The Storage & Stability Cheat Sheet
- 5 days ago
- 8 min read
How to Pick Up “Free” Marks on the PEBC MCQ Exam
Most people think they fail PEBC because of some obscure guideline they didn’t read.
But a quiet chunk of marks comes from boring, unsexy stuff:
Does this live in the fridge or at room temp?
Can I repackage this or does it need the original container?
How long is this good after opening?
Which antibiotic suspensions must be in the fridge… and which ones must not?
On paper, this looks like trivia.
On PEBC, it’s pattern recognition.
The good news: those patterns are predictable - once you know what to look for, you’ll see the same storage and stability rules recycled across questions.
30 Second Summary
This article is for you if storage questions (fridge vs room, original bottle vs blister) feel like random trivia.
You’ll learn a simple set of patterns for common drugs in Canada (insulin, Ozempic, biologics, Pradaxa, clarithro, etc.).
It shows you how to spot wrong answers fast when they say things like “all,” “always,” or “must be frozen.”
If you hate memorizing long lists but want easy marks on storage and stability, this article turns it into a small set of rules you can reuse.
A Tiny Set of Rules for a Big Chunk of Questions
In this post I want to give you a storage & stability framework you can carry into the written exam.
By the end, you’ll know how to:
Remember the 3 big storage conditions and what they actually mean in practice
Identify “special snowflake” products: original container only, light sensitive, don’t shake, fridge vs room temp after opening
Quickly decide if an answer option about storage is obviously wrong, unsafe, or too absolute
Turn random-looking bullets like “keep clarithromycin suspension at room temp” into reliable exam points
This isn’t about memorizing a phone book. It’s about learning a small set of rules that explain a lot of questions.
Where These Rules Come From
Look across current product monographs and patient info for the drugs you actually see every day, and you keep bumping into the same themes:
1. “Fridge First, Room-Temp Later” Injectables
Insulin analogues – typically stored in the fridge before first use; in-use pens/vials often allowed at room temperature for a limited period (exact days vary by product).
GLP-1 agonists (e.g., Ozempic® / semaglutide) – unopened pens: fridge.After first use: can be kept in the fridge or at room temperature for up to 56 days, then must be discarded.
Biologics (e.g., Humira® / adalimumab) – store 2–8 °C in the original carton, protect from light, do not freeze. For travel, can be kept at room temp (≤25 °C) for up to 14 days, then discarded if unused.
2. Original-Container-Only Products
These lose stability or are at risk if you move them into pill organizers or compliance packs:
Dabigatran (Pradaxa®) – must be kept in the original bottle or blister to protect from moisture; bottle has desiccant; “do not store in pill boxes or organizers.”
Nitroglycerin SL tablets – keep in the original glass bottle, tightly capped, protect from light and moisture.
3. Temperature-Flip Products
Some products deliberately change storage rules once dispensed:
Ozempic® – fridge before use; after first use, can be stored room temp (15–30 °C) or fridge for up to 56 days.
Humira® – fridge in original carton; optional single 14-day room-temp window, then discard if not used.
NuvaRing® – can be stored at room temperature (about 20–25 °C) for up to 4 months once dispensed; avoid >30 °C and direct sunlight. Many Canadian/pharmacy sources still store it refrigerated before dispensing to extend shelf-life.
4. Room-Temp-Only Suspensions
Big trap: not all suspensions belong in the fridge.
For example:
Clarithromycin suspension (Biaxin®) – room temp only, protect from light, do not refrigerate, discard after ~14 days.
(TMP/SMX and azithro suspensions are also commonly stored at room temp; always check product-specific guidance, but the overall pattern is “not every milky antibiotic goes in the fridge”.)
Put together, these aren’t random facts. They’re repeatable patterns you can exploit on exam day.
Let’s turn that into a step-by-step system.
The Storage & Stability Shortcut System
Step 1 – Know Your Three Temperatures
You still only need the three buckets:
Room temperature – think ~15–25 °C
Refrigerated – ~2–8 °C
Frozen – freezer (e.g., some vaccines/biologics at distribution level)
On a stem, ask:
“Is this a biologic, insulin, or peptide?”
Think fridge, maybe limited room-temp excursion (Humira, Ozempic, many biologics).
“Is this a standard tablet/capsule?”
Default room temp unless the product is specifically known to be fridge-only.
Anything like “store all insulin in the freezer” or “freeze Humira to keep it stable” is auto-wrong.
Step 2 – The Modern “Original Container Club”
Upgrade your mental list to drugs you see all the time:
Dabigatran (Pradaxa®)
Store 15–30 °C in the original package to protect from moisture.
Labels explicitly say: keep in original bottle/blister; don’t put into pill organizers.
Nitroglycerin SL tablets
Must be kept in the original glass bottle, cap tightly closed, protect from light and moisture.
⚠️ On an exam:
If an option suggests repackaging Pradaxa into a weekly blister → huge red flag
If they ask what not to put in a compliance pack:
Think PRN meds (e.g., zopiclone),
Original-container-only products (Pradaxa, nitro SL tabs),
Very moisture/light-sensitive meds.
Step 3 – Recognize “Temperature Flip” Patterns (Ozempic, Humira, NuvaRing)
PEBC loves products where storage rules change once opened or dispensed.
Common patterns:
Ozempic® (semaglutide)
Unopened: fridge only.
In use: can be kept in the fridge or at room temp (around 15–30 °C) for up to 56 days, then discard.
Humira® (adalimumab)
Standard: 2–8 °C in original carton, protect from light, do not freeze.
Travel: may be stored at room temp (≤25 °C) for up to 14 days, then must be discarded if unused.
NuvaRing®
At/after dispensing: can be stored at room temp (20–25 °C) for up to 4 months, away from heat and sunlight; many pharmacies keep stock in the fridge until sold.
This is how the exam would most likely phrase these types of questions:
“Which statement about Ozempic storage is correct?” “How long can Humira be kept at room temperature?” “Which statement about NuvaRing storage is accurate?”
If one option neatly captures that flip (e.g., “after first use, Ozempic may be stored at room temperature for up to 56 days”), that’s usually your boring-but-correct answer.
Step 4 – Respect the “Do NOT Fridge” Suspensions (Clarithro, etc.)
Common Example - Clarithromycin suspension (Biaxin®)
Store at room temperature, protect from light, do not refrigerate, discard after about 14 days.
Typical trap stem:
“Which statement about clarithromycin oral suspension storage is correct?” a) It must be refrigerated to maintain stability b) It must be frozen before reconstitution c) It should be stored at room temperature and not refrigerated d) It can be stored indefinitely after reconstitution if refrigerated
Decoder:
(a) contradicts modern guidance (“do not refrigerate”)
(b) obviously wrong.
(d) “indefinitely” is absurd; most suspensions are 10–14 days max.
(c) is exactly what current resources say → pick (c).
Same pattern applies to other room-temp-only suspensions (e.g., some TMP/SMX and azithro products): “not every white liquid belongs in the fridge.”
Step 5 – Tag the “Handle With Care” Modern Products
Build a “handle with care” mental list:
Nitroglycerin SL tablets – original glass bottle, tightly capped, away from heat, light, and moisture.
Humira® and similar biologics
Do not freeze, keep in original carton to protect from light, avoid extremes of heat/cold, and do not shake the prefilled pen/syringe.
Most biologic injectables (Shingrix, many monoclonals, etc.) – refrigerated, protect from light, do not freeze or shake, discard if cold-chain broken.
How this shows up on exam questions:
“Which auxiliary label is unnecessary for nitroglycerin SL tablets?”
“Which of the following storage instructions is most appropriate for Humira?”
“Which product specifically should not be repackaged into a pill organizer?”
If you treat these as a small rogues’ gallery, you grab easy marks whenever they appear.
Applied Example: How PEBC Might Test This
Example 1 – Ozempic Storage
Question (modernized, exam-style):Which statement about Ozempic® (semaglutide) pen storage is most accurate?
a. Ozempic pens must be kept frozen at all times to maintain stability.
b. Unopened Ozempic pens may be kept at room temperature until the expiry date on the box.
c. Unopened Ozempic pens should be stored in the refrigerator; after first use, the pen may be stored in the fridge or at room temperature for up to 56 days, then discarded.
d. Once opened, Ozempic must be discarded after 7 days, even if stored in the refrigerator.
Example 1 - Using the Framework
You know Ozempic is a GLP-1 injection: typically fridge before first use, then room temp allowed for a limited window (around 56 days).
(a) “must be kept frozen” → wrong.
(b) says unopened can be room temp long-term → contradicts monograph (unopened should be refrigerated).
(d) 7 days is way too short.
So (c) is your boring-but-correct answer.
Example 2 – Pradaxa and Pill Boxes
Question:Which statement about storing dabigatran etexilate (Pradaxa®) is most appropriate?
a. Pradaxa capsules can be removed from the original bottle and stored in a weekly pill organizer for convenience.
b. Pradaxa must be kept in its original bottle or blister packaging to protect from moisture and should not be stored in pill boxes.
c. Pradaxa capsules must be stored in the freezer to prevent degradation.
d. Pradaxa capsules should be stored in an open container to allow air circulation.
Example 2 - Using the Framework
Decoder:
Current guidance is clear:
Store between 15–30 °C in the original package to protect from moisture.
Keep the bottle tightly closed; do not transfer into pill boxes or organizers.
So:
(a) directly contradicts the monograph.
(c) “must be stored in the freezer” → wrong.
(d) “open container” is the exact opposite of what you want for a moisture-sensitive capsule.
(b) is the only answer aligned with real-world practice.
5-Minute Daily Drill (With Modern Molecules)
Here’s how to drill this with current Canadian-relevant drugs:
Build a tiny list of commonly used products you see at the pharmacy:
Ozempic, insulin glargine/degludec/detemir, Humira (and other common biologics), Pradaxa, nitroglycerin SL tabs, NuvaRing, clarithromycin suspension, Shingrix, etc.
Each day, pick 3 drugs and jot down:
Fridge vs room temp (before and after opening/dispensing)
Original container vs okay to repackage
Any crucial “do not” (do not freeze / do not shake / do not refrigerate / do not repackage)
Write one MCQ per drug using common trap patterns:
Over-absolute: “all,” “never,” “must always”
Unsafe: freezing biologics, repackaging Pradaxa, refrigerating clarithro suspension
Reversing pre- and post-opening rules
Quiz yourself the next day, then layer in 3 new drugs.
Within a week, you’ll:
Have your own mini-bank of modern, exam-style storage questions
Start seeing these topics as free marks, not trivia
Stack Storage With the Rest of the PEBC Prep Game
Storage & stability is just one sliver of the MCQ's content.
But notice what happened here:
We turned scattered bullets into patterns.
We turned “weird one-off facts” into MCQ frameworks.
We used your own notes and PEBC-style patterns to make written questions feel predictable.
That’s the whole idea behind my approach for Knowbly.
Now, do this for storage & stability, auxiliary labels, jurisprudence, documentation, DI questions, communication, and workflow - So you stop bleeding marks on the “soft” parts of the exam that everyone ignores until it’s too late.
If this post made storage questions feel simpler and more “obvious,” that’s your sign there are more easy marks waiting in the rest of the content available through Knowbly - you just need the right lens.
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