 hours the freezer blocks will start warming up. Many clinics have a fridge or fridge/ freezer for injections etc. and the hospital pharmacy certainly does. It is worth asking them to store your freezer blocks while you are in clinic. Even if they only have a fridge it is at least cooler than room temperature. There is a chance though that your local health authority has a 'Health and Safety' rule forbidding items belonging to the public from being placed in an NHS hygienic space.

When your pharmacist says the injections reach room temperature in 30 minutes he means without the precautions you are taking. The brand I was on took 14 hours at room temperature to begin losing efficacy. Brands vary but your Patient Information Leaflet will tell you this.

You can't freeze Injections but it is okay if they touch freezer blocks.

Don't forget to check the optimal storage temperature for your brand (also in the Patient Information Leaflet) and use a digital fridge thermometer placed in the centre of your fridge to maintain this. Factory settings for a fridge are usually 5 Celsius so initially you may need to adjust this.

I hope some of this helps and that next time you have a pharmacist with a better understanding of the Theory of Thermodynamics.

All the best and good luck.

Anag profile image
Anag in reply to Purr-cat

Wow! Perfect information.

Fika500 profile image
Fika500

Thank you so much for all this very helpful information.

Anag profile image
Anag

What about a thermos? Rinse it out with cold water to cool off the inside. Put the injections in and close. It’s easy as long as your thermos is big enough. Hope to have helped.

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