To foil bag or not to foil bag, that is the question!

Whether ‘tis nobler to use the foil bag to avoid the temperature excursions or . . . Putting William Shakespeare aside, what is the point of the foil bag?

Do foil bags keep medicines cold?

The National Vaccine Storage Guidelines ‘Strive for 5’ state that ‘foil bags commonly provided by pharmacists when vaccines are privately purchased are not effective in keeping vaccines at the correct temperature – for example, when the vaccine is left in a car or stored in a domestic refrigerator’.¹

Suppliers of foil bags advise they are for transporting medicines that require short-term storage at a constant temperature until appropriate refrigeration can be reached.

They are not suitable for long-term storage.² It is unclear whether foil bags provide thermal protection and for how long.

Some pharmacists use foil bags to remind the patient that the medicine in the bag needs to go in the fridge.

However, the patient should still be advised to take the medicine straight home to put it in the fridge and not to rely on the false sense of security that the foil bag will keep it cold while they ‘duck into the shops’.

What if the patient doesn’t have a fridge?

Not all patients have consistent access to a fridge (e.g. travelling, power outages, no fixed address).

It is useful to ask patients about this, and tailor your advice accordingly.

Cautionary Advisory Labels 6, 7a, 7b and 13 can supplement your verbal advice about storage where appropriate.³

For some medicines that require refrigeration, the approved Product Information (PI) contains guidance about room temperature storage options if refrigeration is unavailable or impractical.⁴

You can also offer to store the medicine or not-in-use containers at the pharmacy until needed (e.g. pending a doctor’s appointment, not-in-use insulin pens/cartridges).

Opened containers – in or out of the fridge?

It depends on the medicine.

The manufacturer has determined the stability and shelf-life of a medicine using the container and storage conditions outlined in the PI.

Keeping an in-use container in the fridge instead of at room temperature may extend its shelf-life. This might avoid wastage if the dose changes.

However, cold eye drops and injections can cause discomfort. They should generally be allowed to reach room temperature before they are administered.

In-use multi-dose injections or eye drops should be kept at room temperature unless otherwise advised by the PI.⁴

References

1. Australian Government Department of Health. National Vaccine Storage Guidelines ‘Strive for 5’. 3rd edn. Canberra: Australian Government Department of Health; 2019.
2. Stirling Fildes. Foil bags – medium. At: www.stirlingfildeshc.com.au/
3. Sansom LN, ed. Australian Pharmaceutical Formulary and Handbook. 2024. At: https://apf.psa.org.au
4. Medicines information. eMIMS cloud; [2024]. At: www.emims.com.au/Australia/drug/search

Our author

Claire Antrobus MPS (she/her) is PSA’s Manager – Practice Support.