Dare to Prepare: How to Store Refrigerated Medications During a Disaster

The events of this year have highlighted the importance of disaster preparedness. We’re in the middle of a global pandemic, wildfires have been burning in the West, the Gulf Coast has been hit by hurricanes and tropical storms, etc.

I make the effort each September, which is National Preparedness Month, to take a straightforward look at a couple of disaster preparedness topics (you can see past posts here). I’ve been a little busy this month getting ready to move, so I haven’t had time to do this yet. However, I don’t want September to pass without considering at least one topic.

The topic I’m looking at today is how to store refrigerated medications after disasters, specifically disasters that cause power outages. A number of medications, namely antibiotics, biologics, and insulin, require refrigeration. As a Gulf Coast resident who takes one of these medications, I’m always concerned about losing power due to a tropical system, severe thunderstorm, or other disaster. What’s the best way to keep medications cold during a prolonged power outage?

Before disaster strikes

When a disaster is imminent, it is often too late to prepare. Therefore, the best time to prepare is before a disaster strikes.

Keep an up-to-date list of your medications

It is important to always have an updated list of the medications you take. This should include the names of the medications, the indications (i.e., why you need the drugs), and dosing information (i.e., when and how much you take).

Have plenty of medication on hand

Try your best not to get low on your medications! There are two main ways to do this. One is to explain to your doctor that you are trying to be prepared in case there is a disaster and see if he or she will write you a prescription for additional medication so you can always have some extra on hand. If he or she won’t or the insurance company will not pay for additional medication, then simply be sure to refill your medications as soon as you are eligible to do so. You are usually able to refill your medications several days before you run out. If you always refill them on the earliest date you are eligible for a refill, then over time you will accumulate enough medication that you have at least a month’s worth on hand.

Have an evacuation plan

It is important to consider if evacuating is the best course of action. Evacuating isn’t convenient, but neither is being without electricity. If you have advanced warning for a disaster (such as a hurricane), then consider if you should evacuate to a place where you will have electricity for refrigeration.

Have water-tight containers available for storage

To make sure your medications don’t get contaminated during a disaster, be sure to place them in water-tight containers. Keep the medications in their original containers (which contain your name and the prescribing information) and place these inside a water-tight storage box or double bag them in zipper baggies.

Know the storage parameters for your medications and be prepared with a cooler and ice

Read the information that comes with your prescriptions so you know how they must be stored. Many refrigerated medications can be stored at room temperature for certain amounts of time (e.g., 28 days, 14 days). This means your medications may be okay for a couple of weeks. However, you must know the specific parameters. What is considered “room temperature” may differ for various medications. This may be 59-77°F or 59-86°F. If, like me, you live in a warm climate, then you know that true room temperature when you are without air conditioning is often much hotter than those temperature ranges. Therefore, it is important to be prepared with a small cooler and reusable ice packs. For optimal effectiveness, choose a high-quality cooler and long-lasting ice packs (it’s helpful to use reusable ice packs instead of regular ice because these are filled with a gel that stays frozen for longer because the gel has a melting point that is much lower than that of regular ice). Keep the ice packs frozen at all times so they are ready whenever you need them.

When disaster strikes

As long as you do not open it, your fridge will not become warm immediately after losing electricity. Items in the fridge, including your medications, will generally remain cold for 12-24 hours. The items in your freezer (as long as you don’t open the door) will remain frozen. Leave your medications in the fridge for this time, but once it has passed, get the ice packs from the freezer and place these and your medications in the cooler.

With a good cooler and good ice packs, your medications should remain really cold for at least 48 hours. The cold will slowly begin to wane at this point.

After disaster strikes

As the ice packs thaw and the temperature in your cooler rises, you will need to make some decisions. Ideally, you’ll be able to access refrigeration. This may be because your power comes back on or because you are able to use the fridge of a neighbor or friend who has a generator. If you can’t access a working fridge, then you will need to find ice to continue cooling your medications (you may have to drive to a neighboring community to find ice) or you’ll have to store your medications at ambient temperature (if you choose this latter option, then remember that the potency of the medications will decrease over time).

Once things settle down, it is important to examine your medications and make sure they haven’t changed (e.g., liquids haven’t crystallized, pills haven’t become wet). If they have, then they need to be replaced. Likewise, medications need to be replaced if they have been exposed to extreme heat (such as during a fire), have sat at room temperature for longer than recommended by the manufacturer, or have been touched by floodwater. Please note that there is one exception to this. If your medical condition is life-threatening, then experts say it is okay to continue taking your medications until you can get replacements as long as the medications themselves aren’t contaminated (i.e., the packaging may be scorched or have touched floodwater, but the drug itself appears clean and dry).

Final thoughts

It can be a little stressful to think about all of this, but it’s less stressful to plan in advance than to wait until you’re in the middle of a disaster to try to figure it out!

For more information, please check out my sources:

• Safe Drug Use After a Natural Disaster
• How To Safely Store Medicine In The Heat
• 6 Tips for Storing Prescription Medications for an Emergency
• How to Get Your Prescriptions During an Emergency

What additional tips can you share? How have you stored refrigerated medications after a disaster?

Shared at the following:

Encouraging Hearts and Home, Over the Moon, and Busy Monday.