Insulin, Inhalers, EpiPens and Other Cold Sensitive Medicines in a Bitterroot Winter
Some medicines need extra care when it gets cold
Most tablets and capsules handle a chilly drive home without much trouble. A handful of medicines are a different story. They are more delicate, more likely to be carried outside every day, or more important to have working the moment you need them.
If you or someone you care for uses any of the medicines below, a few small changes to your winter routine can make a real difference. As always, the instructions that come with your specific medicine are the final word, and your pharmacist can walk you through them.
Insulin and other injectables
Insulin is one of the most temperature sensitive medicines people keep at home.
Unopened insulin is usually stored in the refrigerator, in the main compartment, away from the back wall and the freezer.
Insulin in use is often kept at room temperature for a set number of days, commonly around 28, though this varies by product. Check your package insert.
Frozen insulin should not be used, even if it looks normal once it thaws. Freezing can break down the insulin so it does not work the way it should.
Winter tips for insulin users:
Carry pens and vials in an inside pocket or an insulated case, close to your body
Never leave insulin in the car, even for a short stop
Check that your refrigerator is not freezing items in the back or bottom
Bring insulin inside right away if it was delivered
Other injectable medicines, including many used for arthritis, migraines and other conditions, often have similar storage rules. If you are not sure, ask.
Inhalers
Cold air is already a common asthma trigger, so this is the season you most need your inhaler to work.
Most rescue and maintenance inhalers are pressurized canisters. When the canister gets very cold, the pressure drops and it may not spray a full dose. You may also notice a weaker puff.
Keep your inhaler in an inside coat pocket, not an outer pocket or the car
If it has been in the cold, warm it in your hands for a few minutes before using it
Shake it as directed and consider a test spray away from your face if it has been very cold
Never warm it with a heater, hair dryer, flame or microwave
Epinephrine auto injectors
EpiPen and other epinephrine auto injectors are meant to stay at room temperature. They should not be refrigerated or frozen, and they should not ride around in a cold glove box all winter.
Carry them in an inside pocket, a purse or a bag you keep with you
Keep backups indoors, not in a vehicle
Check the window on the injector. The liquid should be clear. If it is cloudy, discolored or has particles, it needs to be replaced
If an auto injector may have frozen, talk to your pharmacist about a replacement
In an emergency, use the injector you have and call 911. Do not delay treatment because of a storage question.
Diabetes testing supplies
Glucose meters and test strips have an operating temperature range listed in their instructions. When they are too cold, they can show error messages or give readings that are off.
Keep your meter and strips indoors or in an inside pocket
If they have been out in the cold, let them warm to room temperature before testing
Keep strips in their original sealed container
Continuous glucose monitor readers and phones can also misbehave in deep cold
Liquid medicines and suspensions
Liquid antibiotics, cough and cold syrups and other suspensions can separate or change texture if they freeze. Some liquid antibiotics are kept in the refrigerator after mixing, but they should not freeze.
Before using a liquid medicine that got cold:
Let it come up to room temperature
Shake or mix it as the label directs
Look for clumps, crystals or layers that will not mix back together
Ask your pharmacist if anything looks off
Eye drops, creams and others
Some eye drops are suspensions that may not mix evenly after freezing. Creams and ointments can separate or turn grainy. Suppositories and some patches can also be affected by cold or by being stored near a heat source to warm up. When in doubt, bring it in.
A simple winter checklist
Make the pharmacy your last stop before going home
Keep daily carry medicines close to your body
Keep nothing in the car long term
Bring deliveries inside quickly
Store medicines indoors in a dry spot with a steady temperature
Check anything that got cold before using it
Questions? Ask at the counter
Healthcare Providers Inc. is an independent pharmacy at 1900 North 1st Street in Hamilton, serving the Bitterroot Valley. If you are not sure whether a medicine got too cold, bring it in or call (406) 363 6203. We deliver to Hamilton, Darby, Corvallis and Victor, and we are happy to time deliveries so your medicine does not sit outside.
