How Long Can Refrigerated Medicines Be Left Out?

Storing your medicines properly is key to their efficacy and the success of your treatment. While most drugs can simply be stored in a cool, dry place, some medications are heat sensitive and require refrigeration.

The list of refrigerated medicines is quite extensive. It includes different types of drugs and biological products such as insulin, growth hormones, eye drops, vaccines, some antibiotics, rheumatoid arthritis injections, and numerous other biologic drugs.

While most of these drugs allow for some flexibility and may be unrefrigerated for up to several weeks, others are extremely unstable and quickly deteriorate when out of the fridge. Therefore, knowing how long your refrigerated medicine can be left out is essential to guarantee its effectiveness.

Why do some medicines need to be refrigerated? 

Most medicines that need to be refrigerated belong to the class of biological drugs. At the cutting edge of biomedical research, biological drugs, also called biologics or biopharmaceuticals, are produced with biological sources using a living system such as an animal cell, a plant cell, or a microorganism.

Unlike chemically synthesized drugs made with smaller molecules, biologics tend to be unstable products, heat-sensitive, and susceptible to microbial contamination. Therefore, storing them in the refrigerator allows for greater stability and prolonged effectiveness and lowers the risks of degrading or getting contaminated.

Most but not all refrigerated medicines are administered via injection or infusion. Here are some of the most common examples:

• Insulin (diabetes injection)
• Ozempic and other type 2 diabetes injections like Trulicity or Victoza
• Mounjaro for diabetes and weight loss
• Saxenda and Wegovy for weight loss
• Latanoprost and other glaucoma eye drops
• Humira and other injections used to treat rheumatoid arthritis, like Enbrel, Cimzia, Actemra, Orencia, or Simponi
• Human growth hormones like Genotropin, Norditropin, Humatrope, and others
• Aimovig, Emgality, or Ajovy injections used for severe chronic migraines
• Some asthma injections like Dupixent, Xolair, Fasenra, or Nucala
• Tymlos and Forteo injections for osteoporosis
• Kesimpta, Copaxone, and Avonex for multiple sclerosis
• Trimix and Caverject for erectile dysfunction
• Repatha and Praluent injections for high cholesterol
• Strensiq for  hypophosphatasia 
• Vaccines
• Some antibiotics
• Some tablets and capsules used for chemotherapy and antiretroviral treatment, like Leukeran or Melphalan
• Some pharmaceutical creams and gels
• Others

Related article: A list of medicines that require refrigeration.

What happens if you don’t refrigerate medicines? 

The main risk of not refrigerating these medicines is that they can lose their potency, partially or totally. Bacterial contamination is a rare scenario, but it can happen too.

Refrigerated medicines are very sensitive to heat, and their molecules can start degrading very quickly when not stored in the right conditions (including temperature and light exposure).

Ultimately, using such a medicine that’s been out of the fridge for too long can disrupt your medical treatment. You may not notice immediately that your drug has lost its potency, but you would be receiving the equivalent of a partial dose or no dose at all, which can be dangerous for your health. 

Not only should you be very careful to keep your medicines in the refrigerator, but you must also ensure the temperature inside your fridge is set correctly.

As a rule of thumb, drugs that require refrigeration must be kept between 36°F and 46°F (2°C and 8°C). However, there may be different requirements, so always read the storage instructions for each medicine. Ideally, the temperature inside your fridge should be as stable as possible to avoid temperature fluctuations some medications can be sensitive to. 

Related article: At what temperature should you keep refrigerated drugs?

How long can refrigerated medicines stay out of the fridge? 

How long refrigerated medicines can be left out depends on each specific drug. Unfortunately, there are no catch-all answers, so make sure you read the storage instructions carefully.

It also depends on the ambient temperature at which it is exposed, as well as other storage conditions such as exposure to light, humidity, and others. Let’s take a few examples.

Related article: How to Travel with Refrigerated Medication?

Leaving your medicines unrefrigerated

Some drugs are extremely unstable when unrefrigerated, while others can easily stay unrefrigerated for weeks and even months sometimes.

For example, some vaccines are very heat sensitive and must be injected immediately after being removed from the fridge. Some human growth hormone injections like Genotropin become very unstable once reconstituted and must be injected immediately or kept in the refrigerator for 24 hours.

Orencia and Actemra, two injectable medicines used to treat rheumatoid arthritis, can only be unrefrigerated for 8 hours.

Related article: How long can vaccines be out of the fridge?

Other refrigerated medicines allow for a bit more flexibility and are stable for a few days when unrefrigerated. For example, Aimovig (migraine preventive medication) can be left out for up to 7 days at room temperature. Dupixent, used for severe asthma, can be unrefrigerated for up to 14 days. Trulicity, used to lower blood sugar in type 2 diabetes, can stay at room temperature for up to 14 days too, like Humira and Enbrel, two injectable medicines used to treat rheumatoid arthritis. 

The least heat-sensitive refrigerated medicines can even be unrefrigerated and stored at room temperature for several weeks or even months. For example, most insulins stay fully active at room temperature for about a month. Ozempic, another anti-diabetic injection, can even remain unrefrigerated for 56 days. And Latanoprost (glaucoma eye drops) can be left out for six weeks.

Related article: Why does insulin need to be refrigerated? How to store it properly?

What is room temperature?

Although some refrigerated medicines can be left out for a few days, weeks, or months, it does not free you from being careful about their storage conditions. As a rule of thumb, they should never be exposed to temperatures above 77°F (25°C) or 86°F (30°C) for the most resistant ones. 

Most biologics are also sensitive to light or humidity, so again, always double-check the storage instructions for each specific medicine.

4AllFamily designs portable refrigeration solutions for people using refrigerated drugs. Browse through our catalog of medical-grade travel coolers or reach out so we can help you out!