In-Use Shelf-Life

Introduction

Drug expiration dates reflect the time period during which the product is known to remain stable when it is stored according to its labelled storage conditions.

Nonetheless, at work, many patients may ask you, how long more you can keep using a solution or cream once opened. Or sometimes, is it still fine to keep using an expired medication?

The old adage that "all good things come to an end" applies this situation very well.

• Medications last longer (up to expiry date) when they are stored unopened.
• Using expired medications may cause harm or it has lost its effectiveness over time.

Antibiotic Suspension

Please refer to products leaflet since the recommendation is brand specific.

Amoxicillin 200 mg and Clavulanate 28 mg per 5 ml Syrup

• Augmentin - The dry powder should be stored in unopened containers in a dry place at below 25°C. Reconstituted suspension should be stored in a refrigerator (2-8°C) and used within 7 days.
• Clamovid BID - Refrigerate and use within 7 days after reconstitution.
• Fleming - The dry powder should be stored below 30°C in unopened container in a dry place. Reconstituted suspensions should be stored in a refrigerator (2-8°C) and used within 7 days.

Amoxicillin Trihydrate 125 mg/5 ml and 250 mg/5ml Syrup

• Betamox - Store below 30°C. Protect from light. After reconstitution, store between 2-8°C and to be used within 7 days after mixing.
• Dyna Amoxycillin - Keep refrigerated and to be used within 7 days of mixing.

Ampicillin Sodium and Sulbactam Sodium 250 mg/5 ml Suspension

• Unasyn - Store below 30°C. The reconstituted oral suspension must be stored under refrigeration and discarded after 14 days.

Ampicillin Trihydrate 125 mg/5 ml Suspension

• Ampicilla - Once reconstituted, refrigerate and use within 7 days.
• Dyna Ampicillin - Keep refrigerated (2-8°C) after reconstitution. To be used within 7 days of mixing.

Azithromycin 200 mg/5 ml Granules

• Binozyt - The prepared suspension can be kept at up to 30°C for 5 days.
• Imexa - For both powder and reconstituted suspension, keep container well closed, store below 30°C and protect from light. Use within 5 days after reconstitution.
• Kidimac - Before reconstitution, store below 30°C. After reconstitution, store the suspension at 25°C to 30°C. Reconstituted suspension should be used within 10 days. Discard the reconstituted suspension if more than 10 days. Do not freeze.
• Zithrolide - Dry powder (unopen bottle), store below 30°C. Once reconstituted with water, store in refrigerator at 2-8°C. Once reconstituted with water, the suspension has a shelf life of 5 days.
• Zithromax - Store below 30°C for the powder and the reconstituted suspension. Shelf-life is 5 days for the reconstituted product.
• Zynomax - Store below 30°C for powder reconstituted suspension. The reconstituted suspension form lasts up to 5 days.

Cefuroxime Axetil 125 mg/5 ml Suspension

• Axcel - Store below 30°C. Protect from light. After reconstitution, refrigerate between 2-8°C and use within 10 days.
• Zinnat - The unreconstituted suspension should be stored below 30°C. The reconstituted suspension when refrigerated between 2 and 8°C can be kept for up to 10 days.

Cephalexin 125 mg/5 ml Syrup

• Axcel - Store below 30°C until reconstituted. After reconstitution, refrigerate between 2°C to 8°C and use within 7 days.
• Dynalexin Dry Syrup - Store in a dry place below 25°C. Protect from light. Keep refrigerated after reconstitution. To be used within 7 days of mixing.
• MPI - Before mixing, store in a cool, dry place (15-25°C). Avoid moisture and heat. After mixing, store in refrigerator (2-8°C) and use within 5 days.
• Uphalexin - Store below 30°C, until reconstituted. After reconstitution, refrigerate between 2°C to 8°C and use within 7 days.

Clarithromycin 125 mg/5 ml and 250 mg/5 ml Granules

• Klacid - Store at room temperature (below 30°C) in a well-closed container. Do not refrigerate the reconstituted suspension; store at room temperature.

Cloxacillin Sodium 125 mg/5 ml Suspension

• Cloxacilla - Powder for dry syrup, need no refrigeration until reconstituted. Once reconstituted, refrigerate and use within 7 days.
• Oxacil - Store in a dry place below 30˚C. Protect from light. Store in the refrigerator after reconstitution. Discard 7 days after reconstitution. Consume within 12 months after opening the pouch.

Erythromycin Ethylsuccinate 200 mg/5 ml Suspension

• Ericin - Keep in refrigerated after reconstituted (2-8°C) and use reconstituted suspension within 7 days.

Erythromycin Ethylsuccinate 400 mg/5 ml Suspension

• Eryson - Discard 7 days after reconstitution. Store tightly closed in refrigerator after reconstitution.

Antiviral Suspension

Abacavir 20 mg/ml Oral Solution

• Ziagen - Discard oral solution 2 months after first opening.

Lamivudine 10 mg/ml Oral Solution

• 3TC - Store at or below 30°C. Discard one month after first opening.

Lopinavir 80 mg and Ritonavir 20 mg per ml Oral Solution

• Kaletra - Store Kaletra oral solution at 2-8°C until dispensed. For patient use, refrigerated Kaletra oral solution remains stable until the expiration date printed on the label. If stored at room temperature up to 25°C, oral solution should be used within 2 months.

Oseltamivir 60 mg/5 ml Powder for Oral Suspension

• Fluhalt - Before mixing, store below 30˚C, protected from moisture. Store the prepared suspension under refrigeration (2-8˚C) and use within 14 days.

Nevirapine 50 mg/5 ml Oral Suspension

• Nevirex - Do not store above 30°C. The product should be used within 2 months of opening.

Zidovudine 10 mg/ml Syrup

• Retrovir - Discard 1 month after first opening.

Ear Drops

Unless mentioned otherwise, discard 28 days after opening.

Ear Wax Softener

• Cerumol - Discard the drop 6 months after opening.

Chloramphenicol 5% Ear Drop

• Enclor - Store at 2°C-8°C. Protect from light and freezing. Discard after 30 days from date of opening.

Dexamethasone Sodium Phosphate 0.1% and Neomycin Sulphate 0.5% Eye/Ear Drop

• Neo-Deca - Discard 4 weeks after opening.

Gentamicin 0.3% Eye/Ear Drop

• Beagenta - Do not use 1 month after first opening.

Gentamicin Sulphate 0.3% and Betamethasone 0.1% Eye/Ear Drop

• Betagen - The bottle should be disposed of 4 weeks after opening.

Ofloxacin 0.3% Otic Solution

• Tarivid - This product exhibits good stability for 4 months at room temperature (25°C) after opening.

Eye Drops and Ointments

Unless mentioned otherwise, with preservative: Discard 28 days after opening. Without preservative: Discard after each use.

Artificial Tears/Eye Lubricant Ophthalmic Gel

• GenTeal Gel - Once the tube has been opened, discard any remaining product after 3 months.
• Hylo Gel - Can be used for 6 months after opening.
• Refresh Liquigel - Discard 1 month after opening.
• Systane Gel Drops - Discard any remaining solution 3 months after first opening.
• Vismed Gel Multi - Can be used up to 3 months after first use.

Artificial Tears/Eye Lubricant Ophthalmic Solution

• Eye Glo Moist - Discard contents 4 weeks after opening.
• GenTeal - Once the bottle is opened, discard any remaining solution after 3 months.
• Hialid 0.1% - Discard contents 1 month after opening.
• Hylo Comod - Can be used for 6 months after opening.
• Optavid - Discard the contents 28 days after first opening.
• Optavid Advance - Discard the contents 28 days after first opening.
• Optive - Discard 90 days after opening.
• Optive Advanced - Discard 90 days after opening.
• Optive Fusion - Discard 90 days after opening.
• Optrex Refreshing - Discard 3 months after first opening.
• Refresh Tears - Discard 1 month after opening.
• Systane Balance - Discard any remaining product 6 months after first opening.
• Systane Complete - Discard any remaining emulsion 3 months after first opening.
• Systane Hydration - Discard any remaining solution 3 months after first opening.
• Systane Ultra - Discard any remaining solution 6 months after first opening.
• Systane Ultra UD (Preservative Free) - Discard any remaining solution after use. Do not save solution in an opened vial.
• Tears Naturale II - Discard 6 months after opening.
• Tears Naturale Free - Discard remaining contents after use. Do not save solution in an opened vial.
• Vismed Multi - Can be used up to 3 months after first use.

Artificial Tears/Eye Lubricant Ophthalmic Ointment

• Duratears Lubricanting Eye Ointment - Discard one month after first opening.
• Lacri-Lube Lubricating Eye Ointment (Preservative Free) - Discard unused contents 6 months after opening.

Atropine Sulphate 1% Eye Drop

• Isopto*-Atropine - Discard 1 month after opening.

Betaxolol 0.25% Eye Suspension

• Betoptic-S - Discard 4 weeks after first opening.

Bimatoprost 0.01% Ophthalmic Solution

• Lumigan - Discard unused content 4 weeks after opening.

Bimatoprost 0.03% and Timolol 0.5% Eye Drop

• Ganfort - Discard unused contents 4 weeks after opening.
• Ganfort PF - Store below 30°C. Use once only and discard residue. Once the pouch is opened, use within 10 days.

Brimonidine Tartrate 0.1% Ophthalmic Solution

• Alphagan P - Discard unused contents 28 days after opening.

Brimonidine Tartrate 0.15% Ophthalmic Solution

• Iobrim - Shelf life after first opening: 28 days

Brimonidine 0.2% and Timolol 0.5% Eye Drop

• Combigan - Discard unused contents 4 weeks after opening.
• Brimolol - Discard unused contents 4 weeks after opening.

Brinzolamide 1% and Brimonidine Tartrate 0.2% Ophthalmic Suspension

• Simbrinza - Discard 1 month after first opening.

Brinzolamide 1% and Timolol 0.5% Eye Suspension

• Azarga - Discard 4 weeks after first opening.

Brinzolamide 1% Ophthalmic Suspension

• Azopt - Discard 4 weeks after first opening.

Chloramphenicol 0.5% Eye Drop

• Nicol - Store between 2-8°C. Protect from light. Discard contents 4 weeks after opening.
• Xepanicol - Store in refrigerator between 2-8°C. Do not freeze. Discard eye drops 4 weeks after the first opening.

Chloramphenicol 1% Eye Ointment

• Chlorop - Discard contents 4 weeks after opening.
• Kloraxin- Discard 4 weeks from the date of opening the tube.

Ciclosporin 0.05% Ophthalmic Emulsion

• Restasis - Discard after each use.

Ciclosporin 0.1% Ophthalmic Emulsion

• Ikervis - Discard any remaining emulsion immediately after use.

Ciprofloxacin HCl 0.3% Ophthalmic Solution

• Cipmax - Not to be used 1 month after opening.
• Cipofain - Discard 28 days after first opening.

Cyclopentolate 1% Eye Drop

• Cyclogyl - Discard 1 month after opening.

Dexamethasone 0.1%, Neomycin Sulphate 3500 IU/g and Polymyxin B Sulphate 6000 IU/g Eye Ointment

• Maxitrol - Discard 1 month after opening.

Dexamethasone 0.1%, Neomycin Sulphate 3500 IU/ml and Polymyxin B Sulphate 6000 IU/ml Ophthalmic Suspension

• Maxitrol - Discard 1 month after opening.

Dexamethasone Sodium Phosphate 0.1% and Neomycin Sulphate 0.5% Eye/Ear Drop

• Neo-Deca - Discard 4 weeks after opening.

Dexamethasone Sodium Phosphate 0.1% Eye Drop

• Maxidex - Discard 1 month after opening.

Diquafosol Sodium 3% Ophthalmic Solution

• Diquas - After opening, use within one month.

Dorzolamide 2% and Timolol 0.5% Eye Drop

• Cosopt - Discard 1 month after first opening.
• Cosopt-S - Should be used no longer than 1 month after first opening the pouch. Discard any unused single dose containers after that time.
• Ocudor-T - After opening, store below 25˚C, and discard after 28 days after first opening.
• Zolamidol - Use the solution within 28 days after opening the vial.

Dorzolamide HCl 2% Ophthalmic Solution

• Lamisopt - Use within 4 weeks of opening.
• Ocudor - Use the solution within 28 days.
• Trusopt - Discard 1 month after opening.

Ectoin 2% Eye Drop

• Hydrelo Allergy - Discard 12 hours after opening.

Epinastine HCl 0.5 mg/ml Ophthalmic Solution

• Relestat - Throw away the bottle 28 days after you first opened it.

Fusidic Acid 1% Eye Drop

• Fucithalmic - Discard after 28 days from opening.

Fluorometholone 0.1% Ophthalmic Suspension

• FML Liquifilm - Discard unused contents 4 weeks after opening.

Gatifloxacin 0.5% Ophthalmic Solution

• Zymaxid - Discard 28 days after opening.

Gentamicin 0.3% Eye Drop

• Bactigen - Use the solution within 1 month after opening the vial.

Gentamicin 0.3% Eye/Ear Drop

• Baegenta - Do not use 1 month after first opening.

Gentamicin Sulphate 0.3% and Betamethasone 0.1% Eye/Ear Drop

• Betagen - The bottle should be disposed of 4 weeks after opening.

Ketorolac 0.5% Eye Drops

• Acular - Discard unused contents 28 days after opening.

Ketotifen 0.025% Eye Drop

• Tofen - After first opening, the content should be used within 28 days.

Latanoprost 0.005% and Timolol Maleate 0.5% Eye Drop

• Xalacom - Prior to opening, store at 2-8°C. After opening, may store up to 25°C for 4 weeks.

Latanoprost 0.005% Eye Drop

• Avetaprost - Store in a refrigerator (2°C to 8°C). Protect from light. After opening the bottle, do not store above 25°C and use within 4 weeks.
• Latanost - Store in a refrigerator (2°C to 8°C). Protect from light. After opening the bottle, do not store above 25°C and use within 4 weeks.
• OptaProst - Before opening, store below 30°C, protect from light. After opening, store below 30°C, protect from light and use within 4 weeks.
• Latanost - Store in a refrigerator (2°C to 8°C). Protect from light. After opening the bottle, do not store above 25°C and use within 4 weeks.
• Xalatan - Prior to opening, store at 2-8°C. After opening, may store up to 25°C for 4 weeks.

Levofloxacin 1.5% Ophthalmic Solution

• Cravit - After first opening, to be used within 1 month.

Moxifloxacin 0.5% Ophthalmic Solution

• Vigamox - Discard 28 days after opening.

Nepafenac 0.1% Ophthalmic Solution

• Nevanac - Discard 28 days after opening.

Olopatadine HCl 0.1% Ophthalmic Solution

• Olodin - Discard contents 28 days after opening the bottle.
• Olopan - Use within 4 weeks after first opening the bottle.
• Patanol - Discard 4 weeks after first opening.

Olopatadine HCl 0.2% Ophthalmic Solution

• Pataday - Discard 28 days after opening.
• Patasyn - Discard 28 days after opening.

Omidenepag Isopropyl 0.002% Ophthalmic Solution

• Eybelis - After opening of bottle, use within 1 month.

Pilocarpine 2% Eye Drop

• Isopto* Carpine - Discard 1 month after opening.

Ripasudil HCl Hydrate 0.4% Ophthalmic Solution

• Glanatec - Discard 4 weeks after first opening.

Sodium Chloride 0.9% Eye Drop

• Rinz - Discard 4 weeks after first opening of bottle.

Sodium Cromoglycate 2% Eye Drop

• Allergo-Comod - To be used within 12 weeks after opening.
• Allergocrom - To be used within 4 weeks after opening.

Sodium Hyaluronate 0.5 mg/ml and Ectoine 20 mg/ml Eye Drop

• Hylo Dual - Can be used for 6 months after opening.

Sodium Hyaluronate 2 mg/ml and Ectoine 20 mg/ml Eye Drop

• Hylo Dual Intense - Can be used for 6 months after opening.

Tetrahydrozoline 0.05% Eye Drop

• Allersine - Do not use 1 month after first opening.

Prednisolone Acetate 1% Ophthalmic Suspension

• Econopred* Plus - Discard one month after opening.
• Pred Forte - Discard unused contents 4 weeks after opening.

Proparacaine HCI 0.5% Ophthalmic Drops

• Alcaine - Store refrigerated between 2-8°C. Discard 4 weeks after first opening.

Tafluprost 0.0015% and Timolol 0.5% Ophthalmic Solution

• Tapcom-S - Store in a refrigerator (2-8°C). After opening the foil pouch: do not store above 25°C and protect from light. Use within 28 days.

Tafluprost 0.0015% Ophthalmic Solution

• Taflotan - After opening, to be used within 1 month.
• Taflotan S - Store in a refrigerator (2-8°C) and protect from light. After opening the aluminum foil pouch: Stored below 25°C and protect from light. Use within one month.

Timolol 0.5% Eye Drop

• Iotim - Use the solution within 1 month after opening the vial.
• Timo-Comod - To be used within 12 weeks after opening.
• Timoptol-XE - Discard 1 month after opening.

Tobramycin 0.3% and Dexamethasone 0.1% Ophthalmic Suspension

• TobraDex- Discard 4 weeks after opening.

Tobramycin 0.3% and Dexamethasone 0.1% Ophthalmic Ointment

• TobraDex- Discard 4 weeks after opening.

Tobramycin 0.3% Ophthalmic Ointment

• Tobrex - Discard 1 month after opening.

Travoprost 0.003% Eye Drop

• Izba - Discard 4 weeks after opening.

Travoprost 0.004% and Timolol 0.5% Eye Drop

• DuoTrav - Discard 4 weeks after first opening.

Travoprost 0.004% Eye Drop

• Travatan - Discard 4 weeks after first opening.

Tropicamide 1% Eye Drop

• Mydriacyl - Discard 1 month after opening.

GLP-1 Receptor Agonists

Dulaglutide 0.75 mg and 1.5 mg Solution for Injection in Pre-filled Pen

• Trulicity - Store at 2-8°C. Do not freeze. If needed, each single-dose pen or prefilled syringe can be kept at room temperature, not to exceed 30°C for a total of 14 days.

Exenatide 2 mg Powder and Solvent for Prolonged-Release Suspension for Injection

• Bydureon - Store under refrigeration at 2-8°C; Vials/pens may be stored at ≤25°C for up to 4 weeks. Do not freeze (discard if freezing occurs).

Liraglutide 6 mg/ml Preloaded Injector

• Victoza, Saxenda - Store in a refrigerator (2-8°C). After first use, can also be stored below 30°C and used within 1 month.

Lixisenatide 10 mcg/0.2 ml and 20 mcg/0.2 ml Solution for Injection 3 ml Prefilled Pen

• Lyxumia - Store under refrigeration at 2-8°C. After initial use, may store at <30°C and pen should be discarded 14 days after initial use.

Semaglutide 1.34 mg per ml Solution for Injection Pre-filled Pen

• Ozempic - Store in a refrigerator (2-8°C). Keep away from the cooling element and do not freeze. In-use shelf life: 6 weeks. Store below 30°C or in a refrigerator (2-8°C). Keep the pen cap on when the pen is not in use in order to protect it from light. USA product leaflet suggests that after initial use, store at 2-8°C or 15-30°C for up to 56 days.

Semaglutide 0.25 mg per 0.5 ml, 0.5 mg per 0.5 ml, 1 mg per 0.5 ml, 1.7 mg per 0.75 ml and 2.4 mg per 0.75 ml Solution for Injection Pre-filled Pen

• Wegovy - Store at 2-8°C. If needed, prior to cap removal, the pen can be kept from 8-30°C for up to 28 days. Do not freeze; protect from light. Keep in original carton until time of administration; discard pen after use (for single use only).

Inhalers

Beclomethasone Dipropionate 100 mcg and Formoterol Fumarate Dihydrate 6 mcg Pressurized Inhalation Solution (MDI)

• Foster MDI - Prior to dispensing to the patient, store in a refrigerator (2-8°C) (for a maximum of 15 months). After dispensing, do not store above 30°C (for a maximum of 2 months).

Beclomethasone Dipropionate 100 mcg and Formoterol Fumarate Dihydrate 6 mcg NEXThaler

• Foster NEXThaler - Do not store above 30°C. After first opening the pouch, the medicinal product should be used within 2 months.

Beclomethasone Dipropionate 100 mcg, Formoterol Fumarate Dihydrate 6 mcg and Glycopyrronium Bromide 12.5 mcg Pressurized Inhalation Solution (MDI)

• Trimbow - Prior to dispensing, store in a refrigerator (2-8°C), do not freeze and do not expose to temperatures higher than 50°C. After dispensing, the medicinal product may be stored for a maximum of 2 months at a temperature of up to 30°C.

Beclomethasone Dipropionate 200 mcg/dose Inhaler (Easyhaler)

• Beclomet - 6 months after the laminate pouch has been opened.

Budesonide 200 mcg/dose Inhalation (Easyhaler)

• Giona - 6 months after the laminate pouch has been opened.

Budesonide 80 mcg and Formoterol 4.5 mcg per Actuation, Pressurized Inhalation (MDI); Budesonide 160 mcg and Formoterol 4.5 mcg per Actuation, Pressurized Inhalation (MDI)

• Symbicort Rapihaler - Shelf life after first opening of the foil is 3 months.

Fluticasone Furoate 100 mcg and Vilanterol 25 mcg Inhalation (Ellipta); Fluticasone Furoate 200 mcg and Vilanterol 25 mcg Inhalation (Ellipta)

• Relvar - To be used within 1 month of first opening of the tray. USA and UK product leaflets suggest in-use shelf life of 6 weeks.

Fluticasone Propionate 125 mcg and Formoterol Fumarate Dihydrate 5 mcg per actuation pressurized inhalation, suspension (MDI); Fluticasone Propionate 250 mcg and Formoterol Fumarate Dihydrate 10 mcg per actuation pressurized inhalation, suspension (MDI)

• Flutiform - Use within 3 months of opening the foil pouch.

Salbutamol 200 mcg/dose Inhaler (Easyhaler)

• Buventol - 6 months after the laminate pouch has been opened.

Tiotropium 2.5 mcg/puff solution for inhalation (Respimat)

• Spiriva Respimat - Discard by date is 3 months from the date the cartridge is inserted into the inhaler.

Tiotropium 2.5 mcg and Olodaterol 2.5 mcg per actuation, inhalation (Respimat)

• Spiolto Respimat - Discard by date is 3 months from the date the cartridge is inserted into the inhaler.

Umeclidinium 62.5 mcg and Vilanterol 25 mcg Inhalation (Ellipta)

• Anoro - To be used within 6 weeks of first opening of the tray.

Insulins

Unless mentioned otherwise, store at 2-8°C and once in-use, can store at room temperature for 28 days.

Insulin Aspart 100 IU/ml Injection (Pre-filled Pen/Penfill)

• Fiasp - Before opening, store in a refrigerator (2-8°C). After first opening, use within 4 weeks when stored below 30°C and do not refrigerate.
• NovoRapid - Before opening, store in a refrigerator (2-8°C). After first opening, use within 4 weeks when stored below 30°C or stored in a refrigerator (2-8°C).

Insulin Aspart 30% and Protaminated Insulin Aspart 70% 100 IU/ml Injection (FlexPen)

• NovoMix 30 - Before opening, store in a refrigerator (2-8°C). After first opening, use within 4 weeks when stored below 30°C and do not refrigerate.

Insulin Degludec 100 IU/ml and 200 IU/ml Injection (FlexTouch)

• Tresiba - Before opening, store in a refrigerator (2-8°C). After first opening, use within 8 weeks when stored below 30°C or stored in a refrigerator (2-8°C).

Insulin Degludec 70% and Insulin Aspart 30% 100 IU/ml Injection in Pre-filled Pen

• Ryzodeg - Before opening, store in a refrigerator (2-8°C). After first opening, use within 4 weeks when stored below 30°C or stored in a refrigerator (2-8°C).

Insulin Detemir 100 IU/ml Injection in Prefilled Syringe/Cartridge

• Levemir - Before opening, store in a refrigerator (2-8°C). After first opening, use within 6 weeks when stored below 30°C or stored in a refrigerator (2-8°C).

Insulin Glargine 100 IU and Lixisenatide 33 mcg per ml Injection (Pre-filled Pen)

• Soliqua 30-60 - Store in a refrigerator (2-8°C). Shelf-life after first use is 28 days when stored below 25°C and do not refrigerate.

Insulin Glargine 100 IU and Lixisenatide 50 mcg per ml Injection (Pre-filled Pen)

• Soliqua 10-40 - Store in a refrigerator (2-8°C). Shelf-life after first use is 28 days when stored below 25°C and do not refrigerate.

Insulin Glargine 300 IU/3 ml Injection (Prefilled Pen)

• Basalog One - Store in a refrigerator (2-8°C). The in-use shelf life is up to 28 days when kept at room temperature (up to 30°C).
• Lantus Solostar - Store in a refrigerator (2-8°C). Once in use, pens may be stored for a maximum of 4 weeks not above 30°C, away from direct heat or direct light. Pens in use should not be refrigerated.

Insulin Glargine 300 IU/ml Injection (Pre-filled Pen)

• Toujeo - Store in a refrigerator (2-8°C). Shelf life after first use is 6 weeks when stored below 30°C. USA product leaflet suggests 8 weeks when stored below 30°C.

Insulin Glulisine 100 IU/ml Solution for Injection in Pre-filled Pen 3 ml

• Apidra SoloStar - Store in a refrigerator (2-8°C). Once in use, pens may be stored for a maximum of 4 weeks below 25°C, away from direct heat or direct light. Pens in use should not be refrigerated.

Insulin Lispro 100 IU/ml Injection in Prefilled Syringe/Cartridge

• Humalog - Store in a refrigerator (2-8°C). Once in use, pens may be used for up to 28 days when stored below 30°C. Pens in use should not be refrigerated.

Insulin Lispro 25% and Insulin Lispro Protamine 75% 100 IU/ml Suspension for Injection in Prefilled Syringe/Cartridge

• Humalog Mix 25 - Store in a refrigerator (2-8°C). Once in use, pens may be used for up to 28 days when stored below 30°C. Pens in use should not be refrigerated.

Insulin Lispro 50% and Insulin Lispro Protamine 50% 100 IU/ml Suspension for Injection in Prefilled Syringe/Cartridge

• Humalog Mix 50 - Store in a refrigerator (2-8°C). Once in use, pens may be used for up to 28 days when stored below 30°C. Pens in use should not be refrigerated.

Insulin Recombinant Neutral Human Short-Acting 100 IU/ml Penfill and Refill

• Actrapid - Store in a refrigerator (2-8°C). The in-use shelf life is 6 weeks when stored below 30°C.
• Insugen-R - Store in a refrigerator (2-8°C). After first opening, use within 6 weeks when stored below 30°C.

Insulin Recombinant Synthetic Human, Intermediate-Acting 100 IU/ml Penfill and Refill

• Insulatard - Store in a refrigerator (2-8°C). The in-use shelf life is 6 weeks when stored below 30°C.
• Insugen-N - Store in a refrigerator (2-8°C). After first opening, use within 6 weeks when stored below 30°C.

Insulin Recombinant Synthetic Human, Premixed 100 IU/ml Penfill and Refill

• Mixtard - Store in a refrigerator (2-8°C). The in-use shelf life is 6 weeks when stored below 30°C.
• Insugen-30/70 - Store in a refrigerator (2-8°C). After first opening, use within 6 weeks when stored below 30°C.

Nasal Spray and Drop

Azelastine HCl 137 mcg and Fluticasone Propionate 50 mcg per dose Nasal Spray

• Dymista - Once opened, use within 6 months.

Beclomethasone 50 mcg/dose Nasal Spray

• Beconase Aqueous - Discard 3 months after using the spray.

Ciclesonide 50 mcg/dose Nasal Spray

• Omnaris - Discard 4 months after the bottle is removed from the foil pouch.

Fluticasone Furoate 27.5 mcg/dose Nasal Spray

• Avamys - Used within 2 months after first opening.

Mometasone Furoate 50 mcg Aqueous Nasal Spray

• Nasonex - Used within 2 months of first opening.

Oxymetazoline HCI 0.01% Nasal Drop

• Iliadin Baby Up to Year - After opening the pack, the Iliadin decongestant nasal drop/spray should not be used longer than 6 months.

Oxymetazoline HCl 0.025% Nasal Drop

• Iliadin Child 1-6 Years - After opening the pack, the Iliadin decongestant nasal drop/spray should not be used longer than 6 months.

Oxymetazoline HCl 0.05% Nasal Drop

• Iliadin Adult and Children 6+ - After opening the pack, the Iliadin decongestant nasal drop/spray should not be used longer than 6 months.

Oxymetazoline HCl 0.05% Nasal Spray

• Iliadin Adults Nasal Spray - After opening the pack, the Iliadin decongestant nasal drop/spray should not be used longer than 6 months.

Triamcinolone Acetonide 55 mcg Nasal Spray

• Nasacort AQ - Discard within 2 months after first opening.

PCSK9 Inhibitors

Alirocumab 75 mg and 150 mg Injection (Prefilled Pen/Syringe)

• Praluent - Store at 2-8°C in the outer carton. After removal for the refrigerator, solution must be used within 30 days (below 25°C) or discarded.

Evolocumab 140 mg Injection (Pre-filled Autoinjector/Syringe)

• Repatha - Store between 2-8°C in the original carton. May also store at room temperature in the original carton; however, under these conditions, must use within 30 days.

Pessary

Gemeprost (Prostaglandin E1 Synthetic Analogue) 1 mg Pessary

• Cervagem - Gemeprost suppositories are stored in a frozen state at -10°C.Once foil is opened, any pessary not used within 12 hours should be destroyed.

Lactobacillus acidophilus 100 million viable cells and Estriol 0.03 mg Vaginal Tablet

• Gynoflor - Store Gynoflor vaginal tablet in a refrigerator at 2-8°C. Storage of Gynoflor at room temperature during the treatment period (1-2 weeks) does not affect its efficacy.

Rectal

Hydrocortisone 0.5%, Cinchocaine HCl 0.5%, Framycetin Sulphate 1% and Aesculin 1% Ointment

• Proctosedyl Ointment - Store below 30°C. Discard contents 28 days after opening.

Lignocaine, Aluminium Acetate, Zinc Oxide and Hydrocortisone Ointment

• Xyloproct Ointment - 2 years if stored in a refrigerator (2-8°C). 2 months if stored not above 25°C.

Lignocaine, Aluminium Acetate, Zinc Oxide and Hydrocortisone Suppository

• Xyloproct Suppository - 30 months if stored in a refrigerator (2-8°C). 2 months if stored not above 25°C.

Topical Preparations

Calcipotriol Monohydrate 50 mcg/g and Betamethasone Dipropionate 0.5 mg/g Cutaneous Foam

• Enstilar - Discard 6 months after first opening.

Calcipotriol Monohydrate 50 mcg/g and Betamethasone Dipropionate 0.5 mg/g Gel

• Xamiol - Discard 3 months after opening.

Calcipotriol Hydrate 50 mcg/g and Betamethasone Dipropionate 0.5 mg/g Ointment

• Daivobet - After first opening of container: 12 months.

Clindamycin 1% and Benzoyl Peroxide 5% Gel

• Duac - Pharmacist: Store at refrigerator (2-8°C). Patient: Store at temperatures up to 25°C. Discard after 2 months.

Estradiol 1.53 mg/dose Transdermal Spray

• Lenzetto - Use within 56 days of first use.

Miscellaneous

Acetylcysteine 100 mg/5 ml Oral Solution

• Fluimucil - After opening, do not store for more than 15 days.

Alfacalcidol 2 mcg/ml Drops

• One-Alpha - Store at 2 to 8°C (in a refrigerator). After opening, the shelf life is 4 months when stored at 2 to 8°C (in a refrigerator).

Benzydamine HCl 3.0 mg/ml Throat Spray

• MediThroat Spray 3.0 mg/ml - Use within 6 months after opening.
• Zipelor Forte Oromucosal Spray - After opening, do not keep it more than 12 months.

Ciclosporin 100 mg/ml Oral Solution

• Sandimmun Neoral - Should be stored below 30°C, but not below 20°C for more than 1 month. After opening, Sandimmun Neoral oral solution should be used within 2 months.

Digoxin 50 mcg/ml Elixir

• Lanoxin - Store below 30°C. Discard any unused portion 12 days after opening.

Distilled Witch Hazel 13% v/v in a Solution buffered with Borax and Boric Acid

• Optrex Multi Action Eye Wash - Discard any unused product 28 days after opening.

Flurbiprofen 8.75 mg/dose Spray

• Strepsils Max Pro Direct Spray - Discard product 6 months afer opening.

Frusemide 10 mg/ml Oral Solution

• Vusimide - Store below 30°C. Discard opened bottle after 90 days.

Glyceryl Trinitrate 0.5 mg Sublingual Tablet

• Myonit Insta - Discard after 8 weeks in use.

Glyceryl Trinitrate Aerosol Spray 400 mcg (Metered Dose)

• Nitrosol Spray - Manufacturer's expiry date.

Itraconazole 10 mg/ml Oral Solution

• Sporanox - Discard 1 month after first opening the container.

Multivitamin Drops

• Appeton Baby Drops - Do not use after 1 month of opening.

Povidone Iodine 1% Mouth Wash

• Betadine Gargle and Mouthwash - Use within 6 months after first opening.

Risperidone 1 mg/ml Oral Solution

• Risperdal - Opened container: 3 months when protected from freezing.

Sucroferric Oxyhydroxide 500 mg Chewable Tablet

• Velphoro - Shelf life after first opening of the bottle: 45 days.

Zuclopenthixol 20 mg/ml Drops

• Clopixol - Before opening, store in a refrigerator (2-8°C). After opening, store below 25°C. Use within 6 weeks.

General Recommendations

The manufacturer's expiry, if shorter or the manufacturer's specificized in-use shelf-life takes precedence over the following guidelines. The guidance given here should be used as aid to the pharmacist's own professional judgement on matters of stability and in-use expiry.

Tablets and Capsules

• Blister Packed/Single Unit Dose - Manufacturer's expiry
• Bulk Packs - 1 year form date of opening

Exceptions: Products susceptible to atmospheric moisture, GTN

Liquids

• Preserved Internal and External - 6 months (local policy may direct 3 months for internal liquids)
• Extemporaneously Prepared to a BP Monograph or EDS Formula - 4 weeks from date of manufacture
• Diluted Preserved Liquids - 2 weeks
• Preserved with Chloroform - 2 weeks

Creams

• Packed in Tubes - 3 months (local policy may direct 1 month for unpreserved creams)
• Packed in Jars/Pots - 1 month
• Diluted Commercial Preparations - 2 weeks
• Extemporaneously Prepared in a Suitable Base - 4 weeks from date of manufacture

Ointments

• Packed in Tubes - 6 months
• Packed in Jars/Pots - 3 months
• Diluted Commercial Preparations - 4 weeks
• Extemporaneously Prepared in a Suitable Base - 8 weeks from date of manufacture

Extemporaneous Preparations

You may refer here for recommendations on extemporaneous preparations with unknown stability.

External Links

• FDA - Expiration Dates - Questions and Answers, 2018
• Rotherham CCG - Good Practice Guidance on Expiry Dates of Medicines, 2016
• Ipswich and East Suffolk CCG - Summary of In-use Shelf Lives, 2018