Medrol Left In Cold Car Overnight

In our latest question and answer, the pharmacist discusses concerns with an individual who left their Medrol Dose Pack in a cold car overnight.

Question

On the Medrol pack, it says to keep it at a temperature no lower than 59 degrees Fahrenheit. However, it was out in my car overnight, where I suspect it was in the 30s. Is the medication still effective?

Asked by Janice On Dec 15, 2022

Answered by
Medical Content Reviewed By HelloPharmacist Staff

Published Dec 20, 2022
Last updated Apr 29, 2024

Key points

  • There is no data available to suggest that a Medrol Dose Pack, temporarily left in frozen conditions, will lose a significant amount of potency or effectiveness.
  • While some drugs certainly are susceptible to damage by being stored at freezing temperatures (such as insulin, protein-based drugs, drug solutions, and vaccines), most studies show that many conventional drugs in a solid dosage form (like a tablet) can be generally unaffected by temporary excursions to freezing temperatures.
  • In regard to the tablets in a Medrol Dose Pack, we are more worried about the physical tablets being affected by cold temperatures.
  • If you notice the physical tablets have been affected, such as them being brittle and crumbling, you should replace them with a new prescription.

Answer

While there is always going to be some concern with having your medication exposed to temperatures outside of the recommended storage conditions, the chance of medication being negatively affected depends on a great many factors, including what the medication in question is, what temperature it was exposed to, how long it was exposed, etc...

In regard to leaving your Medrol Dose Pack (methylprednisolone) overnight in a cold car in freezing conditions, it is unlikely that the medication will be negatively affected. In other words, it will likely still work as intended and retain its labeled potency.

I have written about this topic on a few other occasions (such as this one) and the point I try to get across is that some drugs are far more susceptible to cold temperatures than others (such as drugs in liquid dosage forms, insulin, protein-based drugs, etc...).

For example, several studies have found that frozen temperatures can affect some protein-based drugs due to the potential damage that can happen during the thawing and recrystallization process.

However, many conventional drugs in a tablet dosage form, and aren't known to be particularly sensitive to cold, are generally going to be ok if they are left in freezing temperatures for a little while, which can certainly happen during the drug distribution process (or when drugs are delivered by mail, as they often sit in a mailbox for some time).

Although there are very few studies that have evaluated the potentially negative effects of cold temperatures on non-protein-based drug tablets (like Medrol), the studies that are available have shown they there is not an appreciable loss of potency when kept at cold temperatures. Several of the studies I am referring to can be found here, here, and here.

What we're really more concerned with as it pertains to the Medrol Dose Pack, are the physical tablets.

Medrol Dose Pack Storage

According to the manufacturer, a Medrol Dose Pack is recommended to be stored as follows:

Store at controlled room temperature 20° to 25°C (68° to 77°F) [see USP]
Medrol Prescribing Information

There have been no studies or data to suggest that a Medrol Dose Pack being stored at temperatures lower than recommended reduces the potency of the drug or otherwise makes it less effective (unlike some of the other drug examples I listed in the above section).

There is some data to suggest that another dosage form of Medrol, methylprednisolone acetate sterile suspension, should not be frozen as particulates can form in the suspension, which is a danger since the drug is made to be injected. Again though, there is no data showing Medrol tablets are negatively affected.

Are They Safe To Take?

While I wouldn't make a habit of storing Medrol at lower than recommended temperatures, as mentioned, we are more concerned with the physical tablets than the actual drug being affected.

No available data suggests that a Medrol Dose Pack, if left temporarily at frozen temperatures, will be less effective or harmful.

However, take a look at the physical tablets. If the tablets in your Medrol Dose Pack look warped, discolored, or are fragile enough that they are breaking apart, I would get them replaced simply due to the fact that the tablets may be physically degraded and you won't be getting a full dose due to tablet loss.

A Medrol Dose Pack is, fortunately, relatively inexpensive and if you think the drug has been compromised, you can't go wrong with getting a new prescription.

Final Words

Thanks for reaching out to us and please do so again anytime!

References

  • Medrol Prescribing Information, AccessFDA
  • Methylprednisolone Monograph, PubChem
  • Stability of dronabinol capsules when stored frozen, refrigerated, or at room temperature, PubMed
  • Hot and Cold Drugs: National Park Service Medication Stability at the Extremes of Temperature, PubMed
  • The range of medication storage temperatures in aeromedical emergency medical services, PubMed

About the Pharmacist

Dr. Brian Staiger, PharmD

Dr. Brian has been practicing pharmacy for over 13 years and has wide-ranging experiences in many different areas of the profession. From retail, clinical, program development, and administrative responsibilities, he's your knowledgeable and go-to source for all your pharmacy and medication-related questions! Dr. Brian Staiger also has herbalist training and educational certificates in the field of medical ethnobotany. Feel free to send him an email at [email protected]! You can also connect with Dr. Brian Staiger on LinkedIn.

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