What medications are stored in the refrigerator in the pharmacy: a complete list and placement rules

In any pharmacy, a refrigerator is not just a household appliance, but a critical equipment on which the effectiveness and safety of dozens of drugs depends. Errors in temperature conditions can lead to the loss of the therapeutic properties of vaccines, insulin or antibiotics, and in the worst case, to a risk to the health of patients. But how do you understand which medications require refrigeration, and which ones can be stored at room temperature?

This article will help you understand the nuances: we have collected current list of drugswhich must be in the refrigerator compartment of the pharmacy, explained the requirements of GOST and SanPiN, and also gave practical recommendations for organizing storage. Particular attention was paid to insulins, immunobiological drugs injection solutions - their spoilage due to temperature disturbances occurs most often.

Why some medications require storage in the refrigerator?

The main reason is chemical instability of active substances at room temperature. Many protein drugs (for example, insulin or blood clotting factors) denture already at +10°C, losing their structure and therapeutic effect. Other medications, such as some antibiotics or eye drops, contain preservatives that decompose when heated, leading to bacterial growth.

Here are the key groups of temperature-sensitive drugs:

• 💉 Injection solutions (especially in ampoules without preservatives)
• 🧬 Biotechnological drugs (monoclonal antibodies, enzymes)
• 🩸 Blood substitutes and plasma substitutes (albumin, dextrans)
• 🦠 Probiotics and vaccines (live cultures die when overheated)
• 💊 Some coated tablets (for example, pancreatin with lipase)

Interestingly, even for the same drug, the requirements may differ depending on from the release form. For example, insulin in syringe pens are often allowed to be stored at room temperature for up to 1 month after opening, while spare bottles should be kept in the refrigerator. Always check the manufacturer's instructions!

Official requirements for storing drugs in the refrigerator

In Russia there are strict standards regulating the conditions for storing drugs. Key documents:

• 📜 Order of the Ministry of Health No. 706n (on approval of the rules for storing drugs)
• 📄 GOST R 57238-2016 (requirements for refrigeration equipment)
• 🏥 SanPiN 2.1.3.2630-10 (hygienic standards for pharmacies)

According to these documents, the temperature in the refrigerator compartment of the pharmacy must be maintained in the range of +2...+8°C with a deviation of no more than ±1°C. At the same time:

• 🌡️ It is prohibited to place medications on the refrigerator door (due to temperature changes when opening)
• 🚫 You cannot store medications along with food or cosmetics
• 📊 The temperature must be recorded in a log 2 times a day (morning and evening)

Important: if a power failure or refrigerator breakdown occurs in the pharmacy, all drugs stored under improper conditions are considered unsuitable for use and must be disposed of. This rule is stated in clause 4.7 of Order No. 706n.

Full list of drugs that require storage in the refrigerator

Below is an updated list of drugs that should be stored at +2...+8°C in pharmacy conditions. The list is compiled on the basis of manufacturers' instructions and data from the State Register of Medicines (GRLS).

A complete list of drugs for your pharmacy can be generated using a program "Pharmexpert" or database GRLS, where storage conditions are indicated for each drug. Please note: some drugs (for example, Botox or Dysport) require storage at +2...+8°C before opening, and after dilution - use immediately.

What to do if the drug has been thawed?

Thawing of most biological products (especially vaccines and insulins) leads to an irreversible loss of activity. Even if the solution looks normal on the outside, it should not be used! Such drugs must be disposed of as medical waste of class G (toxic).

How to properly organize storage in a pharmacy refrigerator?

Just putting the medicine on the shelf is not enough - you need to ensure uniform cooling and protection from external factors. Here are step-by-step recommendations:

1. Zoning the space

   Divide the refrigerator into zones according to temperature requirements:

   • 🔹 Top shelves (+2...+6°C) - for vaccines and immunobiological drugs
   • 🔹 Middle shelves (+4...+8°C) - for insulins and hormones
   • 🔹 Bottom shelves (coldest) - for drugs requiring +2...+4°C

Humidity control

Use hygrostats or silica gel bags to maintain humidity level 40–60%. Excessive moisture leads to condensation on the ampoules, and insufficient moisture leads to drying out of the stoppers.

Protection from light

Transparent ampoules (for example, with adrenaline or atropine) store in original cardboard containers boxes or use opaque containers.

Checking the temperature with a thermometer|Inspecting the door seals for leaks|Checking the expiration date of drugs on the front shelves|Fixing data in the log book-->

Pay attention to organization of air exchange: do not pack the shelves too tightly - there should be space between the packages for cold circulation air. The optimal filling of the refrigerator is no more than 70% of the volume.

⚠️ Attention! If your pharmacy uses a refrigerator with a system No Frost, please note that it can dry out the air. In this case, be sure to use humidifiers or store medications in airtight containers.

Common mistakes when storing medications in the refrigerator

Even experienced pharmacists sometimes make mistakes that lead to damage to expensive medications. Here are the most common mistakes:

• ❄️ Freezing medications - many biological drugs (for example, Eprex or Aranesp) lose activity already at 0°C. Always make sure that the temperature does not fall below +2°C.
• 🔄 Frequent opening of the door —leads to temperature fluctuations. Optimal: no more than 10 openings per day.
• 📦 Storage in the original shipping packaging —cardboard boxes of vaccines often contain thermal indicators that need to be checked upon receipt.
• 💡 Use of household refrigerators —they do not provide uniform cooling. Pharmacies need class models "Pharma" with forced ventilation.

Another typical problem is improper disposal of expired drugs. For example, insulin cannot be thrown into regular garbage: it must be rendered harmless in accordance with SanPiN 2.1.7.2790-10 (hazard class B or C depending on the form).

Remember: responsibility for violating storage conditions lies not only with the pharmacy, but also with the medical personnel who will administer the spoiled drug to the patient. In the event of an incident, this may be qualified as violation of Art. 6.33 Code of Administrative Offenses of the Russian Federation ("Violation of sanitary and epidemiological requirements for the operation of premises").

How to choose a refrigerator for a pharmacy?

Household models are absolutely not suitable for storing medicines! Pharmacies require specialized refrigerators that are appropriate GOST R 57238-2016. Here are the key selection criteria:

• 🌡️ Accuracy of temperature maintenance — error no more than ±0.5°C (in household refrigerators ±2...3°C)
• 🔋 Autonomous power supply —battery on 12–24 hours of operation during a power outage
• 📊 Monitoring system — built-in sensor with data output on the display and the ability to connect to a PC
• 🔒 Lock on the door —required to comply with the safety regime (clause 5.3 of SanPiN 2.1.3.2630-10)
• 🧊 Defrosting system — preferable system No Frost or drip (but not manual!)

Popular models for pharmacies:

• B Medical Systems RIC-100 —volume 100 l, accuracy ±0.3°C, autonomy 24 hours
• Helmer GX26 —with touch screen and USB port for data export
• Dometic CFX3 40 —portable option for small pharmacies (volume 38 l)

The cost of a professional pharmacy refrigerator starts from 80,000 rubles. You cannot save on this equipment: for example, spoilage of one batch of hepatitis B vaccines (about 50 doses, 3,000 rubles each) will cost more than buying a high-quality refrigerator.

⚠️ Attention! When buying a refrigerator, check the availability of certificate of conformity GOST R i declaration of conformity of the Customs Union. Without these documents, the equipment will not pass the inspection of Roszdravnadzor.

Temperature control: devices and protocols

A simple household thermometer is not enough - a pharmacy requires Continuous monitoring with data recording. Use the following devices:

The temperature control protocol should include:

1. Daily check in the morning and evening (data is entered into a log in the form approved by order of the Ministry of Health No. 706n).
2. Weekly verification of thermometers (using a control device).
3. Monthly calibration of equipment (accredited metrological services can be involved).

If temperature deviations from the norm are detected, it is necessary:

1. Immediately transfer the drugs to the reserve refrigerator.
2. Draw up a report on violation of storage conditions (form No. 14-U).
3. Inform the head of the pharmacy organization.

FAQ: Frequently asked questions about storing medications in the refrigerator

Is it possible to store insulin in the freezer? if it accidentally froze?

No, freezing insulin is strictly prohibited. When frozen, the protein structure of the hormone is destroyed, and the drug becomes ineffective. Even if the solution appears clear after defrosting, it should not be used. Such insulin must be disposed of as medical waste of class G.

How often should you check the temperature in the pharmacy refrigerator?

According to clause 4.5 of Order of the Ministry of Health No. 706n, the temperature must be recorded at least 2 times a day (morning and evening). The logbook must indicate:

• Date and time of measurement
• Thermometer readings
• Name of the employee who conducted the inspection

When using automatic monitoring systems (for example, Testo Saveris) a weekly data upload is sufficient.

What to do if the electricity in the refrigerator goes out?

Act according to the algorithm:

1. Immediately move the drugs to a backup refrigerator or thermal container with cold elements.
2. Check the temperature inside the main refrigerator - if it rises above +8°C, all biological products (vaccines, insulins) are considered spoiled.
3. Draw up an emergency report (form No. 15-U) and inform Roszdravnadzor within 24 hours.

Important: do not try to “reanimate” cooling drugs again will not restore their properties!

Is it possible to store drugs and donor blood in the same refrigerator?

No, this violates clause 3.12 of SanPiN 2.1.3.2630-10. Storage blood components requires separate equipment with a temperature of +4±2°C and a forced ventilation system. Joint storage of drugs and biomaterials can lead to:

• Cross contamination
• Breach of the cold control chain
• Problems during checks of transfusiologists

How to properly transport medications that require refrigeration?

For transportation, use validated thermal containers with cold elements (for example, Va-Q-tec or Softbox). General rules:

• The temperature inside the container must be maintained in the range of +2...+8°C throughout the entire route.
• Use thermal indicators (for example, Fresh-Check) for control.
• Transportation time should not exceed 48 hours (for vaccines - 24 hours).
• When receiving the goods, be sure to check the integrity of the seals and the indicator readings.

Additional requirements apply for vaccines: they can only be transported in WHO-certified containers (for example, WHO PQS).