What would *you* do with your pen if it arrived at room temperature?

[greensidepatch]

Just curious really. I had a pen delivered a couple of weeks ago and it was at room temperature when I opened it (there had been a delay in transit) - what would you have done with the pen?

Check what the manufacturers guidance on storage is. Some medications can be out of their desired range for X hours without affecting it.

I'd have contact the company that sent it and ask why, even with a delay, it wasn't kept cold! I'd have asked for a replacement to be sent out. Normally, medicines required to be kept at a certain temperature have cooler blocks during transit that keep it cold much longer, incase there is a delay.

I'd also use a more reputable company going forward.

I don't order mine loads ahead of time so typically I am using within 30 days of delivery

What would you have done with the pen though?

Pharmacist here. How much of a delay in transit (hours or days)? Is it still well within its expiry date?

If it was from a reputable supplier (ie you have no reason to suspect its been stored incorrectly prior to transport) then a short period of being room temp would be OK.

Return to the fridge until you are ready to use it and use it first/ next (if you already have a pen in the fridge).

I would complain to the supplier (never hurts to ask for a replacement or compensation!) and to let them know the issues with the transport.

This happened to me when I was on Ozempic, I had ordered from Rightangled in the summer months and the pen arrived at room temperature. I put it straight in the fridge and emailed them to query. They replied and said that as long as the liquid visible in the pen was still clear, it was ok to use. I wasn’t convinced and eventually threw the £200+ pen. I had no way of knowing how hot the delivery van had been that day or how long it had been at room temperature. Exp date was fine but I just didn’t feel able to take the risk.

From that point onwards I used Boots, you can collect from the pharmacy and I know that they will have stored it properly.

This happened to me. I popped it in the fridge and have used it within 30 days, which is what the supplier said to do when I asked.

I would let the supplier know. But I'd put it straight in the fridge and hope for the best. I certainly wouldn't throw it away.
Realistically, all that can happen if it has been room temp for too long is that it won't be as effective. It's not going to harm you.

Mine arrived room temp and I didn't really think anything of it (no delays though - came next day). Liquid was clear, I just cracked on. I have kept it in the fridge between doses. It's working fine.

But two hundred quid for something that doesn't work because they've not followed the storage requirements is an issue.

With any parcel I always open a small part of the package and put hand in to feel how cold it is in the closed package.
Then open package and pen and check if cloudy.
Put pen straight into fridge.

Remember the liquid in the pen is probably colder than the package feels as it was chilled and protected by the thick wall of the vial and the box.

If concerned, or there was a pen delay, I put details into the Eli Lilly Temperature Excursion Assessment Tool and depending on answer speak to provider if I wanted a replacement.

https://tempex.lilly.com/uk/

I would have insisted on a replacement pen and have done a few times. Last summer was horrendous for pens arriving warm. The pen should be kept between 2-8 degrees before first use. Any supplier saying different is not following the manufacturer guidelines for a prescription medication.

Weird it has to be stored cold until opened

Not really. Many medications have to be kept cold because the active ingredients deteriorate more quickly when left at room temperature and they deteriorate more quickly than in other formulations (or other formulations aren't feasible). By keeping them cold until the point of delivery (and then until just before use), the effectiveness is maintained so that there's no risk of using something that won't work; the amount of preservatives is minimised this way as well.

Yes and when it's opened it's ok? My pen expires in Feb next year.

Not when kept out of the fridge, it doesn't.

It'll keep at the colder temperature until then, but the 'must use within x days when out of the fridge' is because of this.

Think of it like milk. Milk from the fridge section going straight to your fridge still cold keeps for ages sealed. Milk that's been left out on the bread shelf for an undetermined period isn't going to keep as long. Milk that is opened but kept in the fridge keeps a fair while, but leave it out on the countertop overnight in this weather, especially if you don't already know it's been in the shop getting warm, isn't going to last a fortnight, whether the best before date is tomorrow of mid July.

I’d most likely check the liquid was still clear and then just use as normal.
I don’t order far in advance, I tend to order the day i take the 4th dose so it’s there by the next week.
I can’t see how it could be in any way harmful (though I’m not a scientist) if you’re losing it for weightloss purposes (distinguishing between people who need any type of medication chilled that’s essential to life like insulin for diabetes), the worst case scenario for WLI would most likely be that the medication was slightly less effective but that’s not harmful in the case of WLI in the same way that something like insulin losing efficacy could have catastrophic results.

I’d use it but complain and say it might not be safe and try and get a free replacement.

I would check if it was cloudy, if it was call my supplier, if not put it in fridge

It's not the drug companies that have to keep it in the fridge. We don't. Nothing to do with being opened either

@ThisGutsyBalonz
The pens have to be kept in the fridge before first use to ensure that the medication retains its full potency and effectiveness for the duration of its shelf life. So if it wasn’t refrigerated potentially you could be buying ineffective medication because the molecules can breakdown. After first use you have to make sure it stays below 30 degrees and use withinn 30 days.

My new pen arrived yesterday. It was well insulated but the frozen pack was completely thawed inside. On my provider website they say this is to be expected and to not worry unless you don't receive it within 48hrs of dispatch. I received mine well within 24hrs of dispatch notification so I popped it straight in the fridge and haven't worried about it.

They do. And you do if it's unopened & you won't have taken all doses within 30 days or it's really warm (such as in summer or if the alternative is somewhere like a hot kitchen, near a boiler or radiator, etc).

It would last all the way to the expiry date if refrigerated. If not, you've got 30 days.

I’d probably just use it thinking how much difference is it going to make really, but I may be particularly cavalier

Once opened you will discard in 30 days so also ok to be stored out of fridge <30 degrees for 30 days.

For pen to be ok until expiry date it must be unused and kept refrigerated.

My unused pen arrived. I took it out the box and took it home - but due to traffic I ended up getting home 1.5 hours later! I also ordered ahead of time so don’t need use it until the end of this month… but by then guidelines would say I only have 4 days use out of a 4 week pen :’( due to needing to use it in 30 days… it was put back in the fridge as soon as I was home! Do you think it would be okay to use as normal once I finish my current pen in three weeks?