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Re: Injectible Methotrexate w/out preservative length of viability

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In a message dated 1/11/2006 2:37:32 PM Central Standard Time,

nmsanders@... writes:

Does everyone put their MTX in the fridge???

Missy i take the mtx pills. But i have to keep my Humira in the fridge. I

keep it in the little boxes it comes in and i have a special place for them.

Making sure my daughter dosent leave the fridge open... like she does

sometimes. lol its worked for me so far. hugs

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Hi, My daughter, 6 yo, is on 25 mg. of MTX inj a week. I too have the vial

storage problem/concern. What my daughter's Rheum nurse practictioner told me

was. She would prescribe 1mo. worth and that I would receive four vials from the

pharmacy because you're supposed to draw only once from each vial. Now, I'm told

that you have to refridgerate MTX vials. So, the nurse said that I could just

use however much I needed from the 4 vials for up to 90 days. I always swab the

top of the grey rubber seal with alcohol before I draw to make sure it's extra

sterile also. She said it would be fine. Also, that means I save a little money

on the RX refilling.

Now I have a question for you and anyone on MTX inj. Concerning the vials that

used to have the preservative in them - they didn't use thimerasol as the

preservative did they? Because it has been linked by some to increase the

chances of autism; and that worries me because was only 2 when she started

taking it. I never thought to even ask about preservatives. She doesn't have any

signs of autism now, but I wonder what else the preservative could do to her

little body. Thanks for any answers. And I would use as much as you can while

the vials are good (for 90 days) as long as it is refridgerated. Question:

Does everyone put their MTX in the fridge???

hugs

Missy

nynypa <nynypa@...> wrote:

My Mother has just been prescribed injectable Methotrexate - 10 mg/wk.

The small vial in which it is dispensed by the pharmacy holds enough

for 5 doses. However, the vial does not have a preservative. Upon

questioning regarding storage, the pharmacist has instructed her to

fill 5 syringes at a time from the vial upon initial use and store the

unused 4 syringes away from the light for use on the 4 successive

weeks. I am told that these filled syringes will be viable for a

period of 90 days. I wonder if anyone else on injectable Methotrexate

does this, or if anyone would consider this to be accurate

information.

I am concerned whether, indeed, the medication would be viable for 5

weeks with no preservative. My Mother's rheumatological clinical nurse

believes that it would hold no longer than 24 to 48 hours.

What do others do? Thank you for you response.

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I just started on the injectable and asked the pharmacist if I should

refrigerate the opened vial. He said " That would probably be a good

idea to decrease the chance of [bacterial something or other]. " I

read on the Internet that it should be stored at approx. 55 to 75

degrees. Mine's in the fridge.

Sierra

> My Mother has just been prescribed injectable Methotrexate - 10

mg/wk.

> The small vial in which it is dispensed by the pharmacy holds

enough

> for 5 doses. However, the vial does not have a preservative. Upon

> questioning regarding storage, the pharmacist has instructed her to

> fill 5 syringes at a time from the vial upon initial use and store

the

> unused 4 syringes away from the light for use on the 4 successive

> weeks. I am told that these filled syringes will be viable for a

> period of 90 days. I wonder if anyone else on injectable

Methotrexate

> does this, or if anyone would consider this to be accurate

> information.

>

> I am concerned whether, indeed, the medication would be viable for

5

> weeks with no preservative. My Mother's rheumatological clinical

nurse

> believes that it would hold no longer than 24 to 48 hours.

>

> What do others do? Thank you for you response.

>

>

>

>

>

>

>

>

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Mine has preservative also. I started out with a RX that didn't and it

said on the vial it is for one use only so I had it switched. I get

two doses out of each little vial but it has pres in it so its ok.

Cassy

>

> mine has preservative

>

> kathy in il

>

>

>

>

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I've been taking 1.2cc per week, and the pharmacy supplied 2cc vials without

preservatives. I would load one syringe and even though I was instructed to

throw the rest away, I'm a penny-pincher and would put the vial back in the

cabinet for the next week. I did that for a long time before deciding I would

change to 1cc per week, so now I can get 8 weeks supply for the price of 4

weeks. It all adds up in the long run.

I know it's not right to do this, but I'm hard-headed and stingy. I've left the

excess in the vial and kept it out of light and heat, and had no problems at

all. My thinking on this is that the less you disturb the seal of the vial and

don't change the atmosphere it's in, it will last longer without a chance of

contamination in case a syringe is defective.

Dennis

[ ] Injectible Methotrexate w/out preservative length of

viability

My Mother has just been prescribed injectable Methotrexate - 10 mg/wk.

The small vial in which it is dispensed by the pharmacy holds enough

for 5 doses. However, the vial does not have a preservative. Upon

questioning regarding storage, the pharmacist has instructed her to

fill 5 syringes at a time from the vial upon initial use and store the

unused 4 syringes away from the light for use on the 4 successive

weeks. I am told that these filled syringes will be viable for a

period of 90 days. I wonder if anyone else on injectable Methotrexate

does this, or if anyone would consider this to be accurate

information.

I am concerned whether, indeed, the medication would be viable for 5

weeks with no preservative. My Mother's rheumatological clinical nurse

believes that it would hold no longer than 24 to 48 hours.

What do others do? Thank you for you response.

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I would call the manufacturer and ask.

Not an MD

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org

[ ] Injectible Methotrexate w/out preservative length of

viability

> My Mother has just been prescribed injectable Methotrexate - 10 mg/wk.

> The small vial in which it is dispensed by the pharmacy holds enough

> for 5 doses. However, the vial does not have a preservative. Upon

> questioning regarding storage, the pharmacist has instructed her to

> fill 5 syringes at a time from the vial upon initial use and store the

> unused 4 syringes away from the light for use on the 4 successive

> weeks. I am told that these filled syringes will be viable for a

> period of 90 days. I wonder if anyone else on injectable Methotrexate

> does this, or if anyone would consider this to be accurate

> information.

>

> I am concerned whether, indeed, the medication would be viable for 5

> weeks with no preservative. My Mother's rheumatological clinical nurse

> believes that it would hold no longer than 24 to 48 hours.

>

> What do others do? Thank you for you response.

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Hey Dennis,

I totally get the penny pinching. That is a great idea to get 8 weeks worth.

So, you weren't told to keep it in the fridge?

Missy

Dennis W <betnden@...> wrote:

I've been taking 1.2cc per week, and the pharmacy supplied 2cc vials without

preservatives. I would load one syringe and even though I was instructed to

throw the rest away, I'm a penny-pincher and would put the vial back in the

cabinet for the next week. I did that for a long time before deciding I would

change to 1cc per week, so now I can get 8 weeks supply for the price of 4

weeks. It all adds up in the long run.

I know it's not right to do this, but I'm hard-headed and stingy. I've left the

excess in the vial and kept it out of light and heat, and had no problems at

all. My thinking on this is that the less you disturb the seal of the vial and

don't change the atmosphere it's in, it will last longer without a chance of

contamination in case a syringe is defective.

Dennis

[ ] Injectible Methotrexate w/out preservative length of

viability

My Mother has just been prescribed injectable Methotrexate - 10 mg/wk.

The small vial in which it is dispensed by the pharmacy holds enough

for 5 doses. However, the vial does not have a preservative. Upon

questioning regarding storage, the pharmacist has instructed her to

fill 5 syringes at a time from the vial upon initial use and store the

unused 4 syringes away from the light for use on the 4 successive

weeks. I am told that these filled syringes will be viable for a

period of 90 days. I wonder if anyone else on injectable Methotrexate

does this, or if anyone would consider this to be accurate

information.

I am concerned whether, indeed, the medication would be viable for 5

weeks with no preservative. My Mother's rheumatological clinical nurse

believes that it would hold no longer than 24 to 48 hours.

What do others do? Thank you for you response.

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I was told by my pharmacist not to use the leftover MTX after my first injection

from that vial. I was given 4 vials per month, one needle per vial, each was

tossed after one injection.

kerri sue

nynypa <nynypa@...> wrote:

My Mother has just been prescribed injectable Methotrexate - 10 mg/wk.

The small vial in which it is dispensed by the pharmacy holds enough

for 5 doses. However, the vial does not have a preservative. Upon

questioning regarding storage, the pharmacist has instructed her to

fill 5 syringes at a time from the vial upon initial use and store the

unused 4 syringes away from the light for use on the 4 successive

weeks. I am told that these filled syringes will be viable for a

period of 90 days. I wonder if anyone else on injectable Methotrexate

does this, or if anyone would consider this to be accurate

information.

I am concerned whether, indeed, the medication would be viable for 5

weeks with no preservative. My Mother's rheumatological clinical nurse

believes that it would hold no longer than 24 to 48 hours.

What do others do? Thank you for you response.

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A pharmacist or doctor/nurse has to say that for liability purposes. They have

to cover themselves as much as possible because of all the malpractice lawsuits

that are being filed. Reality is totally different. If y'all recall, the

government argued strongly against mail-order meds from Canada or other

countries. The heat and cold the meds will be subjected to may cause real

problems for the patient. However, mail-order from pharmacies in the good old

USofA is ok. Meds are still subjected to the same treatments, but it's different

because of politics, pure and simple. There's no mention of refrigerating from

the manufacturers, and they certainly aren't stored in a fridge in the pharmacy.

So, you just have to use your head and make a decision you're comfortable with.

Among other things, look at the expiration date of the med. That will be a good

indicator of on-shelf storage. My MTX stays in the box it comes in, in a kitchen

cabinet because of it's convenience. I'll continue doing that until it's proven

to be a bad practice.

As for non-preservative MTX, it would still spoil if it were never opened, from

information I've heard. One problem would be dong as I do, pulling the piston

back in the syringe to unseat it and to add a little air in the vial. That's the

only time it could be contaminated, and the small amount of air injected

shouldn't be a problem unless you're living in an extremely smog-filled

atmosphere.

Dennis

Re: [ ] Injectible Methotrexate w/out preservative length of

viability

I was told by my pharmacist not to use the leftover MTX after my first

injection from that vial. I was given 4 vials per month, one needle per vial,

each was tossed after one injection.

kerri sue

nynypa <nynypa@...> wrote:

My Mother has just been prescribed injectable Methotrexate - 10 mg/wk.

The small vial in which it is dispensed by the pharmacy holds enough

for 5 doses. However, the vial does not have a preservative. Upon

questioning regarding storage, the pharmacist has instructed her to

fill 5 syringes at a time from the vial upon initial use and store the

unused 4 syringes away from the light for use on the 4 successive

weeks. I am told that these filled syringes will be viable for a

period of 90 days. I wonder if anyone else on injectable Methotrexate

does this, or if anyone would consider this to be accurate

information.

I am concerned whether, indeed, the medication would be viable for 5

weeks with no preservative. My Mother's rheumatological clinical nurse

believes that it would hold no longer than 24 to 48 hours.

What do others do? Thank you for you response.

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Hi, my husband is a RN in the ER and he said as long as you clean the top of the

vial with alcohol before each use you can keep a product without preservative

for a long time. My Rheumy told me this also. Just look at your vial before each

use and if it looks cloudy or you see something in it stop using it. I have been

using the same vial for 4 months now.I have enough MTX for 9 months in my large

vial at 1cc a week. Just keep it. They do this in the ER all the time for many

drugs. Different Docs have different ideas about this my Pharmacy told me this

was ok also. If your not comfortable doing this then DONT. The stress is worse

for you and not worth it. Latisha

MELISSA CRIGLER <nmsanders@...> wrote: Hey Dennis,

I totally get the penny pinching. That is a great idea to get 8 weeks worth.

So, you weren't told to keep it in the fridge?

Missy

Dennis W <betnden@...> wrote:

I've been taking 1.2cc per week, and the pharmacy supplied 2cc vials without

preservatives. I would load one syringe and even though I was instructed to

throw the rest away, I'm a penny-pincher and would put the vial back in the

cabinet for the next week. I did that for a long time before deciding I would

change to 1cc per week, so now I can get 8 weeks supply for the price of 4

weeks. It all adds up in the long run.

I know it's not right to do this, but I'm hard-headed and stingy. I've left the

excess in the vial and kept it out of light and heat, and had no problems at

all. My thinking on this is that the less you disturb the seal of the vial and

don't change the atmosphere it's in, it will last longer without a chance of

contamination in case a syringe is defective.

Dennis

[ ] Injectible Methotrexate w/out preservative length of

viability

My Mother has just been prescribed injectable Methotrexate - 10 mg/wk.

The small vial in which it is dispensed by the pharmacy holds enough

for 5 doses. However, the vial does not have a preservative. Upon

questioning regarding storage, the pharmacist has instructed her to

fill 5 syringes at a time from the vial upon initial use and store the

unused 4 syringes away from the light for use on the 4 successive

weeks. I am told that these filled syringes will be viable for a

period of 90 days. I wonder if anyone else on injectable Methotrexate

does this, or if anyone would consider this to be accurate

information.

I am concerned whether, indeed, the medication would be viable for 5

weeks with no preservative. My Mother's rheumatological clinical nurse

believes that it would hold no longer than 24 to 48 hours.

What do others do? Thank you for you response.

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