How do you store allergy medication safely?

How often do you see other patients and parents carrying their allergy medication in supermarket plastic bags, plastic boxes, the bottom of rucksacks or stuffed into handbags?

Considering millions of adrenaline auto-injectors are circulating worldwide, with an estimate of roughly one million in circulation, solely in the United Kingdom, the need for more education on allergy management is clear.

Prescription allergy medication needs to be stored safely, in order to ensure its effectiveness. It’s clear that awareness is key when it comes to safely transporting allergy medication, and the best solution is continued and sustained training and information provided by healthcare professionals to carriers of allergy medication.
So, are there really specific storage conditions and, if so, how do we know what they are?

Let’s go back in time and try to understand adrenaline auto-injectors - the main medication needed in case of anaphylaxis.

Although it’s now widely known that adrenaline is produced in the supra-renal glands of the human body, this was only found by a Japanese immigrant to the United States (Jokichi Takamine) in 1901.

Before that, many studies had been done to understand why dogs who had their glands removed would eventually die. The research into what these glands were for started in the 16th century when they were discovered.

Since Jokichi Takamine named the substance produced in them “adrenaline”, more research has been done to understand how it works and what led to it being more stable or degrading.

Interestingly, it’s only since the late 20th century that we’ve had proper research showing the degradation of adrenaline when exposed to either sunlight or high temperatures. This research was focused on GPs carrying adrenaline in their bags in Pert, Western Australia.

The evidence they had is that a Doctor’s black bag could reach temperatures as high as 80°C.
So, let’s look at what the evidence has shown so far:

1. Adrenaline must be kept between 15°C    and 25°C, although it is still safe if kept between 15°C  and 30°C.
2. From 37°C, adrenaline starts losing its activity, from 10% to 20%, increasing with further exposure.
3. Direct exposure to sunlight degrades adrenaline.
4. Low temperatures do not degrade adrenaline but affect the auto-injectors' mechanism.
5. High temperatures also affect the mechanism inside the auto-injectors.
6. A car’s boot or glove compartment can reach temperatures up to 100°C  when exposed to direct sunlight during a hot summer’s day.

Understanding what the evidence shows is easy, but how should you weave this into your everyday life?
The best and easiest way to do so is by carrying their medication in an insulated bag specifically designed to place it inside. Along with this, there are a few more steps needed to be taken, although they are relatively easy ones.

Let’s make a short list of the “dos” and “don’ts” to keep your medication safe:

DO:

• Keep your injectors and other medication in a specific allergy bag that’s capable of keeping the temperature stable for a few hours, aiming for a maximum of four hours. Using this method, you will also prevent exposure to direct sunlight.
• Store your medication in a dry place.
  
• Keep your medication out of reach of children and pets.
• Keep your medication organised.
  

DON’T:

• Do not freeze your injectors, as this may lead to mechanism malfunction.
• ​Do not keep your Adrenaline inside the fridge, next to an ice pack or on ice.
• Always check the expiry date of your medication.
• Always check the adrenaline’s colour. If it’s no longer transparent, you need to replace it urgently.
• Store your medication in a humid room such as a bathroom or kitchen.
  

If you follow those tips, you or your child can relax knowing that your medication is stored optimally.