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Short answer. FEFO stands for first expired, first out (WHO’s glossary writes “first expiry/first out”). It means the stock with the earliest expiry date is distributed or used before an identical item with a later expiry date, whatever order the two arrived in.
This guide is general information for lab, clinic and warehouse staff, not medical advice. It explains the term as regulators word it and turns that wording into a receiving-to-rotation checklist.
Definition and scope
The World Health Organization defines FEFO in the glossary of its guidance on good storage and distribution practices for medical products (WHO Technical Report Series No. 1025, Annex 7, 2020) as “a distribution procedure that ensures that the stock with the earliest expiry date is distributed and/or used before an identical stock item with a later expiry date is distributed and/or used.”
Two parts of that sentence matter in practice:
- Earliest expiry date decides the order. Arrival date, purchase date and shelf position do not.
- “Identical stock item”. FEFO compares like with like: two lots of the same product. It does not rank unrelated products against each other.
WHO also defines the expiry date itself: the date on the container, usually on the label, up to and including which the product is expected to remain within specifications if stored correctly. WHO notes it is established for each batch by adding the shelf-life to the date of manufacture. That is why two deliveries of the same product can carry different dates, and why FEFO needs the date recorded for each batch. See also expiry vs. expiration and lot numbers.
Scope note: Annex 7 addresses medical products. Read it as WHO’s guidance for medical products, not as a rule that automatically governs every laboratory reagent or device; your own quality system and the manufacturer’s instructions decide that.
How FEFO is used in practice
WHO’s storage guidance (section 12.30) says materials and medical products should be stored in conditions that assure quality is maintained, stock should be appropriately rotated, and the “first expired/first out” (FEFO) principle should be followed. The same annex adds record-keeping and checking duties (13.1 and 13.4) that make rotation possible: stock level records, kept on paper or electronically and updated after each operation, with periodic reconciliation; and checks of all stock at regular intervals to find items close to their retest or expiry date, with appropriate action such as removal from usable stock.
The US Centers for Disease Control and Prevention describes the same earliest-first idea for vaccines in its vaccine inventory management page, without using the word FEFO: doses with the earliest expiration dates are placed in front of those with later dates; stock is rotated at least once a week and each time a delivery is received; and expired products are removed immediately so they cannot be used by mistake. CDC’s page is vaccine-specific, so treat it as an illustration of the practice, not a general rule for other supplies.
Receiving-to-rotation checklist
The table lines up each step with the passage that supports it. It does not replace your own procedures.
| Stage | What the source says | Source |
|---|---|---|
| At receipt | Record the batch number and expiry date at the point of receipt, to facilitate traceability. | WHO TRS 1025 Annex 7, section 18 |
| Accepting goods | Medical products should not be supplied or received after their expiry date, or so close to it that it is likely to be reached before the products are used. | WHO TRS 1025 Annex 7, 18.37 |
| Keeping records | Maintain stock level records and update them after each operation; reconcile periodically. | WHO TRS 1025 Annex 7, 13.1 |
| Storing and issuing | Rotate stock and follow the first expired/first out principle; place earliest dates in front. | WHO 12.30; CDC vaccine inventory management |
| Rotation checks | Check all stock at regular intervals for items close to expiry; CDC’s vaccine page sets this at least weekly and at each delivery. | WHO 13.4; CDC |
| Expired stock | Remove from usable stock; CDC says remove expired vaccines and diluents immediately. | WHO 13.4; CDC |
For how this sits inside a wider system of storage zones and records, see medical warehouse zones, storage conditions and records and inventory control methods for labs and clinics.
Related concepts
- FIFO (first in, first out). Issues by arrival order. It matches FEFO only when older arrivals also expire first. The head-to-head is in FIFO vs. FEFO.
- LIFO (last in, first out). See FIFO vs. LIFO.
- Expiry date. The batch-level date defined by WHO above.
- Beyond-use date (BUD). CDC states that a BUD replaces the manufacturer’s expiration date but never extends it, and to always use the earlier date.
Where it matters for labs, clinics and supply decisions
FEFO only works if the date data exists. Without a batch number and expiry date captured at receipt, staff cannot tell which of two identical packs should go first, and an item close to expiry cannot be found at a rotation check. The checklist above therefore starts at the receiving dock rather than the shelf.
The BUD point is the practical edge case. If an item has a beyond-use date shorter than its printed expiry, the order should be ranked on the earlier effective date, as CDC’s rule to always use the earlier date implies. Whether a given supply category carries a BUD, and how it is set, is defined by the manufacturer or your own policy, not by FEFO itself. For shelf-life questions on a specific item type, see storing gloves: shelf life, conditions and rotation.
Common misunderstandings
FEFO is the same as LIFO or “last in, first out”
No. FEFO ranks by expiry date. WHO’s guidance does mention loading vehicles last in, first out (18.36) to save time when unloading, but that concerns transport loading, not which stock is issued from the store.
Arrival date is what counts
Not under FEFO. A later delivery with an earlier expiry date is issued first.
FEFO compares everything on the shelf
WHO’s wording is “identical stock item”: the comparison is between lots of the same item.
FEFO removes the need for expiry checks
No. WHO still calls for regular checks of all stock for items close to retest or expiry, and for removal from usable stock.
The printed expiry is always the effective date
Not where a beyond-use date applies; CDC says to use the earlier of the two.
FAQ
What is FEFO?
FEFO is first expired, first out: the identical stock item with the earliest expiry date is distributed or used first, as WHO’s glossary defines it.
What does FEFO meaning in a lab or clinic store come down to?
Record batch and expiry at receipt, store and issue by earliest expiry, check stock at regular intervals, and remove expired items from usable stock.
Is FEFO different from FIFO?
Yes. FIFO follows arrival order and FEFO follows expiry date. See the FIFO vs. FEFO comparison.
Sources
- World Health Organization, Good storage and distribution practices for medical products, WHO Technical Report Series No. 1025, Annex 7 (2020); glossary, sections 12.30, 13.1, 13.4, 18.36, 18.37. Date checked: 2026-11-03.
- Centers for Disease Control and Prevention, Vaccine Inventory Management. Date checked: 2026-11-03.
