How much medication should I keep on hand for emergencies?

The CDC recommends at least a three-day supply as an absolute minimum, but Ready.gov and the Red Cross recommend at least a two-week supply for older adults. If you live in an area prone to hurricanes, winter storms, or other events that can disrupt pharmacy access for extended periods, a 30-day buffer is a reasonable target. Talk to your doctor about writing prescriptions for a 90-day supply where insurance allows it, and refill before you run low rather than waiting until the last few days.

How long can insulin stay unrefrigerated during a power outage?

According to the FDA, insulin in vials or cartridges (opened or unopened) can remain unrefrigerated at temperatures between 59 and 86 degrees Fahrenheit for up to 28 days and continue to work. Above 86 degrees, insulin loses effectiveness gradually. Under emergency conditions, you may still need to use insulin stored above that range, but replace it as soon as properly stored insulin becomes available. Never use insulin that has been frozen.

Can a pharmacist refill my prescription early during an emergency?

In most states, pharmacists can provide emergency refills of maintenance medications when the prescriber cannot be reached. During a declared state of emergency, many states expand this authority to allow up to a 30-day supply of non-controlled medications without prescriber authorization. Policies vary by state and do not typically apply to Schedule II controlled substances. Ask your pharmacist about your state's emergency refill policy before you need it.

What should be on a medication list for emergencies?

For each medication: the drug name (brand and generic), the dose, how often you take it, what it treats, the prescribing doctor and their phone number, and the pharmacy name and phone number. Also include over-the-counter medications taken regularly, known drug allergies, and any medications that require refrigeration or special storage. Keep a copy in your wallet, a copy on your refrigerator, a copy in your emergency bag, and a copy with the person who would need to take over your care.

Medication Preparedness for Older Adults

Why this is the defining issue

About 80% of older adults have at least one chronic condition.

Heart disease, diabetes, hypertension, COPD, atrial fibrillation, thyroid conditions. Each one depends on medication that works because it is taken consistently, at the right dose, at the right time. A three-day disruption in blood thinners, insulin, or blood pressure medication can cause a medical emergency that no amount of stored water or flashlight batteries will solve.

The CDC has noted that adverse events are significantly more likely when essential medications for chronic disease are unavailable during an emergency. Insulin and blood thinners are among the most frequently cited examples, but any maintenance medication that keeps a condition stable can become a crisis when it runs out.

This guide covers the full medication preparedness chain: knowing exactly what you take, maintaining a reasonable supply, storing it properly, protecting refrigerated medications during outages, and making your medication information accessible to the people who might need to take over your care.

Sources used in this guide

FDA: Safe Drug Use After a Natural Disaster
FDA: Insulin Storage and Switching Between Products in an Emergency
CDC: Emergency Preparedness for Older Adults
Ready.gov: Older Adults; Tips for Medications
American Red Cross: Older Adults Emergency Preparedness
CDC Preventing Chronic Disease: Disaster Preparedness and Chronic Disease Needs of Vulnerable Older Adults (2008)

Step 1

Write the list. Keep it current.

The FDA and Ready.gov both emphasize keeping an up-to-date list of all medications. This list is the single most important medication preparedness tool you own. A first responder, an emergency room doctor, a pharmacist in another city, or a family member stepping in to help can only work with information they can see.

For each prescription medication

Drug name (both brand and generic)
Dose (e.g., 10 mg, 500 mg)
Frequency (e.g., twice daily, once at bedtime)
What it treats (e.g., blood pressure, blood sugar)
Prescribing doctor and their phone number
Pharmacy name, phone number, and prescription number
Whether it requires refrigeration or special storage

Also include

Over-the-counter medications taken regularly
Vitamins and supplements
Known drug allergies and adverse reactions
Food allergies that affect medication (e.g., grapefruit interactions)
Insurance information: Medicare, Medicaid, or private plan
Date the list was last updated

Keep a copy in your wallet, a copy on the refrigerator, a copy in your emergency bag, and a copy with the person who would take over your care. Update it whenever a medication changes.

Step 2

Build a buffer. Refill before you need to.

The CDC recommends at least a three-day supply as an absolute minimum. Ready.gov and the Red Cross recommend that older adults maintain at least a two-week supply. If you live in an area prone to hurricanes, winter storms, or flooding, a 30-day buffer is a reasonable target.

01

Refill at 50%, not 10%

The simplest habit change: refill when you are halfway through the current supply rather than waiting until the last few days. Most pharmacies and insurance plans allow refills when 75% of the supply period has elapsed.

02

Ask about 90-day prescriptions

Many insurance plans, including Medicare Part D, allow 90-day supplies for maintenance medications, often through mail-order pharmacies. This naturally builds a larger buffer and reduces the number of refill trips.

03

Know your state's emergency refill law

In most states, pharmacists can provide emergency refills of maintenance medications when the prescriber cannot be reached. During a declared emergency, many states allow up to a 30-day supply without prescriber authorization. Ask your pharmacist about your state's policy before you need it.

Important note on controlled substances

Emergency refill laws generally do not apply to Schedule II controlled substances (certain pain medications, stimulants). If you take a controlled substance, talk to your prescriber about maintaining an adequate supply and having a written backup plan in case your pharmacy becomes inaccessible. Some prescribers will write a letter explaining your need for the medication that you can carry with you during an evacuation.

Step 3

Store medications properly.

The FDA advises that drugs exposed to excessive heat, flooding, or contaminated water may need to be replaced. Proper everyday storage reduces the risk that a power outage or weather event destroys your supply.

Everyday storage

Most medications should be stored in a cool, dry place away from direct sunlight. The bathroom medicine cabinet is one of the worst locations because of humidity and temperature swings. A bedroom closet shelf or a kitchen cabinet away from the stove is usually better.

The FDA recommends that if flooding is a possibility, store medication bottles in watertight containers such as plastic bins with lids. Drugs exposed to flood or contaminated water should be discarded, even if the containers appear sealed, because screw-top caps and snap lids do not provide a reliable water barrier.

Medications that need refrigeration

Some medications require refrigeration to maintain potency. Insulin, certain liquid antibiotics, some eye drops, and certain biologic medications fall into this category. Ready.gov recommends having a cooler and chemical ice packs available for these medications in case of a power outage.

The FDA advises that if power has been off for an extended period, temperature-sensitive drugs should be replaced as soon as possible. However, if a refrigerated medication is absolutely necessary to sustain life, such as insulin, it may be used until a new supply is available.

During a power outage

What the FDA says about insulin without refrigeration.

FDA guidance

Insulin in vials or cartridges (opened or unopened) can remain unrefrigerated at temperatures between 59 and 86 degrees Fahrenheit for up to 28 days and continue to work. Manufacturers recommend storing unopened insulin in a refrigerator at approximately 36 to 46 degrees Fahrenheit; stored this way, it maintains potency until the expiration date on the package.

Above 86 degrees Fahrenheit, insulin loses effectiveness gradually. The longer the exposure to extreme temperatures, the less effective it becomes. Under emergency conditions, you may still need to use insulin stored above 86 degrees, but you should try to keep it as cool as possible and replace it with properly stored insulin as soon as it becomes available.

Insulin in the infusion set of a pump device should be discarded after 48 hours, or immediately if exposed to temperatures above 98.6 degrees.

Never use insulin that has been frozen. Freezing destroys its effectiveness permanently.

Source: FDA, "Information Regarding Insulin Storage and Switching Between Products in an Emergency." Accessed August 2026.

Keeping insulin cool without power

A cooler with ice packs (avoid direct contact between insulin and ice to prevent freezing)
An evaporative cooling case such as the FRIO, which activates with water and maintains lower temperatures for up to two days
A dark interior closet or basement, which is typically the coolest area of a home without air conditioning

Other refrigerated medications

Certain biologic medications, some liquid antibiotics, some eye drops, and certain injectable medications also require refrigeration. The temperature sensitivity and safe windows vary by product.

If you take a refrigerated medication other than insulin, ask your pharmacist or call the manufacturer before an emergency to learn how long it remains effective without refrigeration and at what temperature it must be discarded. Write this information on your medication list.

Step 4

The medication bag that goes with you.

If you need to leave your home, your medications need to leave with you. A small bag or pouch kept in the same place at all times, ready to grab, makes the difference between an orderly departure and a frantic search through cabinets.

What goes in the medication bag

A current printed medication list (the one from Step 1)
At least a 7-day supply of each prescription medication in its original labeled container
An insulated pouch or cooler bag for refrigerated medications, with an ice pack stored in the freezer
Copies of Medicare, Medicaid, or insurance cards
Doctor and pharmacy contact information
A list of medical conditions, surgeries, and implanted devices
Blood glucose monitor and test strips (if applicable)
Syringes or other administration supplies
A pillbox pre-loaded with at least 3 days of sorted daily doses

Keep this bag near the door, near your car keys, or wherever you would naturally grab it on the way out. Some people keep it inside a larger emergency bag. The important thing is that it is always in the same place and always current.

Step 5

Someone else needs to be able to take over.

The Red Cross recommends that older adults establish a support network of at least three people who will check on them in an emergency. Those people need to know your medications, or at minimum, they need to know where to find the list.

Where to put your medication list

In your wallet or purse (a folded card)
On your refrigerator (the first place many EMTs look)
In your emergency medication bag
With your primary caregiver or emergency contact
In your household records binder
As a photo on your phone (backup, not primary)

What a caregiver needs to know beyond the list

Which medications are taken with food and which on an empty stomach
Which medications must not be missed (e.g., blood thinners, anti-seizure)
Signs that a medication is not working (e.g., blood sugar symptoms)
How to use any delivery devices (injector pens, inhalers, nebulizers)
Where the medications are physically stored in the home

After a disruption

Inspect, replace, do not assume.

Discard medications that have been

Exposed to flood or contaminated water, even in sealed containers
Exposed to excessive heat from a fire
Frozen (especially insulin)
Visibly changed in color, consistency, or smell

Source: FDA, "Safe Drug Use After a Natural Disaster." Accessed August 2026.

The exception for life-sustaining medications

The FDA acknowledges that a medication may be needed to treat a life-threatening condition when a replacement is not yet available. In those cases, if the medication appears unchanged (for example, pills in a wet container appear dry), it may be used until a replacement can be obtained.

This is an emergency measure, not a storage strategy. Replace affected medications as soon as possible and contact your prescriber about whether dosing adjustments are needed.

This week

Five things to do right now.

1

Write your medication list. All of it. Include the pharmacy, the doctor, and the insurance. Date it.

Time: 20 minutes

2

Check how many days of each medication you have on hand right now. Refill anything under 7 days.

Time: 10 minutes

3

Put a copy of the medication list on the refrigerator, in your wallet, and in your emergency bag.

Time: 5 minutes

4

Give a copy of the list to the person who would take over your care in an emergency. Tell them where the medications are stored.