Storage of Adrenaline 1:1000 Injection
Adrenaline 1:1000 injection should be stored at controlled room temperature (20-25°C/68-77°F), protected from light and freezing—refrigeration is NOT required. 1
Official Storage Requirements
The FDA-approved prescribing information explicitly states that epinephrine injection 1 mg/mL (1:1000) should be stored between 20° to 25°C (68° to 77°F) per USP Controlled Room Temperature standards. 1 The product must be protected from light and freezing, but refrigeration is not specified or necessary. 1
Key Storage Principles
Room temperature storage is appropriate and maintains drug stability:
- Epinephrine is light-sensitive and requires protection from light exposure, but cold storage is not mandated. 1
- Solutions should be inspected visually before use and discarded if colored, cloudy, or containing particulate matter. 1
- Multi-dose vials must be discarded 30 days after initial use regardless of storage temperature. 1
Evidence Supporting Room Temperature Storage
Research demonstrates adequate stability at ambient temperatures:
- Adrenaline 1:10,000 solution maintained full potency after 1 year of storage at room temperature in biological assays. 2
- Adrenaline stored in ambulances and drug storage rooms at temperatures of 27-34°C across different seasons in Thailand showed 90-115% drug remaining with no significant quality changes when analyzed by HPLC. 3
- General practice studies confirm adrenaline 1:1000 is more stable at ambient temperatures than previously suggested. 4
Critical Temperature Thresholds
Avoid excessive heat exposure:
- Storage at excessively high temperatures (70°C) for 5-10 days significantly degrades epinephrine, reducing delivered doses to 77-97% of labeled dose. 5
- Auto-injectors stored at extreme heat cannot be relied upon to deliver accurate doses and should not be used while hot or after cooling. 5
- However, typical room temperature variations (even up to 34°C in tropical climates) do not compromise stability over 4-week periods. 3
Common Pitfalls to Avoid
Do not refrigerate unnecessarily: Refrigeration is not required and may create unnecessary workflow barriers to accessing this life-saving medication during emergencies. 1 The drug should be readily accessible at room temperature in emergency settings including operating rooms, emergency departments, and ambulances. 6
Ensure proper light protection: Store in original packaging or amber vials to prevent photodegradation, which is a more significant concern than temperature within the recommended range. 1
Monitor expiry dates: Regular checks of expiration dates are essential, as outdated drugs are sometimes carried despite stated protocols. 4