Before the first dose

Medication safety checklist

Eight things to check when a pen arrives. They take about three minutes and they catch the failures that are actually common — a broken cold chain, a tampered box, a pharmacy that is not on the register.

Have these in front of you

  • The pen, still in its box
  • The packaging it was delivered in
  • The patient information leaflet
  • The name of the pharmacy that dispensed it

Work down the list in order. The moment a line fails, stop there — do not carry on to the next group, and do not inject anything while you are waiting for an answer.

Group 1 of 3 — the pharmacy

Who actually dispensed it

  • ✓ Registered. The dispensing pharmacy appears on the GPhC register, or the PSNI register in Northern Ireland. The trading name on the website is often not the name on the register — that is normal, but the registration should still resolve.
  • ✓ Named. The paperwork names a pharmacy and a responsible pharmacist, not just a brand.
  • ✓ Assessed. You completed a consultation before the order was accepted. A site that sells a prescription-only medicine without one has skipped the step that matters most.

Our provider directory lists the date we last checked each pharmacy against the register.

Group 2 of 3 — the package

What arrived at the door

  • ✓ Sealed. The box is intact, with no sign of opening, resealing or damage in transit.
  • ✓ In date. The expiry date is printed clearly and has not passed — with enough margin left to finish the pen.
  • ✓ Cold on arrival. It came in insulated packaging and was still cold when you opened it. These medicines are refrigerated products; a warm parcel is a broken cold chain, not a minor detail.

Group 3 of 3 — the pen itself

What is inside the box

  • ✓ Right medicine, right dose. The label matches what you were prescribed, including the strength. Starting doses are deliberately low; a pen that skips ahead is wrong even if the name is right.
  • ✓ Clear liquid. The solution in the cartridge is clear and colourless. Cloudy, discoloured or visibly particulate liquid is a fail.
  • ✓ Leaflet included. The patient information leaflet for that product is in the box, in English, and matches the pen.

Stop — do not use

If any line above fails, do not inject it

Put the pen back in the fridge if it is still cold, keep the packaging exactly as it arrived, and contact the pharmacy that dispensed it. Photograph anything that looks wrong before you send it back — it is the only record you will have.

If you have already injected from a pen that fails one of these checks, or you feel unwell afterwards, contact your prescriber or a pharmacist. Call NHS 111 if you are unsure how urgent it is, and 999 for severe symptoms such as difficulty breathing or swelling of the face or throat.

What this checklist cannot do

Passing every line tells you the supply chain looks sound. It does not tell you the medicine is right for you, that the dose is correct for where you are in titration, or that it is safe alongside anything else you take. Those are judgements for the prescriber who assessed you, and nothing on a comparison site replaces them.

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