First-line resources In-house past enquiries Relevant Medicines Q&As via Electronic Medicines Compendium UKMi Fridge Database Search by individual drug name. Provides stability information for medicines, intended for storage in the fridge, inadvertently stored outside recommended storage temperatures. Medical Manufacturers’ Information departments Bibliographic databases e.g. Medline, Embase The Cochrane Library Local resources Answering the enquiry The individual Summaries of Product Characteristics should always be checked as product’s formulations may change. Keywords: ROOM TEMPERATURE/FREEZING and relevant drug names. Enquiries about products in multi-compartment compliance aids (MCA), also known as monitored dosage systems (MDS) Background information The MCA What type of device is being used? How long will the product be stored in the device? Is the medicine being repackaged within a single MCA compartment? Does the device provide protection from water vapour and/or atmospheric gases i.e. sealed “blister” type or unsealed? Does the device provide protection from light? The medicine(s) Brand name(s) of medicine(s) to be stored in the MCA. Solid dose formulation: film coated or sugar coated (sugar coating provides a better barrier to moisture and light), hard or soft gelatin capsule shells (both have a high water content. Do not put with tablets, or put hard and soft gelatin capsules in the same compartment), effervescent/dispersible or hygroscopic (are sensitive to moisture), buccal/sublingual (may be swallowed by mistake). Cytotoxic medicines should not be put in an MCA. Type of packaging: foil packaging/desiccant (usually indicates moisture sensitivity), glass container (usually provided for a reason, so do not put in an MCA), dark coloured blister pack (indicates light sensitivity). Do(es) the medicine(s) have additional/complex instructions (some MCAs cannot accommodate additional instructions)? Does the patient take other medicines not in an MCA (PRN medicines and/or multiple methods can cause confusion for patients and/or carers)? Chemical structure: hydrolysis is most likely to occur in ester-containing drugs (RCOOR').
First-line resources In-house past enquiries Relevant Medicines Q&As via Electronic Medicines Compendium UKMi Fridge Database Search by individual drug name. Provides stability information for medicines, intended for storage in the fridge, inadvertently stored outside recommended storage temperatures. Manufacturers’ Medical Information departments Bibliographic databases e.g. Medline, Embase The Cochrane Library Local resources Answering the enquiry The individual product’s Summaries of Product Characteristics should always be checked as formulations may change. Keywords: ROOM TEMPERATURE/FREEZING and relevant drug names. Enquiries about products in multi-compartment compliance aids (MCA), also known as monitored dosage systems (MDS) Background information The MCA What type of device is being used? How long will the product be stored in the device? Is the medicine being repackaged within a single MCA compartment? Does the device provide protection from water vapour and/or atmospheric gases i.e. sealed “blister” type or unsealed? Does the device provide protection from light? The medicine(s) Brand name(s) of medicine(s) to be stored in the MCA. Solid dose formulation: film coated or sugar coated (sugar coating provides a better barrier to moisture and light), hard or soft gelatin capsule shells (both have a high water content. Do not put with tablets, or put hard and soft gelatin capsules in the same compartment), effervescent/dispersible or hygroscopic (are sensitive to moisture), buccal/sublingual (may be swallowed by mistake). Cytotoxic medicines should not be put in an MCA. Type of packaging: foil packaging/desiccant (usually indicates moisture sensitivity), glass container (usually provided for a reason, so do not put in an MCA), dark coloured blister pack (indicates light sensitivity). Do(es) the medicine(s) have additional/complex instructions (some MCAs cannot accommodate additional instructions)? Does the patient take other medicines not in an MCA (PRN medicines and/or multiple methods can cause confusion for patients and/or carers)? Chemical structure: hydrolysis is most likely to occur in ester-containing drugs (RCOOR').
Enquiry-answering-guidelines-2017-July-2018-partial-update.docx