Short answer: Vagifem and Imvexxy: 68-77°F (20-25°C), excursions 59-86°F (15-30°C), and Vagifem’s label adds “Do not refrigerate.” Estrace Cream: room temperature, protected from temperatures above 104°F (40°C). Intrarosa is the exception: 41-86°F (5-30°C), at room temperature or in the refrigerator. Sources: each label, section 16 or How Supplied, and the patient leaflets.
Vagifem and Imvexxy are estradiol vaginal inserts, Estrace is an estradiol vaginal cream, and Intrarosa is a prasterone (DHEA) vaginal insert. All four treat menopause symptoms in the vagina, and each label has its own storage line.
| Product | Section 16 | Patient leaflet | Packaging |
|---|---|---|---|
| Vagifem 10 mcg inserts | 20-25°C (68-77°F); excursions 15-30°C (59-86°F). Do not refrigerate. | Room temperature 68-77°F (20-25°C); excursions 59-86°F (15-30°C). Do not refrigerate. | Single-use applicators in blister packs; cartons of 8 or 18 |
| Imvexxy 4 mcg and 10 mcg inserts | 20-25°C (68-77°F); excursions 15-30°C (59-86°F) | Room temperature 68-77°F (20-25°C) | Opaque push-through blisters; cartons of 18 (starter) or 8 (maintenance); not child-resistant |
| Estrace Cream 0.01% | Room temperature, printed as 20-25°C (59-77°F); protect from temperatures above 40°C (104°F) | Room temperature, printed as 59-77°F (20-25°C); protect from temperatures above 104°F (40°C) | 1.5 oz (42.5 g) tube with a calibrated applicator |
| Intrarosa 6.5 mg inserts | 5-30°C (41-86°F); room temperature or refrigerator | 41-86°F (5-30°C); room temperature or refrigerator | 4 blister packs of 7 inserts (28), with 28 applicators |
Vagifem section 16.2 and its patient leaflet both end with “Do not refrigerate.” Imvexxy gives only the temperature, and its range starts at 59°F, so the fridge is outside it. Generic estradiol inserts carry their own labels; check the one from your pharmacy.
The Estrace label reads: “Store at room temperature 20° to 25°C (59° to 77°F). Protect from temperatures in excess of 40°C (104° F).” The patient leaflet says “between 59°F to 77°F (20°C to 25°C).” The two scales do not match: 20°C is 68°F, and 59°F is 15°C. This page quotes the label as printed. Keeping the tube at 68-77°F (20-25°C) fits both readings; your pharmacist can confirm.
The clear limit is the top one: keep the tube away from heat above 104°F (40°C), such as a hot car or a sunny windowsill. See the Estrace Cream dosing schedule, Imvexxy vs Estrace Cream and Estrace Cream vs Vagifem.
Yes. Intrarosa section 16.2: “Store at 41°F to 86°F (5°C to 30°C). Can be stored at room temperature or in the refrigerator.” The patient leaflet says the same. The label does not mention freezing; 41°F is the bottom of its range. The inserts are a solid fat, bullet-shaped insert used with a separate applicator, which is thrown away after use. See the Intrarosa dosing schedule, Intrarosa side effects and Osphena vs Intrarosa.
None of these needs an ice pack. Keep them in your carry-on, in the original blister pack or tube, and out of a hot car. Do not put Vagifem in the fridge at your destination. More on Vagifem, Imvexxy and Imvexxy vs Vagifem.