NAPLEX Question of the Week: Storage and Pill Organizers

An important part of pharmacy practice is proper storage of medications. This week's question focuses on this area.
NAPLEX Question of the Week: Storage and Pill Organizers

A 65 year old female stops by the pharmacy to pick up a pill organizer to help organize her medications. She currently takes enteric coated aspirin 81mg daily, Plendil 5mg daily, Micardis 80mg daily, Lipitor 80mg HS, Centrum multivitamin, and Allegra 180mg daily. Which of her medications should not be stored outside of its original packaging in the pill organizer?

A. Plendil

B. Centrum multivitamin

C. Allegra

D. Micardis

E. All of these may be stored safely in the pill organizer

The correct answer is D. Area 5.6 of the Naplex Competency statements is "Packaging, Storage, Handling, or Disposal": https://nabp.pharmacy/programs/examinations/naplex/competency-statements-2021/. Micardis (or Micardis HCT) is should be dispensed to each patient in individual foil packaging due to the hygroscopic nature of the medication. Removing the medication from the packaging could cause loss of potency and loss of effectiveness. Therefore this medication if stored in a pill planner would have to be stored in its foil packaging until just before use. Another example of this would be Maxalt-MLT used for migraines. 

Many medications, especially when administered in the inpatient setting,  may be packaged as individual tablets/capsules but this is for convenience only and not due to strict storage requirements. If you work in a community pharmacy, take note of specific storage used for medications so you can commit to memory unique conditions for storage or handling.

Happy Independence Day!

Dr. B