text: These are also called injectable formulations and are used with intravenous, subcutaneous, intramuscular, and intra-articular administration. The drug is stored in liquid or if unstable, lyophilized form.
  Many parenteral formulations are unstable at higher temperatures and require storage at refrigerated or sometimes frozen conditions. The logistics process of delivering these drugs to the patient is called the cold chain. The cold chain can interfere with delivery of drugs, especially vaccines, to communities where electricity is unpredictable or nonexistent. NGOs like the Gates Foundation are actively working to find solutions. These may include lyophilized formulations which are easier to stabilize at room temperature.
  Most protein formulations are parenteral due to the fragile nature of the molecule which would be destroyed by enteric administration. Proteins have tertiary and quaternary structures that can be degraded or cause aggregation at room temperature. This can impact the safety and efficacy of the medicine.