Follistim AQ cartridges can stay out of the fridge for up to 3 months when stored at or below 77°F (25°C). This applies to both unopened cartridges and cartridges already in use, though once you puncture a cartridge with a needle for the first time, a separate 28-day clock starts regardless of temperature.
Room Temperature Storage Limits
Before first use, Follistim AQ should be refrigerated between 36°F and 46°F (2°C to 8°C). But the manufacturer allows storage at room temperature, defined as up to 77°F (25°C), for a maximum of 3 months. After 3 months at room temperature, the cartridge should be discarded even if it hasn’t expired yet. The earlier date always wins: if your cartridge expires in 6 weeks, that’s your deadline whether it’s been refrigerated or not.
Do not freeze Follistim. Freezing can damage the protein structure of the medication and make it ineffective. If a cartridge has been frozen, discard it.
Once You Start Using a Cartridge
After the first needle puncture, a Follistim AQ cartridge is good for 28 days. You can keep it refrigerated or at room temperature during that window, but it must be discarded after day 28 regardless. This is because puncturing the rubber stopper introduces a small risk of contamination over time, even with sterile technique.
Many people keep their in-use cartridge at room temperature for convenience and to reduce injection discomfort, since cold medication can sting more going in. This is perfectly fine within that 28-day window as long as the temperature stays at or below 77°F.
Why Temperature Matters
Follistim’s active ingredient, follitropin beta, is a protein. Proteins are sensitive to heat because elevated temperatures cause them to unfold and lose their shape, which is what allows them to work in your body. Research on follicle-stimulating hormone proteins shows that high heat rapidly destroys their biological activity. At moderate room temperature, this breakdown happens slowly enough that the medication remains effective within the 3-month window. Above 77°F, degradation accelerates in ways the manufacturer can’t guarantee against.
Follistim is also light-sensitive. Store it in its original packaging or in a dark place. Don’t leave cartridges sitting on a countertop near a window.
How to Tell If It’s Gone Bad
Before every injection, check the liquid in the cartridge. It should be clear and colorless. If you notice cloudiness, discoloration, or visible particles floating in the solution, do not use it. These changes signal that the protein has degraded or that contamination has occurred. A cartridge that looks normal is not guaranteed to be fully potent if it’s been stored outside recommended conditions, but visible changes are a definitive reason to discard it.
If You Accidentally Left It Out
If your Follistim sat on the counter overnight at normal room temperature, it’s almost certainly fine. The 3-month room temperature allowance gives significant flexibility for situations like this. The more important questions are how warm the environment was and how long the exposure lasted. A few hours or even a full night at typical indoor temperatures falls well within the approved range.
Where it gets more concerning is if the medication was exposed to heat above 77°F for an extended period. Left in a hot car in summer, sitting near a heat source, or stored in a room without air conditioning during a heat wave are all situations that could compromise the medication faster than the label accounts for. If you’re unsure, inspect the solution visually and contact your pharmacy or fertility clinic for guidance specific to your situation.
Traveling With Follistim
For short trips of a few days, a small insulated pouch with a cool pack is enough to keep Follistim in a safe range. Avoid placing the cartridge directly against an ice pack, since freezing is just as damaging as overheating. Wrap the cool pack in a cloth or use a pouch with a built-in barrier.
On flights, always carry Follistim in your carry-on bag. Checked luggage compartments can reach freezing temperatures at altitude, and you also risk losing the medication if your bag is delayed. TSA allows injectable medications through security with their original packaging and prescription label. A letter from your clinic can smooth the process but isn’t strictly required.
For longer trips, request a mini-fridge at your hotel. Most hotels will accommodate medical refrigeration requests at no extra charge. If that’s not an option, the 3-month room temperature window gives you flexibility as long as you keep the cartridge out of direct sunlight and away from heat sources.