# Antibiotics



## CapitalKane49p (Apr 7, 2020)

Any, MDs, RNs, Nurse Practitioners, Pharmacists or Combat Medics out there?

SHTF Scenario.

All is lost and you are on the move to meet up with the rest of your group. You pull into a small town and stop at a pharmacy, the place looks intact. The pharmacist comes out and asks if they can hitch ride with you to the next town as their transit is toast. In exchange for the lift you can take as much of any 5 antibiotics in the store as you want. You have a full FA kit and enough over the counter meds to last you for years. No Oxy either as that is long gone. Your only focus is antibiotics which in this new world are worth their weight in gold. 
Keep in mind that a least one of your choices has to be one that does not contain any penicillin as one of the group members you are meeting up with is allergic to it. 
Which ones do you take and WHY? You are not allowed to ask the pharmacist what they would recommend. 

Thoughts?

Godspeed


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## NewRiverGeorge (Jan 2, 2018)

Leavquin (broad spectrum quinolone be careful with children under 12 and the elderly as it can cause tendon rupture
Zyvox (treats MRSA)
Omnicef (good for sinus infections, Bronchitis, etc. Good choice for pneumonia in people allergic to penicillin has less than a 10% chance of reaction)
Zpak (broad spectrum)
Bactrim (treats multiple infections including mrsa skin infections)

Honorable mention: Augmentin (however has amoxicillin)

However, if this pharmacy has IV antibiotics that opens up a whole other chapter.


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## Camel923 (Aug 13, 2014)

Good thoughts @NewRiverGeorge. I would say consider doxycycline which treats a lot of infections and is good against Lyme's disease. Under the circumstances of this serino Ticks can be a real issue. I like the idea of leavquin.


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## jimcosta (Jun 11, 2017)

*KapitalKane49P:*
Please pardon me for jumping in here but I risk it in the event that it may possibly help you. I do not know you or your prepping background.
So I do not know if this is a medical question to which you already know the answer or a sincere declaration that you do not have antibiotics in your personal kit.

I assume you have no antibiotics. If this is correct you may not know that you can get most of the antibiotics you need now in the form of fish medicine. They can be obtained very *cheaply and without prescriptions*.

Our group is well supplied. My Daughter-In-Law is a pharmacist. She says the medications are made by the human drug suppliers and the same dosages as for humans. They are the same medications.
If requested I can supply you with vendors and her instructions on when and dosages for certain illnesses, and which antibiotic to never purchase as when it ages it becomes poison. I will have to look up the name.
She gave us a list of about half a dozen meds to inventory.

If you already have antibiotics then my apology for jumping in here.

*P. S.* Supplier: https://www.fishantibioticsdirect.com/products/fish-cin

Becomes poison with age: FISH-CYCLINE (tetracycline);
All on our list below last for years and may get a little weak over time, but still good.

*Our Starter Kit:*

FISH-MOX (amoxicillin 250mg)
FISH_MOX FORTE (amoxicillin 500mg)
FISH_MOX FORTE (amoxicillin 500mg)
FISH-CILLIN (ampicillin 250mg)
FISH-FLEX Keflex 250mg)
FISH-FLEX FORTE (Keflex 500mg)
FISH-ZOLE (metronidazole 250mg)
FISH-PEN (penicillin 250mg)
FISH-PEN FORTE (penicillin 500mg)
Sulfa Forte


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## SOCOM42 (Nov 9, 2012)

Amoxycillin, Ciproflaxin, cephalexin, clavamox, doxycycline, erythromycin, these are all oral and cover almost every bacterial infection.

Then there is another needed, one few consider, Ofloxacin Ophthalmic solution USP, 0.3%.

I have these in storage and are rotated out thanks to Doc. brother.


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## SOCOM42 (Nov 9, 2012)

Camel923 said:


> Good thoughts @NewRiverGeorge. I would say consider doxycycline which treats a lot of infections and is good against Lyme's disease. Under the circumstances of this serino Ticks can be a real issue. I like the idea of leavquin.


Yeah, I had it once, caught it quick, kid has had it twice, there is an overabundance of those little bastards around here.

One thing with the Doxy, it does not store well and becomes toxic with age, all of mine is in a freezer @ 30 below f.


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## Sc0rPs (Oct 10, 2020)

Just like to add you may not be able to get antibiotics without a prescription but you can still get ones for pets, which is the same thing.


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## BamaDOC (Feb 5, 2020)

NewRiverGeorge said:


> Leavquin (broad spectrum quinolone be careful with children under 12 and the elderly as it can cause tendon rupture
> Zyvox (treats MRSA)
> Omnicef (good for sinus infections, Bronchitis, etc. Good choice for pneumonia in people allergic to penicillin has less than a 10% chance of reaction)
> Zpak (broad spectrum)
> ...


 @NewRiverGeorge these are good recommendations.
@Camel923 mentioned lyme disease which brings up a good point.
almost all of the above mentioned antibiotics will help with most bacterial infections.
what we forget is the nonbacterial infections which are also common in times of natural disasters.

After the tornadoes from years ago.. we had a huge bump in *fungal *infections from spores stirred up in the soil that people were scratching, cutting their skin from the clean up. (fluconazol, posaconazole, Itraconazole)

In the gulf each year we have skin infections from summer heated water with contaminated with sewage (clostridium and vibrio) (anaerobic bugs.. metronidazole) minocycline doxycycline ciprofloxacin

Ameobic and protozoal infections are becoming more common because of untreated sewage , and flooding. and require different antibiotics (Metronidazole tinidazole)

and lastly dont forget worms... anyone who has lived in the third world and seen someone pooping out intestinal worms will never want to experience that.
be its mechanism of action [7].

_Ivermectin is the drug of choice for the treatment of onchocerciasis and for strongyloidiasis. (See "Onchocerciasis" and "Strongyloidiasis".)

Ivermectin has activity against other filarial worms including Wuchereria bancrofti, Brugia malayi, Mansonella ozzardi, and Loa loa. It is not the drug of choice for these infections, though it may be useful in certain circumstances. (See related topics.)

Ivermectin is effective against several intestinal nematodes including ascariasis, trichuriasis, and enterobiasis [8]. Ivermectin is also used to treat cutaneous larva migrans. Ivermectin is ineffective against human hookworms [8]. (See "Ascariasis" and "Enterobiasis (pinworm) and trichuriasis (whipworm)" and "Hookworm-related cutaneous larva migrans".)

Ivermectin is also effective for treatment of ectoparasitic infections including scabies and head lice. (See "Scabies: Epidemiology, clinical features, and diagnosis" and "Pediculosis capitis".)

Ivermectin should not be administered to pregnant or lactating women, and its safety in children <15 kg is not known. In areas of West Africa where loiasis is endemic, ivermectin should be used with caution; it should be avoided in those with high-grade microfilaremia who are susceptible to treatment-induced encephalopathy. (See "Loiasis (Loa loa infection)".)

Albendazole - Albendazole has a broad range of activity against helminthic infections, including neurocysticercosis, echinococcosis, ascariasis, hookworm, and trichuriasis. (See related topics.)

Albendazole also has activity against a number of less common tissue nematode infections, including cutaneous larva migrans [10], visceral and ocular larva migrans [11], gnathostomiasis [12], intestinal capillariasis [13], clonorchiasis [14], Lagochilascaris minor [15], and human infections with the nematodes Trichinella pseudospiralis [16] and Oesophagostomum bifurcum [17]. (See related topics.)

Absorption of albendazole is enhanced by taking it with fatty meals [18]. Albendazole should be taken with fatty foods for treatment of invasive systemic parasitic infections; it should be taken with no food (eg, on an empty stomach) for treatment of intraluminal parasitic infections with no systemic involvement. Side effects of albendazole include abdominal pain, nausea, vomiting, and increased hepatic transaminases; these are generally transient and usually do not require discontinuation of the drug [19]. Neutropenia and, rarely, agranulocytosis can occur with longer-term treatments (as for echinococcosis or neurocysticercosis), so blood counts should be monitored. Alopecia can occur during prolonged treatments but resolves after albendazole treatment ends.

Mebendazole - Mebendazole is a benzimidazole derivative that is effective against a spectrum of intestinal and tissue nematode infections, including ascariasis, hookworm, enterobiasis, and trichuriasis, and as an investigational drug for Capillaria. Side effects of mebendazole include mild abdominal pain and diarrhea. Mebendazole is not available in the United States and albendazole is an alternative. _


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## stevekozak (Oct 4, 2015)

jimcosta said:


> *KapitalKane49P:*
> Please pardon me for jumping in here but I risk it in the event that it may possibly help you. I do not know you or your prepping background.
> So I do not know if this is a medical question to which you already know the answer or a sincere declaration that you do not have antibiotics in your personal kit.
> 
> ...


They all seem to be sold out. I was looking for them on another site today with the same result.


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## CapitalKane49p (Apr 7, 2020)

jimcosta said:


> *KapitalKane49P:*
> Please pardon me for jumping in here but I risk it in the event that it may possibly help you. I do not know you or your prepping background.
> So I do not know if this is a medical question to which you already know the answer or a sincere declaration that you do not have antibiotics in your personal kit.
> 
> ...


I am as prepared as I can be but the one nagging worry I have is that should times get tough a simple scratch or minor infection can end up killing a person. I've got some pretty good FA skills but am lacking antibiotics knowledge. All the responses I've received so far have been very helpful and I can see I've got a fair amount of homework to do.

Thanks to all.

Godspeed.


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## BamaDOC (Feb 5, 2020)

sorry about the long reply...
I have access to a number of medical sources such as 








as well as online medical journals and resources like uptodate.com

if anyone has a particular question... feel free to message me


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## BamaDOC (Feb 5, 2020)

from the above mentioned source on wilderness medicine (auerbachs wilderness medicine book)

https://play.google.com/store/books...VBobICh2NrQZ0EAQYAiABEgJ5vfD_BwE&gclsrc=aw.ds

this is the chapter on drug stability in the wilderness
they have a list for a med kit for .. a mini er or rescue pack in austere environments.
obviously alot of these drugs you need a prescription for .. but they list drugs which would be considered essential.. and the most bang for the buck.. plus they are easier to store and administer..

hope this helps..

_Drugs for A Basic Field Kit

A basic field medical kit includes the following types of medications: 
Analgesic

Antianaphylactic and antiallergy

Antibiotic

Antiemetic

Antiepileptic

Antipyretic

Sterile fluid (for IV use)

How to Read the Drug List

The following list summarizes stable conditions for drugs most likely to be included in field or tactical medical kits. 16 The list offers options for similar types of drugs, depending on the particular requirements of the users.

Certain terms are used for brevity's sake. Room temperature is defined as 15° to 30° C (59° to 86° F). Controlled room temperature is defined as 20° to 25° C (68° to 77° F). Excessive heat is defined as a temperature exceeding 40° C (104° F).

In the United States, availability of medications is subject to regulations of the Food and Drug Administration and Drug Enforcement Agency (DEA). The following labels note drug availability in the United States: OTC (over-the-counter), Rx (prescription required), DEA Schedule (S II, S III, or S IV indicating drugs with abuse potential, with S II having the greatest abuse potential and S IV the least), or NA (not available).

Packaging and inert compounds used with a medication may vary, especially for generic drugs. In all cases, information from the manufacturer should supplement the guide below.

Deviation from the manufacturer's recommendations is the decision of the treating medical professional and not recommended by the authors of this Appendix. Medications are generally listed by their generic names. Mention of trade names does not imply endorsement.

Drug List

Acetaminophen Capsules, Tablets, Oral Solution, and Suppositories (OTC)

Store capsules, tablets, and the oral solution at a controlled room temperature. Most are fairly stable in light, moisture, and heat, but high humidity should be avoided for gel-coated capsules. High humidity and light should be avoided for oral-dissolving and chewable tablets. Excessive heat (≥ 40° C [104° F]) should be avoided for extended-release tablets. Solid forms of acetaminophen remain stable for 3 years and liquid forms remain stable for 2 years from the date of manufacture. Store suppositories at 8° to 25° C (46° to 77° F).

Acetaminophen With Codeine Tablets and Oral Solution (S III)

Store tablets and the solution in light-resistant containers at a controlled room temperature.

Acetaminophen With Hydrocodone Tablets and Oral Solution (S II)

Store tablets and the solution in light-resistant containers at a controlled room temperature.

Acetazolamide Tablets, Extended-Release Capsules, Oral Solution, and Injection (RX)

Store tablets and extended-release capsules at a controlled room temperature. Brief excursions to 15° to 30° C (59° to 86° F) are permitted for tablets. Dry powder for the injection solution should be stored in an unopened vial at a controlled room temperature. Powder reconstituted with 5 mL sterile water is stable for 12 hours at room temperature, and is stable for 3 days if refrigerated at 2° to 8° C (36° to 46° F).

An extemporaneous formulation can be prepared in three ways:

To prepare a solution of acetazolamide 50 mg/mL, crush 20 acetazolamide 250-mg tablets in 25 mL glycerin or distilled water. Add flavored syrup or 2 : 1 simple syrup or flavored syrup to bring the total volume to 100 mL. Shake well before use. This solution should be stored under refrigeration and is stable for 1 week.

To prepare a solution of acetazolamide 5 mg/mL, crush two acetazolamide 250-mg tablets in 7 mL polyethylene glycol 400, 53 mL propylene glycol, 15 mL 70% sorbitol solution, 15 mL 85% sucrose solution, 1 mL sweet syrup, 0.5 mL ethanol, and 8 mL of 0.1M citrate to achieve a total volume of 100 mL.

The solution can be prepared in a concentration of acetazolamide 25 mg/mL by crushing 10 acetazolamide 250-mg tablets in 50 mL Ora-Sweet and 50 mL Ora-Plus. Store the solution in an opaque container at room temperature. This solution remains stable for 60 days.

Acetic Acid Otic Solution (OTC)

Store the solution in an airtight, light-resistant container at room temperature. Protect from heat.

Albuterol Tablets, Syrup, and Inhaled Formulation (RX)

Store tablets at 2° to 25° C (36° to 77° F). Store extended-release tablets at 15° to 30° C (59° to 86° F). Store syrup at 2° to 30° C (36° to 86° F). Store capsules for inhalation at room temperature.

For the inhalation route, be certain that albuterol is at room temperature prior to use. For the nebulization route, store albuterol solution for inhalation 0.083% (Proventil), 0.5% (Ventolin), and 0.42% or 0.21% (Accuneb) at 2° to 25° C (36° to 77° F). Accuneb nebulized solution must be used within 1 week after removal from the foil pouch. In the pouch, Ventolin Nebules inhalation solution can be stored at 2° to 8° C (36° to 46° F) for up to 6 months and remains stable at room temperature for 14 days.

Store albuterol aerosol inhalers containing chlorofluorocarbon propellants at room temperature. Store albuterol sulfate aerosol inhalers containing hydrofluoroalkane (HFA) propellants out of direct sunlight at 15° to 25° C (59° to 77° F). To avoid bursting, do not exceed 49° C (120° F). Do not puncture or incinerate. If infrequently used, Ventolin HFA is stable for 6 months from removal from the pouch. Store Ventolin HFA canisters with the mouthpiece down. If frequent nebulization is required, 200 mcg/mL of albuterol sulfate inhalation solution in normal saline remains stable for 7 days at room temperature or under refrigeration when placed in polyvinyl chloride or polyolefin bags, polypropylene syringes and tubes, or borosilicate glass tubes.

Aloe Vera Gel, Ointment, and Laxatives (OTC)

Store gel, ointment, and laxatives away from excessive heat and prolonged strong direct light.

Amiodarone Tablets, Oral Solution, Inhalants, and Injections (RX)

Store tablets in a light-resistant container at a controlled room temperature. An extemporaneous 5 mcg/mL formulation can be created by crushing five amiodarone 200-mg tablets into a 200-mL solution of 1 : 1 of Ora-Plus to Ora-Sweet or Ora-Sweet SF. Solution stored in a glass or plastic bottle under refrigeration remains stable for 91 days. The solution remains stable at room temperature for 6 weeks. Shake before use. Store conventional amiodarone ampules at a controlled room temperature. Ampules may be briefly removed for use at temperatures of 15° to 30° C (59° to 86° F). Protect all injection solutions from light and excessive heat. Do not freeze.

Antacids (OTC)

Store aluminum hydroxide and magnesium hydroxide (often called milk of magnesia) products in tightly sealed containers at a controlled room temperature. Store calcium carbonate conventional tablets at 15° to 30° C (59° to 86° F). Store calcium carbonate chewable tablets below 25° C (77° F). Protect all products from light, moisture, and excessive heat. Do not freeze.

Aspirin Tablets, Oral Solution, and Suppositories (OTC)

Store tablets and solution in tightly sealed, light-resistant containers at room temperature. Protect from moisture. Store suppositories in the original sealed wrapper at 2° to 15° C (35° to 59° F). Do not freeze. Protect from light, moisture, and excessive heat. Discard aspirin if a strong vinegar odor is present, because potency may be significantly decreased.

Atenolol Tablets (RX)

Store tablets in light-resistant containers at a controlled room temperature.

Atropine Injection and Ophthalmic Solution (RX)

Store ophthalmic and injection solutions in light-resistant containers at room temperature. In order to prevent contamination, do not touch the applicator tip directly to the eyes or skin. Atropine sulfate 1 mg/mL injection solutions in Tubex (0.5-mL and 1-mL) packaging have been shown to remain stable for 3 months. Atropine methyl nitrate 10 mg/mL solutions have been shown to remain stable for 6 months. Inspect the solution prior to administration for the presence of particulate matter, cloudiness, or discoloration, and discard if present. Do not freeze.

Azithromycin Tablets, Oral Solution, Injection, and Ophthalmic Solutions (RX)

Store tablets at room temperature. Store dry powder for reconstitution below 30° C (86° C). After reconstitution, store suspension at 5° to 30° C (41° to 86° F) and discard after use. After reconstitution, store extended-release solution at a controlled room temperature and use at room temperature. Do not refrigerate or freeze. The solution remains stable for 12 hours. Shake oral azithromycin suspension before use and do not take simultaneously with antacids containing aluminum or magnesium. The injection solution remains stable for 24 hours if stored at 30° C (86° F), or for 7 days if stored under refrigeration below 5° C (41′ F). Store ophthalmic solution in an unopened bottle under refrigeration at 2° to 8° C (36° to 46° F), and at 2° to 25° C (36° to 77° F) once opened. The solution remains stable for 14 days.

Bacitracin Topical Formulation (OTC)

Store the aqueous topical formulation at 2° to 8° C (36° to 46° F) for up to 1 week. Store the nonaqueous topical formulation at room temperature for 3 days, and for longer periods if stored in an anhydrous base, such as lanolin and paraffin.

Bismuth Subsalicylate Tablets and Oral Solution (OTC)

Store tablets and suspension in tightly sealed containers at room temperature. Protect from direct light and excessive heat. Do not freeze the suspension.

Bretylium Tosylate (RX)

Store at a controlled room temperature.

Bupivacaine Injection (RX)

Store the injection solution at a controlled room temperature. Protect solutions containing epinephrine from light. Bupivacaine hydrochloride 1.25 mg/mL in 0.9% sodium chloride injection solution in disposable polypropylene syringes is stable for 32 days at 3° to 23° C (37° to 73° F).

Butorphanol Tartrate Nasal Spray and IM and IV Injections (S IV)

Store nasal spray at room temperature. Store the injection solution in the original container at 20° to 25° C (68° to 77° F). Protect from light. Discard if discoloration occurs or particulate matter forms in injection solution.

Calcium Chloride, Calcium Gluceptate, and Calcium Gluconate Injection (RX)

Store injection solutions of calcium chloride, calcium gluceptate, and calcium gluconate at room temperature. Sterile solutions of calcium in water are indefinitely stable.

Calendula Topical Formulation (OTC)

Protect from heat, moisture, and direct light.

Ceftriaxone Injection (RX)

Store dry powder for solution preparation in a light-resistant container at or below 25° C (77° F). Dry powder for injection solutions should not be combined with diluents containing calcium, such as Ringer's or Hartmann's solution, because there will be particulate formulation. After constitution, intramuscular (IM) solutions in water or normal saline remain stable for 2 days at 25° C (77° F) and for 10 days refrigerated at 4° C (39° F) in a concentration of 100 mg/mL; however, at a concentration of 250 mg/mL, such solutions remain stable for only 24 hours at 25° C (77° F) and 3 days refrigerated at 4° C (39° F). IV solutions at concentrations of 10, 20, and 40 mg/mL remain stable for 2 days at 25° C (77° F) and for 10 days refrigerated at 4° C (39° F). Do not refrigerate injection solutions that contain 5% dextrose and 0.9% or 0.45% sodium chloride diluent solutions. IV solutions of ceftriaxone that contain 5% dextrose and 0.9% sodium chloride solution can be frozen at −20° C (−4° F) in PVC or polyolefin containers and remain stable for 26 weeks. Thaw at room temperature before use, and discard any unused, thawed solution.

Cephalexin Capsules, Tablets, and Oral Solution (RX)

Store capsules at room temperature. The suspension is stable for 14 days under refrigeration.

Charcoal, Activated (OTC)

Store activated charcoal in an airtight container. Sealed aqueous suspensions are stable for 1 year.

Ciprofloxacin Tablets, Capsules, Oral Solution, Injection, Ophthalmic Solution, and Otic Solutions (RX)

Store tablets below 30° C (86° F). Store extended-release tablets at 25° C (77° F). Brief excursions are permitted at room temperature. Store microcapsules and diluent for oral suspensions below 25° C (77° F). Do not freeze. After reconstitution, the solution should be stored below 30° C (86° F); it remains stable for 14 days. Store the ophthalmic solution in original vials at 2° to 25° C (36° to 77° F). Protect from light and excessive heat. Do not freeze tablets or oral and ophthalmic solutions. Store the otic solution in a light-resistant container at room temperature of 15° to 25° C (59° to 77° F).

Crotalidae Antivenom (RX)

Store vials at 2° to 8° C (36° to 46° F). Do not freeze. Use within 4 hours of reconstitution.

Cyclopentolate Hydrochloride Ophthalmic Solution (RX)

Store ophthalmic solution in the original container at room temperature. Use only if the sealing neckband on the container is intact.

Dabigatran Tablets (RX)

Store in a tightly sealed container at 25° C (77° F). Brief excursions are permitted at room temperature. Protect from moisture. Once the container has been opened, use within 4 months.

Deet ( N , N -Diethyl- Meta -Toluamide, Diethyltoluamide)-Containing Insect Repellent (OTC)

Store the repellent below 49° C (120° F). Store away from heat and flame.

Dermabond (2-Octyl Cyanoacrylate) Topical Skin Adhesive (RX)

Store the adhesive below 30° C (86° F). Discard if the package is open or has been tampered with. Discard the excess after use because the adhesive hardens on exposure to air. Protect from moisture and direct heat.

Dexamethasone Tablets and Oral, Injection, Implantation, Intravitreal, and Ophthalmic Solutions (RX)

Store tablets in a light-resistant container at a controlled room temperature. Protect from moisture. Store the oral solution in the original bottle and only dispense with the supplied calibrated dropper at a controlled room temperature. Once opened, the oral solution remains stable for 90 days. Discard if precipitation forms. Store the implantation, intravitreal, and ophthalmic solutions at room temperature. Extemporaneous formulations remain stable for 91 days.

Dextroamphetamine Tablets, Capsules, and Oral Solution (S II)

Store non-extended-release capsules and tablets at room temperature. Store extended-release capsules and tablets at a controlled room temperature. Store the elixir in an airtight, light-resistant container at room temperature.

Dextrose Oral Solution (OTC) and Injection (RX)

Store oral solution in a well-filled, airtight container. For injection, do not exceed 25° C (77° F). Do not freeze or expose to extreme heat. Discard if cloudy prior to use and discard any unused portions once open.

Diazepam Tablets, Oral Solution, Suppositories, and Injection (S IV)

Store tablets, oral solution, and suppositories at room temperature. Protect from light, heat, and moisture. Do not freeze the oral solution. Suppositories are stable for 8 months at 40° C (104° F) and can withstand at least three freeze-thaw cycles. Brief excursions are permitted to room temperature. Store the injection solution at a controlled room temperature. Do not refrigerate.

Digoxin Tablets and Injection (RX)

Store at a controlled room temperature. Brief excursions are permitted to room temperature. Protect from light. Protect tablets from moisture.

Diltiazem Tablets, Oral Solution, and Injection (RX)

Store tablets at 25° C (77° F). Brief excursions are permitted to 15° to 30° C (59° to 86° F). Avoid excess humidity. An extemporaneous formulation of a 1-mg/mL solution can be prepared using 250 mg diltiazem (2.5 mL of diltiazem hydrochloride stock solution) combined with dextrose, fructose, mannitol, sorbitol, or sucrose to a volume of 250 mL. A solution of 12-mg/mL diltiazem can be prepared by crushing 16 tablets of 90-mg diltiazem in 10 mL of 1 : 1 mixtures of Ora-Plus with either Ora-Sweet or Ora-Sweet SF or in 1 : 4 mixtures of flavored syrup with simple syrup and then bringing the solution to a total volume of 120 mL. Protect from light.

Diphenhydramine Tablets, Oral Solution (OTC), and Injection (RX)

Store at a controlled room temperature in a light-resistant container. Do not freeze oral and injection solutions.

Domeboro (Acetic Acid and Aluminum Acetate) Otic Solutions (OTC)

Store otic solutions in a tightly sealed container at either room temperature or under refrigeration. Protect from direct light, heat, and moisture. Do not freeze.

Dopamine Hydrochloride Injection (RX)

Store the injection in a light-resistant container. Discard if the injection has yellow-brown discoloration or if pH outside of the 4.0 to 6.4 range is detected, because these are indications of decomposition. Dopamine 6.4 mg/mL in 5% dextrose injection is stable at a controlled room temperature for up to 24 hours in ambient humidity and in the presence of light.

Doxycycline Capsules, Tablets, Oral Solution, and Injection (RX)

Store capsules and tablets in light-resistant containers at room temperature. Store doxycycline hyclate delayed-release tablets in light-resistant containers at a controlled room temperature. Brief excursions are permitted at room temperature. Store lyophilized powder in a light-resistant container at a controlled room temperature. Refrigerate in a light-resistant container immediately after reconstitution, or dilute the injection solution to 0.1 to 1 mg/mL within 12 hours after reconstitution, where it will remain stable for up to 48 hours at 25° C (77° F) and 72 hours at 4° C (39° F). Avoid direct sunlight during storage and infusion. Infusions of doxycycline made with lactated Ringer's or 5% dextrose in lactated Ringer's diluents must be used within 6 hours of reconstitution to ensure stability. Solutions of 10 mg/mL doxycycline in sterile water can be frozen and stored at −20° C (−4° F) and remain stable for up to 8 weeks. Avoid excess heat after thawing and discard any unused thawed solution.

Edoxaban Tablets (RX)

Store at a controlled room temperature. Brief excursions are permitted at room temperature.

EMLA (Lidocaine/Prilocaine) Topical Formulation (RX)

Store EMLA at room temperature. Do not freeze. Discoloration does not necessarily indicate lack of stability. Precipitate indicates that the solution is not stable.

Epinephrine Injection and Topical, Inhaled, and Intranasal Formulations (RX)

Store injection ampules at 5° to 25° C (41° to 77° F). Do not freeze. Injection ampules stored at 38° C (100° F) will last less than 3 months at low humidity (15%) and less than 4 months at high humidity (85%). An extemporaneous formulation of a topical anesthetic solution can be prepared with 2.25 mg/mL of racemic epinephrine hydrochloride, 40 mg/mL of lidocaine hydrochloride, 5 mg/mL of tetracaine hydrochloride, and 0.63 mg/mL of sodium metabisulfite. Store this topical solution in a light-resistant container at 18° C (64° F) for no more than 4 weeks, and at 4° C (39.2° F) for up to 26 weeks. Store the epinephrine inhaler at a controlled room temperature. Do not exceed 49° C (120° F). Do not puncture or incinerate the inhaler. Store the intranasal solution in a light-resistant container at 15° to 25° C (59° to 77° F). Do not freeze.

Erythromycin Tablets, Oral Solution, and Topical Ointment (RX)

Store tablets and oral solution at less than 30° C (86° F). Reconstituted granules must be used within 10 days. Reconstituted erythromycin ethyl succinate solution must be used within 14 days if kept at room temperature. Reconstituted EryPed solution should be stored at less than 25° C (77° F) and used within 35 days. Refrigeration of the suspension is encouraged for the best taste. Optimal stability is maintained at pH above 6.0, with significant decomposition at or below pH of 4.0. Store the topical ointment at less than 27° C (81° F).

Famotidine Tablets (OTC) and Injection (RX)

Store regular and chewable tablets at a controlled room temperature. Brief excursions for chewable tablets to room temperature are permitted. Protect from moisture. Store injection vials in a light-resistant container at 2° to 8° C (36° to 46° F).

Fentanyl Oral Lozenges, Sublingual Tablets, Sublingual Spray, Buccal Film, Injection, and Intranasal Formulation (RX)

Store oral lozenges, sublingual tablets, sublingual spray, and buccal film at a controlled room temperature. Brief excursions to room temperature are permitted. Protect from moisture. Do not freeze. Store the injection solution in a light-resistant container at a controlled room temperature. Store the intranasal canister in a light-resistant container at 2° C to 25° C (36° F to 77° F).

Fluocinolone Acetonide Topical Ointment, Otic Solution, and Shampoo (RX)

Store topical cream, ointment, and shampoo at room temperature. Do not freeze. Store the otic solution at a controlled room temperature.

Furazolidone Tablets and Solution (NA)

Store tablets and liquid in light-resistant containers. Tablets can be crushed and administered with a spoonful of corn syrup. Exposure to strong light may cause darkening.

Furosemide Tablets, Solution, and Injection (RX)

Store tablets and solution in light-resistant containers at 25° C (77° F). Brief excursions are permitted to 15° to 30° C (59° to 86° F). Protect from moisture. Store the injection solution in a light-resistant container at room temperature. Discard all types of furosemide if discoloration occurs.

Glucagon Injection (RX)

Store dry powder in a light-resistant container at a controlled room temperature. Do not freeze. Powder remains stable for 24 months. Use the injection solution immediately after reconstitution and discard unused portions.

Haloperidol Tablets and Injection (RX)

Store tablets in a tightly closed, light-resistant container at a controlled room temperature. Store the injection solution in a light-resistant container at room temperature. Do not freeze.

Hydrocortisone Tablets, Solution, Injection, and Topical Cream (RX)

Store tablets, oral solution, injection, and topical cream at room temperature in the original container. Protect from light, moisture, and heat. Do not freeze the oral solution or injections.

Hydromorphone Tablets, Solution, Suppositories, and Injection (S II)

Store tablets, solution, suppositories, and injectables in light-resistant containers at a controlled room temperature. Excursions are permitted to 15° to 30° C (59° to 86° F). Slight yellow discoloration of the injection liquid does not affect potency.

Ibuprofen Tablets and Solution (OTC)

Store the tablets at a controlled room temperature and the solution at room temperature.

Insulin (Regular) Injection and Inhaled Formulation (RX)

Store the subcutaneous and IV injections in a light-resistant container refrigerated at 2° to 8° C (36° to 46° F). Do not freeze. Store the open vials at room temperature for up to 31 days. Store inhalers refrigerated at 2° to 8° C (36° to 46° F). Store at room temperature for up to 10 days. Discard unused cartridges from an open blister pack strip after 3 days.

Intravenous Solutions (D 5 W, Ns, Lr, D 5 ns, and Other Admixtures)

Store solutions below 90° C (194° F) and preferably at room temperature for ease of use. Pure sodium chloride and lactated Ringer's solutions at concentrations used in medicine are unlikely to show precipitation at 0° C (32° F), or if frozen for 3 months.

Isoproterenol Hydrochloride Inhalant and Injection (RX)

Store the inhalation solution and injection in light-resistant containers at room temperature. The injection is stable indefinitely in normal saline. Avoid excessive heat. Discard inhalation or injection solution if pink or brown discoloration or precipitation occurs. Store isoproterenol (5 mg/L) in 5% dextrose in water at room temperature. This solution remains stable for 24 hours.

Ivermectin Tablets (RX)

Store below 30° C (86° F).

Kaletra (Lopinavir/Ritonavir) Tablets (RX)

Store tablets at a controlled room temperature. Brief excursions are permitted at room temperature. Once the tablet container is opened or tablets are exposed to high humidity, tablets remain stable for up to 2 weeks.

Ketoconazole Tablets, Shampoo, Foam, and Gel (RX)

Store tablets in light-resistant containers at a controlled room temperature. Protect from heat and moisture. Store the shampoo in a light-resistant container below 25° C (77° F). Store the foam in a light-resistant container at a controlled room temperature. Do not refrigerate. Avoid direct light. Store the foam at a controlled room temperature with excursions permitted to room temperature.

Store drops in a tightly sealed container below 30° C (86° F).

Lacosamide Tablets, Oral Solution, and Injection (RX)

Store at a controlled room temperature. Brief excursions are permitted at room temperature. The oral solution remains stable for up to 7 weeks after the bottle has been opened. Do not freeze. Once the injection is diluted, store at room temperature for up to 4 hours.

Lacrisert (Hydroxypropyl Methylcellulose) Ophthalmic Solution (RX)

Store drops in a tightly sealed container below 30° C (86° F).

Lemon Grass (Cymbogogon) Citronella Oil Topical Formulation (OTC)

Store at room temperature. Protect from heat, moisture, and direct light.

Levetiracetam Tablets, Oral Solution, and Injection (RX)

Store immediate-release tablets, extended-release tablets, and oral solution at 25° C (77° F). Brief excursions are permitted at room temperature. The injection diluted in solution in a polyvinyl chloride bag is stable for at least 24 hours. Discard the unused portion of the vial after opening.

Levofloxacin Tablets, Solution, Injection, and Ophthalmic Formulation (RX)

Store tablets at 15° to 30° C (59° to 86° F). Store the oral solution at 25° C (77° F). Brief excursions are permitted at 15° to 30° C (59° to 86° F). The injection solution remains stable for 72 hours if stored at or below 25° C (77° F). Injection solution can be diluted in plastic or glass containers, and then frozen at −20° C (−4° F), where it remains stable for up to 6 months. Thaw slowly (no hot water baths or microwaves) at 25° C (77° F) or under refrigeration at 8° C (46° F). Use immediately after thawing. Do not refreeze. Store flexible containers of premixed solutions in a light-resistant container at or below 25° C (77° F). Avoid excessive heat and do not freeze. Store levofloxacin 0.5% and 1.5% ophthalmic solutions at 15° to 25° C (59° to 77° F).

Lidocaine Injection and Topical, Intradermal, and Ophthalmic Solutions (RX)

Store injection solution in a light-resistant container at room temperature. Do not freeze. Do not reuse "one-time-use" injection bottles, because they lack methylparaben preservative. Store the topical gel and jelly at a controlled room temperature. Store the viscous topical preparation, topical patches, and intradermal powder in sealed original packaging at room temperature at 15° to 30° C (59° to 86° F).

Lidocaine/Epinephrine/Tetracaine (LET) Topical Solution (RX)

Store solution in a light-resistant container. The solution remains stable at 18° C (64° F) for 4 weeks, and at 4° C (39° F) for 26 weeks.

Lindane (Gamma-Hexachlorocyclohexane) Lotion and Shampoo (RX)

Store lotion and shampoo at a controlled room temperature.

Loperamide Hydrochloride Capsules (OTC)

Store capsules at 15° to 25° C (59° to 77° F). Placing the contents of 10 of the 2-mg capsules in hard fat, such as suet, leaf lard, or fatback lard, and rolling into shape can also create rectal suppositories of 20 mg loperamide.

Lorazepam Tablets, Oral Solution, and Injection (S IV)

Store tablets in a tightly sealed container at a controlled room temperature. Store oral solution at 2° to 8° C (36° to 46° F). Discard an opened bottle after 90 days. Store IM and IV solutions in light-resistant containers at 2° to 8° C (36° to 46° F).

Malarone (Atovaquone/Proguanil) Tablets (RX)

Store in a light-resistant container at a controlled room temperature. Brief excursions to room temperature are permitted.

Mannitol Injection (RX)

Store vials of mannitol solution and powder for reconstitution at a controlled room temperature. Discard the unused portion of the solution. Concentrations of 15% or more may crystallize when exposed to lower temperatures. To resolubilize crystals, place the vial in a heated water bath at 60° to 80° C (140° to 176° F) and shake occasionally. Using a microwave is not recommended, because the vial is likely to explode. Cool to room temperature before use. Do not heat the solution if a white flocculent precipitate forms after contact with PVC, because crystals will re-form rapidly.

Mebendazole Tablets (RX)

Store at 15° to 25° C (59° to 77° F).

Meperidine Hydrochloride Tablets, Oral Solution, and Injection (S II)

Store tablets and the oral solution at a controlled room temperature. Brief excursions are permitted to 15° to 30° C (59° to 86° F). Store the injection solution in a light-resistant container at a controlled room temperature.

Metoprolol Tablets, Oral Solution, and Injection (RX)

Store tablets at a controlled room temperature. Brief excursions are permitted to room temperature. An extemporaneous oral suspension solution can be created by combining 12 crushed 100-mg metoprolol tablets with a small amount of Ora-Sweet, Ora-Sweet SF, or Ora-Plus and bringing the volume to 120 mL with water. The suspension remains stable for 60 days under refrigeration. Shake well before use. Store the injection ampules in tight, light-resistant, moisture-free containers at a controlled room temperature.

Metronidazole Capsules, Tablets, and Injection (RX)

Store capsules at 15° to 25° C (59° to 77° F). Store extended-release tablets at a controlled room temperature. Brief excursions are permitted to room temperature. Store the injection solution in a light-resistant container at room temperature.

Midazolam Oral Solution and Injection (S IV)

Store oral solution at a controlled room temperature. Brief excursions are permitted to 15° to 30° C (59° to 86° F). Store injection solution at a controlled room temperature. The injection solution may be stored for at least 28 days at 3° to 25° C (37° to 77° F).

Modafinil Tablets (S IV)

Store tablets at a controlled room temperature.

Morphine Sulfate Tablets, Epidural Suspension, and Injection (S II)

Store tablets in light-resistant containers at a controlled room temperature. Excursions are permitted to room temperature.

Store the epidural extended-release suspension under refrigeration at 2° to 8° C (36° to 46° F). Do not freeze. Unopened vials remain stable for 30 days at a controlled room temperature. Do not return vials to the refrigerator once they have been stored at room temperature. Solution withdrawn from the vial can be stored at room temperature for up to 4 hours prior to administration. After that, all withdrawn solution should be discarded.

Store injection solution in the original carton at a controlled room temperature. Brief excursions are permitted to 15° to 30° C (59° to 86° F). Do not freeze. Discard any unused solution.

Pain cocktails containing preservatives without alcohol or chloroform water will remain stable for 3 weeks after compounding.

Moxifloxacin Tablets, Oral Solution, Injection, and Ophthalmic Route (RX)

Store tablets and injection solution at a controlled room temperature. Brief excursions are permitted to 15° to 30° C (59° to 86° F). Do not refrigerate injection solution because precipitate forms. Extemporaneous oral suspension can be formed to create 60 mL of 20 mg/mL moxifloxacin hydrochloride by combining three crushed 400-mg tablets with 30 mL of Ora-Plus, Ora-Sweet, or Ora-Sweet SF. When stored in a light-resistant amber plastic bottle, oral suspension remains stable for 90 days if stored at 23° to 25° C (73° to 77° F). Store 0.5% moxifloxacin ophthalmic solution at 2° to 25° C (36° to 77′ F).

Mupirocin Topical Formulation (RX)

Store cream and ointment at a controlled room temperature. Do not freeze cream.

Nalbuphine Hydrochloride Injection (RX)

Store injection solution in a light-resistant container at a controlled room temperature.

Naloxone Hydrochloride Injection (RX)

Store injection solution ampules and vials in original containers at a controlled room temperature. Use infusion solutions within 24 hours of opening. For Evzio, store between 15° and 25° C (59° and 77° F). Brief excursions are permitted to 4° to 40° C (39° to 104° F).

Neosporin Ointment (OTC)

Store ointment in the original container with the cap tightly sealed at room temperature. Protect from light, moisture, and heat.

Nifedipine Capsules, Tablets, Oral Solution, and Injection (RX)

Store capsules in a light-resistant container at 15° to 22° (59° to 77° F). Store tablets in a light-resistant container below 30° C (86° F). An extemporaneous formulation of an oral solution can be made by combining five nifedipine 10-mg tablets and soaking them in a small amount of 1% hypromellose for 5 minutes and then bringing the total volume to 50 mL with 1% hypromellose. Package the 1-mg/mL extemporaneous suspension in single-dose syringes stored in opaque black plastic bags. Solution remains stable for 28 days at 6° or 22° C (43° or 72° F).

Store injection solution in a light-resistant container below 25° C (77° F). Because the infusion is extremely light sensitive, the solution retains its potency for 1 hour in daylight and 6 hours in artificial light. Do not remove the vial from the container until immediately before use.

Nitroglycerin Capsules, Sublingual Tablets and Sprays, Injection, Patches, and Topical Formulation (RX)

Store capsules at room temperature. Store sublingual tablets and sprays at a controlled room temperature. Protect tablets from moisture. Sprays may have brief excursions to room temperature. Store concentrated nitroglycerin for injection solution in a light-resistant container at room temperature. Injection solutions in polyolefin containers can be stored at room temperature for at least 24 hours. Premixed nitroglycerin in either normal saline or 5% dextrose can be stored for 48 hours at room temperature and 7 days under refrigeration. The extemporaneous formulation of solutions with a concentration of 0.035 to 1 mg/mL in glass containers remains stable for 70 days at room temperature and 6 months under refrigeration. Store transdermal patches at room temperature. Store topical ointment at a controlled room temperature.

Norfloxacin Tablets, Oral Solution, and Ophthalmic Solution (RX)

Store tablets at a controlled room temperature in tightly sealed containers. Brief excursions to room temperature are permitted. Extemporaneous oral solution can be created by crushing three 400-mg tablets into a small amount of Ora-Plus and flavored syrup to taste and bringing the total volume to 60 mL to create a 20-mg/mL solution. Under experimental conditions, the suspension remains stable (containing ≥ 93% norfloxacin) for at least 56 days at a temperature of 23° to 25° C (73.4° to 77° F) or under refrigeration at 3° to 5° C (37.4° to 41° F). Store the ophthalmic solution at room temperature.

Ofloxacin Tablets, Injection, Ophthalmic Solution, and Otic Solution (RX)

Store tablets in a tightly sealed container below 30° C (86° F). Store single-use vials and premixed bottles of injection solution in light-resistant containers at room temperature. Brief exposure to temperatures up to 40° C (104° F) are permitted. Do not freeze. In diluted concentrations between 0.4 and 4 mg/mL and stored in a glass or plastic container, solution remains stable for 14 days under refrigeration at 5° C (41° F), or for 6 months frozen at −20° C (−4° F). Solution will remain stable for up to 14 days under refrigeration at 2° to 8° C (36° to 46° F) after thawing. Do not use hot water or a microwave oven for rapid thawing. Store ophthalmic and otic solutions at 15° to 25° C (59° to 77° F).

Penicillin G Procaine Injection (RX)

Store at 2° to 8° C (36° to 46° F). Avoid freezing. Injection is stable for 7 days at 25° C (77° F) and 1 day at 40° C (104° F). Wycillin remains stable for 6 months if stored at room temperature.

Penicillin GK and G Sodium Injection (RX)

Store penicillin GK vials at a controlled room temperature. Once they have been diluted, refrigerate for up to 7 days. Once prepared, penicillin G solutions remain stable and free from allergenic components for 24 hours at room temperature or under refrigeration. At a concentration of 40 million units/L, more than 90% potency was retained for 1 month for penicillin GK, and for 39 days for penicillin G when stored in PVC containers at −20° C (−4° F), and for 70 days for penicillin G under refrigeration.

Phenobarbital Tablets, Solution, and IM and IV Injections (S IV)

Store tablets, oral solution, and IM and IV injection solutions in tightly sealed light-resistant containers at a controlled room temperature. Protect oral solution and tablets from moisture. Slight discoloration is allowable. Discard the solution if there is more discoloration or any precipitation.

Phenylephrine Injection and Ophthalmic Solution (RX) and Nasal Spray (OTC)

Store injection solution in a light-resistant container at a controlled room temperature. Brief excursions to room temperature are permitted. Once it has been diluted, the solution is stable for 4 hours at room temperature and 24 hours if refrigerated. Store nasal spray in light-resistant containers at room temperature. Refrigerate ophthalmic solution. Discard all forms of phenylephrine if brown discoloration occurs or a precipitate forms.

Phenytoin Capsules, Tablets, Oral Solution, and Injection (RX)

Store capsules, tablets, and oral solution at a controlled room temperature. Keep extended-release tablets and oral solution in a light-resistant container. Do not freeze oral solution. Store phenytoin sodium injection solution at a controlled room temperature. The solution is usable while clear or faintly yellow. Discard if the solution becomes hazy or if a precipitate forms and persists at room temperature. Because phenytoin is more stable in saline than in dextrose, use or discard phenytoin in 5% dextrose solution within 2 hours of mixing.

Polysporin Ointment (RX)

Store at room temperature. Do not freeze.

Potassium Permanganate Astringent Solution (OTC)

Store solution in a tightly sealed container at 15° to 30° C (59° to 86° F).

Povidone-Iodine Solution (OTC)

Store solution at a controlled room temperature. Brief excursions are permitted to 15° to 30° C (59° to 86° F).

Prednisone Tablets and Oral Solution (RX)

Store tablets and oral solution at a controlled room temperature. Brief excursions to room temperature are permitted. Extemporaneous formulations should be stored at room temperature or under refrigeration, and will remain stable for 1 to 2 months.

Prochlorperazine Capsules, Tablets, Oral Solution, and Injection (RX)

Store capsules, tablets, and solution in tightly closed light-resistant containers at room temperature. Slight yellow discoloration is acceptable. Discard if more discoloration develops. If preparing an IV admixture, use it immediately or dissolve the prochlorperazine in a dextrose solution and store under refrigeration in a light-resistant container. Prochlorperazine 5 mg/mL or 10 mg/2 mL retained 100% potency when it was stored at room temperature in Tubex containers for 3 months.

Promethazine Capsules, Tablets, Solution, Injection, and Suppositories (RX)

Store capsules, tablets, and oral and injection solutions in a light-resistant container at a controlled room temperature. Light pink discoloration of white promethazine tablets does not indicate a significant loss of potency. Discard the solution if color or precipitate develops. Refrigerate suppositories. Suppositories remain stable at room temperature for 2 weeks, and under refrigeration for weeks.

Pseudoephedrine and Pseudoephedrine/Triprolidine Capsules and Tablets (OTC)

Store capsules and tablets in light-resistant containers at 15° to 25° C (59° to 77° F). Protect them from moisture.

Rivaroxaban Tablet (RX)

Store at 25° C (77° F). Brief excursions are permitted to room temperature.

Rocuronium Injection (RX)

Store at 2° to 8° C (36° to 46° F). Do not freeze. Injection solutions can be stored at a controlled room temperature for 60 days. Open vials should be used within 30 days.

Sildenafil Tablets (RX)

Store tablets at a controlled room temperature. Brief excursions are permitted to room temperature.

Simethicone Capsules, Tablets, Drops, and Ultrasound Suspension (OTC)

Store capsules, tablets, and drops in a light-resistant container below 40° C (104° F), and preferably at room temperature. Do not freeze.

Sodium Bicarbonate Tablets, Injection, and Suppositories (RX)

Store tablets at room temperature. Do not refrigerate. Store injection solution at a controlled room temperature in an airtight container to stop the solution from changing to sodium carbonate. Brief exposure to 40° C (104° F) does not affect stability or potency.

Sodium Sulfacetamide Tablets, Cream, Lotion, Ointment, and Ophthalmic Route (RX)

Store tablets and cream in light-resistant containers at 15° to 30° C (59° to 86° F). Do not freeze vaginal cream. Store 10% sulfacetamide topical lotion and ointment at room temperature. The lotion will remain stable for 4 months. Do not freeze. Store ophthalmic solution in a light-resistant container at 8° to 15° C (46° to 59° F). Discard if it becomes darkened.

Succinylcholine Injection (RX)

Store at 2° to 8° C (36° to 46° F). The injection solution is stable at a controlled room temperature for 14 days. Once it has been diluted, discard within 24 hours.

Temazepam Capsules (S IV)

Store capsules in light-resistant containers below 30° C (86° F). Protect from moisture.

Tetanus Toxoid, Tetanus Toxoid/Diphtheria/Acellular Pertussis, and Hyperimmune Tetanus Globulin Vaccine Solutions (RX)

Store vaccine solutions at 2° to 8° C (36° to 46° F). Do not freeze. The solutions are stable for 72 hours at a controlled room temperature.

Tetracaine Hydrochloride Ophthalmic Solution (RX)

Store ampules in light-resistant containers at 2° to 8° C (35.6° to 46.4° F) to prevent oxidation and crystallization. Tetracaine hydrochloride remains stable for 3 days at room temperature, and retains the original manufacturer's expiration date if returned to refrigeration. For topical "LET" solution information, see the Lidocaine/Epinephrine/Tetracaine entry.

Tetracycline Capsules, Tablets, Oral Solution, Injection, and Topical Ointment (RX)

Store capsules, tablets, oral solution, and topical ointment in light-resistant containers at room temperature. Reconstituted solutions are stable for 12 hours, and tetracycline hydrochloride is stable in 5% dextrose and water for 6 hours. Do not use outdated products, because they may cause proximal renal tubular acidosis and Fanconi's syndrome.

Tolnaftate Topical Antifungal Solution (OTC)

Store topical solution at room temperature. Solidification may occur at lower temperatures, but the solution reliquefies easily when warmed.

Triazolam Tablets (S IV)

Store tablets at a controlled room temperature.

Trimethoprim/Sulfamethoxazole (80 Mg/400 Mg) Tablets, Oral Solution, and Injection (RX)

Store tablets, oral solution, and unopened injection vials at a controlled room temperature. Protect tablets from moisture. Store the oral solution in a light-resistant container. Injection solution, including 80 mg trimethoprim in 100 mL D 5 W, is stable for 4 hours, but will last longer if it is more dilute. Vials drawn into a polypropylene syringe will remain stable for 60 hours. Do not refrigerate. Do not inject intramuscularly. Discard if cloudiness or precipitation develops.

Truvada (Emtricitabine/Tenofovir) Tablets (RX)

Store in a tightly closed container at 25° C (77° F). Brief excursions are permitted at room temperature.

Verapamil Hydrochloride Capsules, Tablets, and Injection Solution (RX)

Store verapamil sustained-release and all immediate-release tablets in a light-resistant container at 15° to 25° C (59° to 77° F). Immediate-release tablets remain stable for 3 years. Protect all tablets and capsules from moisture. An extemporaneous oral suspension of 50 mg/mL verapamil can be created from 20 of the 80-mg verapamil tablets in a 1 : 1 mixture of Ora-Plus with Ora-Sweet, Ora-Sweet SF, or flavored syrup mixture (1 : 4 concentrated flavoring to simple syrup). When stored in light-resistant amber polyethylene terephthalate bottles, the solution retains 91% potency for 60 days at 25° C (77° F) or under refrigeration at 5° C (41° F).

Store verapamil hydrochloride powder and premixed vials in a light-resistant container at room temperature. Protect from moisture. Discard unused portions of the injection solution.

Warfarin Tablets (RX)

Store in a light-resistant container at room temperature. Protect from moisture.

Zinc Salts (OTC)

Store zinc salts in an airtight, nonmetallic container. An extemporaneous formulation of an oral solution can be made up for zinc sulfate by combining 22 g of zinc sulfate powder with 250 mL of flavored syrup and bringing the total volume to 500 mL with purified water. The solution of 10 mg/mL zinc remains stable for 60 days under refrigeration, or for 12 months after addition of a paraben concentrate for a final zinc concentration of 0.5%.

Zolpidem Tablets, Sublingual Tablets, and Spray (S IV)

Store sublingual, immediate-release, and extended-release tablets and oral spray in a light-resistant container at a controlled room temperature. Protect from light and moisture. Brief excursions are permitted to temperatures of 15° to 30° C (59° to 86° F). Do not freeze.
_


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## SOCOM42 (Nov 9, 2012)

With the exception of the Ofloxacin Ophthalmic solution USP, 0.3%, all the others are in deep freeze suspension.

Have done culture plates with various stored items, even after 10-15 years they were still effective preventing staff growth

Others, injectables, are refrigerated down to 33-34 degrees.

As mentioned before any with "cycelene" in the name gets toxic after use by date.


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## ActionJackson (Sep 4, 2020)

CapitalKane49p said:


> Any, MDs, RNs, Nurse Practitioners, Pharmacists or Combat Medics out there?
> 
> SHTF Scenario.
> 
> ...


I avoid antibiotics if at all possible but I have taken them and will again under the most necessary conditions. Generally, I try to keep my immune system at an optimum level so my body can fight off infection naturally. I also seek standard, holistic, natural remedies for minor situations (tea tree oil; oil of oregano; vitamin C in heavy doses; echinacea; etc.)

Since I'm not familiar with modern antibiotic nomenclature, I don't know how to answer the rest of your question (not honestly, anyway).


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## spritey1964 (Jun 25, 2015)

I realize the question revolves around a SHTF scenario - are you all comfortable with taking fish antibiotics? I question it's sterilization vs. human drugs (& fillers that water down what you are getting vs. what you think you are).

I realize OTC v. Rx - but I was shocked on the answer on the fish stuff. 

Has anyone had to use it?

Thanks.


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## SOCOM42 (Nov 9, 2012)

If anyone is interested on where to get human grade antibiotics legally for a price, PM me for the info.

I have no interest in the place but am a customer for some of their products, and have been for many years.

I get the harder ones from Doc. brother remainder at this place. I have tested their potency with typical lab processes.

They were applied against known common bacterial forms such as staff aureus.


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## jimcosta (Jun 11, 2017)

*Spritey1964: *

We have a 50 person survival group completed and ready to go.

My Daughter-In-Law, a Pharmacist, is also a member. She checked out the FISH antibiotics for us and assures us they are safe and the real thing.
They are manufactured in the same batches as human antibiotics and are only available in human dosages. The only difference is they are packaged in FISH labeled bottles. To the Pharmaceutical company they are just another market but the same product.

One member did use one of them and it took care of his problem.
Attached is what I had my Daughter-In-Law give us in the way of *quick notes on their use* in the event she was not here.

*But you are looking for a real Comfort Letter*, not just a stranger's word for it, right?

Be aware that *James Wesley Rawles* is considered one of the founders of the Prepper movement. He has written numerous books on the subject.
His website is: SurvivalBlog.com

Be aware that Joe Alton, MD (also known as Dr. Bones) and his RN Wife Amy, have been helping Preppers in the area of medicine.
Their website is: Survival Medicine

Now see the article on *Antibiotic Substitutes *written by Dr. (Bones) Alton, also attached here.

Hope this comforts you.


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## spritey1964 (Jun 25, 2015)

Thank you. Please take no offense - I just don't believe everything on a blog. What you said makes sense, just unconventional. In an SHTF scenario. All things are different.


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## bigwheel (Sep 22, 2014)

Thanks for the links. My Grandaughter the Dr. Of Pharamacy at Walmart would have a fit to consider this nonsense and could lose her card if she got quoted too loud to say do it. Now my pld pal Les the Welder swears by those things and gets them at the feed store. Whos right? Not sure.


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## StratMaster (Dec 26, 2017)

spritey1964 said:


> I realize the question revolves around a SHTF scenario - are you all comfortable with taking fish antibiotics? I question it's sterilization vs. human drugs (& fillers that water down what you are getting vs. what you think you are).
> 
> I realize OTC v. Rx - but I was shocked on the answer on the fish stuff.
> 
> ...


I used it several times. I also researched, and the president/CEO of Thomas Labs said straight out on their website that the Fish Biotics were EXACTLY the same as the ones prescribed for humans. Off the very same production line, no difference whatsoever. They are REQUIRED to put "not for human consumption" on the label. I had a prescription from a dentist, and took the opportunity to compare the prescribed pharmas to the Fish variety: SAME gel capsules. SAME production codes. SAME. You can buy them and store them for future use with confidence.


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## bigwheel (Sep 22, 2014)

BamaDOC said:


> sorry about the long reply...
> I have access to a number of medical sources such as
> View attachment 108849
> 
> ...


Thanks Doc. Very interesting.


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## Dhamp40 (Nov 25, 2020)

I was wondering about regular medication u take but cant get extra to store. Is there substitute and how long do they last? What about meds that ur body gets physically addicted to. No not pain pills.


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## Dhamp40 (Nov 25, 2020)

One example trazadone


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## stevekozak (Oct 4, 2015)

Dhamp40 said:


> One example trazadone


Stop taking it, Why are you taking it? That is my advice.


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## paulag1955 (Dec 15, 2019)

Here is what I have stored: Metronidazole, Ciprofloxacin, Amoxicillin, Ketoconazole, Doxycycline. A recent addition: Azithromycin. 

Other than the Azithromycin, these are all drugs that have been prescribed for my dogs at some point (yes, they are sickly). So I'm well versed in the dosing guidelines for 80 pound German Shepherds. For humans not so much. I checked the expiration date on the Doxycycline I have on hand and it's in May of 2022. That's well beyond a year past my purchase date.


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## MisterMills357 (Apr 15, 2015)

Once again, I am out of my league. I can't make heads or tails out of some of the entries.


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## Eyeball (Nov 8, 2020)

Sc0rPs said:


> Just like to add you may not be able to get antibiotics without a prescription but you can still get ones for pets, which is the same thing.


That's a useful tip but I haven't got any pets so I doubt if I could get antibs from a vet.
Anyway is there any danger in taking meds that are only meant for animals?


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