Do Chemotherapy Drugs Need to Be Refrigerated? A Guide to Safe Storage

October 8, 2025 •

4 min read

The proper storage of medications, especially powerful compounds like those used in chemotherapy, is critical for maintaining drug efficacy and patient safety. While some chemotherapy drugs must be refrigerated, many can be safely kept at room temperature, making it essential to know the specific requirements for each medication.

Quick Summary

Storage requirements for chemotherapy drugs vary significantly depending on the specific medication. Proper temperature control, protection from light, and adherence to pharmacist instructions are vital to prevent chemical degradation, ensure effectiveness, and maintain patient safety.

Key Points

Storage Needs Vary by Drug: Not all chemotherapy drugs require refrigeration; some are stable at room temperature, while others must be kept cool.
Label is the Authority: Always follow the specific storage instructions provided on the medication's label and by your pharmacist or oncology care team.
Temperature Extremes are Harmful: Excessive heat, direct sunlight, and high humidity can degrade chemotherapy drugs, making them less effective or unsafe.
Refrigerated vs. Room Temp: Examples of refrigerated drugs include Etoposide capsules and certain biologics, while many oral tablets can be stored at room temperature.
Safe Home Handling is Essential: Store all medications in a cool, dry place, away from children, pets, and food, and in their original containers.
Pharmacist is Your Guide: When in doubt, always ask your pharmacist about proper storage and handling procedures, especially for new prescriptions.

Why Proper Temperature Control is Critical for Chemotherapy

The chemical stability of a medication is crucial to its effectiveness and safety. Chemotherapy and other anticancer drugs contain active substances designed to target and destroy cancer cells. Exposure to improper temperatures, humidity, or sunlight can cause these substances to degrade, potentially rendering the medication ineffective or, in some cases, forming toxic byproducts.

This is why a strict "cold chain"—a temperature-controlled supply chain—is used for certain heat-sensitive medications during transport from the manufacturer to the pharmacy and, ultimately, to the patient. For patients administering oral chemotherapy or other medications at home, understanding and following the specific storage instructions is a non-negotiable part of their treatment plan.

Chemotherapy Drugs That Need Refrigeration

Several types of chemotherapy and supportive cancer medications require cold storage to maintain their stability. These include many injectable drugs and some oral medications. The general temperature range for refrigeration is between 2°C and 8°C (36°F and 46°F).

Examples of temperature-sensitive cancer medications that often require refrigeration include:

Etoposide capsules (VePesid): This is a specific oral chemotherapy capsule that must be refrigerated, and it's easy to overlook this requirement as most oral medications are stored at room temperature.
Chlorambucil (Leukeran): This is another oral chemotherapy drug that is temperature-sensitive and requires refrigeration.
Injectable medications: Biologic therapies and supportive care drugs often require refrigeration. Examples include erythropoietin-stimulating agents (e.g., Procrit) and granulocyte colony-stimulating factors (e.g., Neupogen, Neulasta).
Reconstituted drugs: Some medications that are mixed from a powder just before use have limited stability and must be refrigerated for a certain amount of time.

Chemotherapy Drugs Stored at Room Temperature

Many oral chemotherapy drugs can be stored at room temperature, typically defined as between 20°C and 25°C (68°F and 77°F), with excursions permitted to 15°C to 30°C (59°F–86°F). It is crucial to keep these medications in a cool, dry place away from direct heat sources and sunlight. Bathrooms and kitchen areas near stoves should be avoided due to fluctuating temperatures and humidity.

For example, while some types of oral etoposide must be refrigerated, many oral chemotherapies do not. Always check the medication label and consult with your pharmacist to confirm the specific storage requirements for your prescription.

Comparison of Chemotherapy Drug Storage Conditions


Storage Condition	Temperature Range	Common Medication Forms	Key Storage Precaution	Examples of Drugs	Sources
Refrigerated	2–8°C (36–46°F)	Injectable liquids, some capsules	Do not freeze; store away from food	Etoposide capsules, Erythropoietin, G-CSF	,,
Controlled Room Temperature	20–25°C (68–77°F)	Many oral tablets and capsules	Store in a cool, dry place away from heat and light	Many oral chemotherapies	,
Frozen	-25°C and -10°C (-13°F to 14°F)	Some research-stage or specific drugs	Requires a medical-grade freezer	N/A (less common for home use)

Important Safety Guidelines for Storing All Chemotherapy at Home

Regardless of whether refrigeration is required, all chemotherapy medications are potent substances that demand careful handling. The following guidelines help ensure the safety of both the patient and other household members:

Original Container: Always store medications in their original, sealed containers to protect them from environmental factors like air and light.
Secure Location: Keep all chemotherapy drugs in a secure location, well out of the reach of children and pets. This is especially important for oral forms that may be mistaken for other pills.
Wash Hands: Wash your hands thoroughly with soap and water before and after handling any chemotherapy medication.
Wear Gloves: For caregivers handling oral chemotherapy, wearing gloves is recommended to prevent skin exposure. The patient typically does not need gloves but should wash their hands after taking the medication.
Isolate from Others' Medications: Store chemotherapy drugs separately from other household medications and food items to avoid mix-ups and contamination.
Never Split or Crush: Unless explicitly instructed by a pharmacist, never split, crush, or chew chemotherapy tablets. This can release the drug into the air and alter its intended dosage and absorption.
Proper Disposal: Follow specific instructions from your care team on how to dispose of leftover medication and any contaminated supplies.

For more detailed information on safe handling, a comprehensive guide is available from the Memorial Sloan Kettering Cancer Center.

Conclusion

Ultimately, whether a chemotherapy drug needs to be refrigerated depends on the specific medication's chemical properties. Improper storage, including exposure to heat or humidity, can compromise drug efficacy and potentially cause serious health risks. Therefore, it is critical to carefully review the medication's label and consult your pharmacist or oncology care team for precise storage and handling instructions. Never make assumptions about how to store a medication. Following these guidelines is an essential step in ensuring a safe and effective treatment regimen.

Frequently Asked Questions

For chemotherapy drugs that require refrigeration, the ideal temperature range is typically between 2°C and 8°C (36°F and 46°F). This is standard for medications that are part of a regulated cold chain.

Generally, you should not transfer chemotherapy drugs from their original container to a pill box unless specifically advised by your care team. The original packaging protects the medication from light and moisture, which can cause it to degrade.

If a refrigerated drug has been left out, contact your pharmacist or oncology team immediately for guidance. The CDC suggests that during a power outage, refrigerated drugs used for life-sustaining purposes should be used with caution and replaced as soon as possible, but specific advice will depend on the drug.

Yes, humidity can affect chemotherapy pills, particularly if they are not stored in their original sealed container. High humidity can cause some drugs to break down, so it is recommended to avoid storing medications in bathrooms.

Yes, but you must take precautions. Use an insulated cooler with cold packs to maintain the proper temperature during travel. Always keep the medication with you in your carry-on luggage if flying, and never leave it in a hot car.

Visually inspect the medication. Changes in color, texture, or odor, or if pills stick together, are signs that the drug may be compromised. If you have any concerns, do not take the medication and talk to your pharmacist.

The temperature inside the door of a refrigerator can fluctuate more than in the main compartment, especially with frequent opening and closing. For temperature-sensitive medications, it is safer to store them in the body of the refrigerator, like in the crisper bin.