Hydroxocobalamin Ampoule and heat dam... - Pernicious Anaemi...

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Hydroxocobalamin Ampoule and heat damage ??

MartynLewis profile image
18 Replies

Given our recent 'heat wave' in the UK it started me thinking... Is it possible to tell if the content of an ampoule of hydroxocobalamin has suffered damage due to heat? I'm thinking visually rather than in a laboratory !

Whilst I put my stash of ampoules into the fridge in preparation for the heat, it just occurred to me that in future there may be occasions where either that isn't possible or the temperature creeps above 25 degrees without realising, on holiday or travelling for example.

Just wondered people's thoughts and also it may help somebody who didn't manage to get theirs in the fridge.

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MartynLewis
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18 Replies
jade_s profile image
jade_s

I don't think so. When i lost my 100 pack, i was injecting it for days and i didn't visually see a difference, only noticed when the neuropathy came roaring back.

I now have an electronic thermometer that records the min/max temps. I take it everywhere now & am quite obsessive about keeping it cool. I'm also conservative so if it's above 22C, in the fridge/cooler it goes! Same with folic acid. I had 12 boxes that spoiled in a different heat wave. 😭🤷‍♀️

MartynLewis profile image
MartynLewis in reply to jade_s

Out of interest, do you think your 100 pack was damaged by heat or by light? Or both.

Were they being stored in their original box therefore away from light?

Reading deniseinmilden comment below on storing ampoules in her car suggests in her experience heat has not been a big problem.

If heat is such a big problem, you’d think a small sticker on the ampoule which changed colour above say 25 degrees and once triggered remained that colour would not be rocket science - just to give an indication that an ampoule MAY have been exposed to ‘extreme conditions’ and its quality MAY be altered.

I recently collected 20 ampoules from my local chemist but thinking back it was a very hot day and was warm walking back home at midday. There is every chance the temperature was well over 25. Who knows.

jade_s profile image
jade_s in reply to MartynLewis

Interesting replies! I'm fairly sure it was heat, because i was aware of the light issue. The 100 pack was in its original packaging in my suitcase. It was around 27 to 29 C for several weeks but i wasn't measuring temps exactly back then. Maybe i am just very sensitive to any drops in efficacy?

ruffnut profile image
ruffnut

Hi Martyn, I live in Queensland Australia and we have very hot Summers here many days in the 40s. I keep my ampoules in a foil lined zipped lunch bag in a cupboard. In 30 yrs no problem.

deniseinmilden profile image
deniseinmilden in reply to ruffnut

Perfect! Thank you!The foil lining keeps the light out, apart from anything else, and that's the most important thing.

deniseinmilden profile image
deniseinmilden

I keep a few in my car as an emergency backup in case I forget to do a jab in the morning or end up away from home unexpectedly, and every so often I use these up and replace them.

They are regularly exposed to extremes of heat and they have always been fine.

Light is much more important than heat for B12 stability.

On that score I wonder about these fancy fridges with UV lights in them? OK if they are in a box I guess.

Cherylclaire profile image
CherylclaireForum Support

I've also wondered about delivery, and how temperature could affect B12 in transit.Or when they leave the delivery tucked underneath your doormat !

Guess not everything is within our control - but maybe ordering in cooler months works better.

I like the foil lined zipped lunch bag idea though.

Davy28 profile image
Davy28

I didn't think they were supposed to be put in the fridge at all as its changing the temperature of them , I just keep them in a dark store cupboard!

EllaNore profile image
EllaNore

I don't know if this helps. But I ordered B12 from Canada over a month ago and the US post office has sent it to seven different states multiple times in fact, it's been bouncing around from California to Louisiana to Illinois to Texas and back to Iowa three or four times now to each place. So I called the Canada Superstore and he assured me that all B12 ampules are frozen and then heated and Frozen and heated several times, so that they become stabilized. These were his words. He said that there is no problem with the B12 amples being shipped in hot weather. He assured me that they are very stable. So if you're unsure you could probably call your pharmacist and ask them and hopefully they would tell you the same thing. I think medicine like that has to be made sure it's stable before it can be shipped out to different places.

MartynLewis profile image
MartynLewis in reply to EllaNore

That's very interesting EllaNore thank you for sharing.

jade_s profile image
jade_s in reply to MartynLewis

Cyano is also supposed to be more stable than hydroxy.

Interesting info though!

Pickle500 profile image
Pickle500 in reply to jade_s

Hi Jade_s

Do you mind if I ask if you mean that it's likely EllaNore is referring to Cyanocobalamin for North American transits? And that its a more stable solution in terms of it's less likely to lose potency than Hydroxy?

EllaNore profile image
EllaNore in reply to Pickle500

Yes, that is what I bought. It just got here. It's one more stable than the other? I had no idea. Sorry for any confusion.

Pickle500 profile image
Pickle500 in reply to EllaNore

No, not at all. That's a very helpful update and makes a lot of sense. Canada can see low lows and high highs and so it stands to reason the B12 would be protected in this way.

Chances are it's the process/glasswear for all types of B12

jade_s profile image
jade_s in reply to Pickle500

Yes indeed. Sorry for any confusion to you or EllaNore

EllaNore profile image
EllaNore

Well, this kind of confused me more. Found this article:

How to Store Injectable B12 Cyanocobalamin

How to store vitamin B12

Photo Rollex Medical

If you are suffering from a vitamin B12 deficiency or self-injecting for other reasons, then you have vitamin B12 vials or ampoules around your house. Chances are that you have been instructed on their storage, but the following are common storage practices. Always consult your supplier if you have further questions regarding storage of your injectable B vitamin supplements.

You can store your vials and ampoules of vitamin B12 cyanocobalamin and B-Complex out of sunlight in a cool room between the stable temperatures 59-86 Fahrenheit or 15-30 Celsius. However, ideal storage temperatures range between 59-77f / 15-25c. The B vitamins should not get near freezing temperatures.

Although your vials might have dark amber glass instead of clear glass protecting them, it is still necessary to protect the nutrients contained inside by shielding B-vitamins from direct or bright sunlight. You can do this by keeping your B12 injections in their original box, a paper bag or wrapping the vials in aluminum foil.

T.P. Drug Laboratories Storage Recommendations

B12 1000 & 2000mcg, B-100 Complex, and Trivit-B Complex should always be stored below 25c / 77f.

Unopened Vitamin B-12 can be stored out of the refrigerator as long as the storage place maintains a stable temperature below the recommended 25c / 77f. The bathroom is never the ideal storage place because of excess humidity and temperatures. Store in a cool cabinet away from direct sunlight and humid areas, and never near a shower, sauna, atrium or Jacuzzi.

After opening a vial, refrigerate and keep the top covered. Always clean with an alcohol swab before withdrawing its contents.

Ampoules should be used immediately after opening.

When Not to Use

• Do not use if the solution is cloudy, leaking, or has particles.

• Do not use if the solution has changed color from the original color.

• Do not use after the expiration date code provided or printed on the packaging.

Safety

For safety purposes always store your B vitamin supplements and needles out of reach of children and pets. Potential side effects of ingesting large quantities of B vitamins can be diarrhea, swelling of the throat and lips and difficulty breathing.

Throw away unused or expired B-Vitamins, but do not flush down a toilet or pour down a drain unless you are told by a trained professional that it is okay to do so. Check with your pharmacist if you have questions about the best way to throw out B-Vitamins for injection and ask if there is a take-back program in your area.

EllaNore profile image
EllaNore in reply to EllaNore

I also found this:

Stability

Vitamin B12 is stable to heat but is sensitive to light, oxygen, acid and alkali.

ForViolet profile image
ForViolet

My bottle of cyanocobalamin says "store at temperatures between 20 and 25C".

"Protect from Light".

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