What is often being overlooked?

Let us pause for a moment and reflect together on whether you are taking all measures to maintain the efficacy of your treatment. Surely you are doing everything you can in keeping your doctor’s appointments, taking your medications as prescribed and probably even following a diet and exercise program if necessary. But wait, there’s more!

Most patients often overlook a crucial element inside their medicine package—the medicine leaflet. Among various instructions, it tells you about the medicine storage temperature at which you must keep your cold chain requiring medicine at all times.

This requirement applies even when transporting them from the pharmacy to your home.  Not following these temperature guidelines, your medicine may already be broken when you put it in your fridge at home. You may be unwittingly jeopardising the effectiveness of your treatment.

Since most people are unaware of this, and since the safe transportation of your medicine is a very easy way to support your health, let’s take a closer look!

Would you like to be one step ahead of your doctors?

This question is of course to be taken with a wink! Healing is always a holistic and very individual process. As a patient, and also as a doctor, there are many things to consider at once. Unfortunately, the aspect of correct cooling of the medicine is often forgotten along the way. 

Even the most esteemed health professionals often overlook advising patients to store and transport their medication at the recommended temperature due to a lack of time. 

Through many personal conversations with medical specialists, we have found that doctors only ask their patients about their cooling of the medicine after about 3 to 4 years, when the patient keeps coming back to the practice because their illness is progressing or because their medication is not working. Sometimes it works, sometimes it doesn’t. The patient is regularly adjusted to a different dosage and the medicine brand itself also gets changed. Nevertheless, the patient hardly seems to experience any improvement in their situation. It is often only after many futile endeavours that the doctor asks about cooling when transporting the medication. In the meantime, the disease has progressed unnecessarily. 

Understand the medicine transport temperature requirements

A small but very important step on your way to better health!

The Patient Medication Information (PMI) as medication package insert often only contains information on the correct “storage” of your medication. The actual meaning of the term “storage” goes beyond “storing” the medicine in the refrigerator at the pharmacy or in your home. It also refers to the transport of your medication. Safe “storage” includes the entire journey of your medicine from the pharmacy to your home, not just the time in the refrigerator. This also applies to all other occasions when you leave the house with your medicine. The medicine storage temperature guidelines for the storage of medicines must therefore be strictly adhered to at all times and everywhere. If you do not store and transport your medicines under the prescribed conditions, this can destroy the effect of your medicine.

You will find information on how to store and transport your medicine correctly in the package leaflet for your medicine. There are different types of “storage”.

Let’s take a closer look at the meaning of the terms used in the medication package insert PMI. Below we describe what the individual expressions mean. We hope that this overview can become your compass, helping you to take the right steps towards a speedy recovery.

Refrigerate; do not freeze

Medicines labeled “Refrigerate; do not freeze” must be stored between 2 to 8 ºC (35.6 to 46.4 °F)  to uphold their effectiveness.

Incorrect transportation and storage can lead to freezing. Freezing can destroy your medicine and thus impair its effectiveness. The greatest risk during transport is the use of an unsuitable cool bag.

Almost all commercially available medical cool bags — even rental cooler bags from many pharmacies who provide home delivery services — cause the medicine to freeze. To avoid this, you should opt for the patented and certified COOL*SAFE medicine cool bag.

Protect from light

Sunlight and chemicals can impair with the effect of your medication. To keep it safe, pills with light-sensitive ingredients often have a colourful coating. If you are dealing with MS and are taking dimethyl fumarate or Tecfidera, you will find in your PIL the instructions to always put them in a shady spot. 

Keep refrigerated (Store between 2º and 8ºC).

If your patient medication information (PMI) says that you should keep your medication in the refrigerator (between 2 and 8 °C /35.6 to 46.4 °F), take it seriously and pay attention to this temperature range also during transport. Multiple sclerosis patients who take Ocrevus, TYSABRI, GLATOPA or Kesimpta, for example, must adhere meticulously to the temperature guidelines, as these medicines rely on the temperature range of 2 – 8 °C

(35.6 to 46.4 °F) at all times. Even on such short distances as from the pharmacy to home, this is important: there is always the risk of freezing in the first few minutes to an hour after the medicine has been placed in the wrong cooler bag.

COOL*SAFE keeps the right medicine storage temperature and protects your medicine from freezing and your treatment success has a secure basis!

Attention: Your medicine can also become too cold in the refrigerator!

Store at room temperature (15 to 25 °C) (59 - 77 °F)

It is all about not exposing your medication to the summer heat. However, 25 degrees can be reached very quickly. This is why some medicines and creams need a place in your fridge when it gets very warm in your home. Your medication will — so to speak — feel too warm just as quickly as we humans do 😉

Certain multiple sclerosis drugs, such as Mavenclad, VUMERITY, and Aubagio, specify room temperature storage (15 to 25 °C or 59 to 77 °F) or slightly extended (up to 30 °C or 86 °F) on their PIL. This means you also have to transport it in this temperature range!

Here too, improper transport can destroy the effect of your medication. This in turn costs you time, money and above all your speedy recovery. It is therefore important to adhere to the prescribed temperature range also when transporting to protect your health and well-being.

Medicines and treatments for MS

Although MS cannot yet be cured by conventional medical methods, there are medicines that can help the patient to suffer fewer and less severe relapses. Treatments with these drugs are called disease-modifying therapies.

They are taken either as a pill, an injection or an infusion.

They aim to reduce the amount of damage and scarring to the myelin sheath (a layer surrounding your nerves), which is associated with MS relapses. These treatments can thereby help to slow down the impairments in MS.

Disease-modifying therapies aren’t suitable for everyone with MS. They’re only prescribed to those with relapsing remitting MS or patients with primary or secondary progressive MS who have relapses.
People with progressive MS who don’t have relapses are very unlikely to benefit from the treatments and could still experience side effects from them.

Treatment for a relapse usually involves either:

  • a 5-day course of steroid tablets taken at home
  • injections of steroid medicine given in hospital for 3 to 5 days

Medication can reduce the severity and frequency of relapses of relapsing-remitting MS. They can also reduce or delay physical limitations.

It is said that there was allegedly no way to predict how well these MS medications will work for an individual. It is therefore all the more important that you ensure that your medication retains its effect! Only if you protect your medication can your medication protect your health!

Disease-modifying therapy means treatment to delay, change, or interrupt the natural course of the disease. For MS, this means taking medicine over a long period of time to reduce not only the number of attacks but also how severe they are.

Safe transport and correct storage of your medication are of fundamental importance for the success of your treatment. Even in the refrigerator, your medicine can lose its effect. Therefore, request our free guide HERE on how to store medicines correctly in the refrigerator.

Oral Drugs​

Common oral MS medicines and their storage requirements

Mavenclad

Cladribine (Mavenclad)


This is written on your medication leaflet:
Keep away from moisture.

This is what it means:
Keep your medication in a cupboard or drawer in the coolest and driest room in your house. Avoid storing them in the bathroom or refrigerator.
Learn more
tecfidera

This is written on your medication leaflet:
Store it at room temperature and away from light.

This is what it means:
The capsules must be protected from light and must not exceed approx. 25 °C. They require cooling above approx. 25 °C - either in your refrigerator or in a safe cool bag during transport.
Learn more
Vumerity-Slide3

diroximel fumarate (Vumerity)


This is written on your medication leaflet:
Store it at room temperature and away from excess heat and moisture (not in the bathroom).

This is what it means:
The capsules should be stored in a dry room at a maximum temperature of approx. 25 °C. They require cooling above approx. 25 °C - either in your refrigerator or in a safe cool bag during transport. Make sure that the medicine does not become moist in the refrigerator.
Learn more
bafiertam

This is written on your medication leaflet:
Store an unopened bottle of the capsules in a refrigerator, do not freeze.

This is what it means:
Unopened vials must be kept strictly in the cold chain. They must be transported and stored refrigerated at 2 to 8 °C. They must not be allowed to freeze.

Transport in COOL*SAFE is very important in this respect, as COOL*SAFE protects your medicine from freezing.
Learn more
gilenya

fingolimod (Gilenya)


This is written on your medication leaflet:
Store GILENYA at room temperature between 15 °C to 30 °C (59 °F to 86 °F).

This is what it means:
The capsules must not get colder than 15 °C and must not exceed 30 °C. Your medication requires safe cooling when the ambient temperature rises above 30 °C - either in your refrigerator or during transport in a safe medical cool bag: COOL*SAFE.
Learn more
zeposia

ozanimod (Zeposia)


This is written on your medication leaflet:
Store ZEPOSIA at room temperature between 20 °C to 25 °C (68 °F to 77 °F).

This is what it means:
The capsules must not get colder than 20 °C and must not exceed 25 °C. Your medication requires safe cooling when the ambient temperature rises above 25 °C - either in your refrigerator or during transport in a safe medical cool bag: COOL*SAFE.
Learn more

Other oral drugs include: siponimod (Mayzent), teriflunomide (Aubagio), ponesimod (Ponvory)

Injections

Common injectable MS medicines, their transport and their storage requirements

Avonex

interferon beta-1a (Avonex, Rebif)


This is written on your medication leaflet:
  • Store AVONEX in the refrigerator between 2°C to 8°C (36°F to 46°F).
  • Do not freeze AVONEX. Do not use AVONEX that has been frozen.
  • The Avonex Pen can be stored at room temperature (between 15 °C and 30 °C) for up to one week


This is what it means:
Your medicine must be stored and transported in this temperature range of 2 to 8 °C. Fortunately, this package insert even states that the medicine may not freeze. This means that you must ensure that it does not get too cold, especially in the refrigerator, and that it must be transported in a secure medical cooler bag. As the medicine freezes in almost all medical cool bags, COOL*SAFE comes into consideration here. Otherwise, your medication is already broken when you put it in your fridge at home.

Please also read the notes on Copaxone and Kesimpta, as they also apply to Avonex and Rebif.
Learn more
extavia

This is written on your medication leaflet:
Do not store above 25 °C. Do not freeze. After preparing the solution, you should inject it immediately. If this is not possible, you can still use the solution within 3 hours if it has been stored at 2-8 °C (in the refrigerator).

This is what it means:
This note concerns storage and transportation. Here too, the specific advice is to protect the medicine from freezing, which may well be the case in the refrigerator. However, it can also get warmer than 8 °C/46 °F in the refrigerator. We therefore recommend that you download our free leaflet on the safe storage of medicines in the refrigerator HERE.
Learn more
copaxone

glatiramer acetate (Copaxone, Glatopa)


This is written on your medication leaflet:
Storage before use: The medicine must be stored in the refrigerator, protected from frost, in the dark (e.g. in the outer carton). If the medicine is stored under light protection in the original packaging at room temperature between 15 - 25 °C, it may be used for a maximum of 1 month and must then be stored in the refrigerator again.

This is what it means:
Generally, it is better for the medicine if it is stored and transported in the cold chain between 2 and 8 °C. Here, too, the manufacturer will point out separately that it may not freeze. Please also read the instructions for Avonex and Kesimpta, as they also apply to Copaxone and Glatopa. What does the information mean that it must not be exposed to room temperature for more than 1 month? To answer this, we need to understand that chemical reactions are set in motion when the ambient temperature is higher. These chemical reactions are inhibited when the drug is refrigerated. Once this activation has taken place, it has an effect on how long your medicine works. Once the medication has been exposed to higher temperatures, the pens or syringes may no longer work as well as if they had always been refrigerated.

Once the medication has been exposed to higher temperatures, the pens or syringes may no longer work as well as if they had always been refrigerated.
Therefore, you should not be surprised if the last pens/syringes in your pack no longer have such a strong effect and you notice increased symptoms of illness. Your doctor must then consider whether he or she really needs to increase the dose of the medication or whether it is "only" due to the interrupted cooling. To avoid this unnecessary risk, it is better to transport your medication from the pharmacy to your home with COOL*SAFE.
Learn more
Plegridy

peginterferon beta-1a (Plegridy)


This is written on your medication leaflet:
  • Store in the refrigerator (2° C to 8 °C).
  • Do not freeze. Discard Plegridy that has been frozen accidentally.
  • Plegridy can be stored for up to 30 days at room temperature (up to 25 °C) outside the refrigerator, but must be protected from light.
  • If necessary, the packages can be taken out of the fridge and put back in more than once.
  • Make sure that the syringes are not stored outside the refrigerator for longer than 30 days.
  • Dispose of all syringes that have been stored outside the refrigerator for more than 30 days.
  • If you are unsure how long a syringe has been stored outside the refrigerator, dispose of the syringe.

This is what it means:
Please read the information on Avonex/Rebif and Copaxone/Glatopa.
Based on the information on this package leaflet, it is easy to see how important it is to maintain the correct temperature so that you do not suffer any unnecessary side effects or so that your medication retains its effect altogether. The particularly strong emphasis on the part of the manufacturer shows how sensitive cold chain medicines are in general.
Learn more
Kesimpta

ofatumumab (Kesimpta)


This is written on your medication leaflet:
  • Store in the refrigerator (2 °C - 8 °C). Do not freeze.
  • If necessary, Kesimpta can be stored once for up to 7 days unrefrigerated at room temperature (not above 30 °C). If Kesimpta is not used during this period, it can then be returned to the refrigerator for a maximum of 7 days.


This is what it means:
Please read the information on Avonex/Rebif and Copaxone/Glatopa.
Primarily, this means that your medicine must be disposed of after the 7 days in the refrigerator, and having been exposed to room temperature once beforehand. If the entire pack has gotten warmer than 8 °C, then you must throw the entire pack away. You must also make sure that your medicine arrives home safely from the pharmacy and does not get warmer than 8 °C under any circumstances
Write the date on the pack when your medicine reached temperatures above 8 °C. If you do not use KESIMPTA within these 7 days, dispose of the medicine.
Learn more

 

Actively ask your medicine manufacturer whether they will provide you with a COOL*SAFE medicine cool bag free of charge. Your doctor can request COOL*SAFE for you from some pharmaceutical companies.

If your medicine manufacturer does not provide you with COOL*SAFE, it is up to you to protect your medicines during transport. Take your health into your own hands and order your COOL*SAFE HERE. Don’t leave it to anyone else.

COOL*SAFE: Only if you protect your medicine can your medicine protect your health!