Extreme heat and some medications can be a dangerous combination

Houston-Sydney-Massachusetts – Extreme heat can increase the danger of heat-related illnesses and, more subtly, threaten health by amplifying the side effects of many common medications.

Heat can also damage medications such as insulin, which requires refrigeration. Inhalers can explode. Epinephrine injectors, such as EpiPens, can malfunction. Medications that are shipped through the mail can deteriorate.

A look at common problems and solutions related to heat and medicine:

What medications could cause problems with heat?

Blood pressure pills that reduce fluid in the blood can cause dehydration. Beta-blockers for heart conditions can reduce blood flow to the skin and make you less aware of dangerous heat.

Some antidepressants can make it harder to stay calm. Aspirin and other over-the-counter pain relievers reduce fluid and sodium levels, making it difficult to manage high temperatures.

In addition, the combination of heat and medication side effects can lead to dizziness and falls. Alcohol increases the danger, said pharmacist Bradley Phillips of the University of Florida College of Pharmacy.

Learn more about your medications’ side effects and storage requirements at the National Library of Medicine’s MedlinePlus website.

Phillips said you can also check with your doctor or pharmacist. Ask how much water you should drink if you take medications that increase dehydration.

He recommends staying hydrated and “not relying on your body’s ability to tell you that you’re thirsty.”

Some medications (antibiotics, antifungals, and acne) can increase sun sensitivity, leading to rashes and burns. If you’re taking them, stay under an umbrella or wear sun-protective clothes and sunscreen, said Dr. Mike Ren, a family physician at Baylor College of Medicine in Houston.

“You may be on antibiotics, not think too much of it, go to the beach and then come back with a huge sunburn,” Ren said.

How should travel medications be stored?

Generally, medications should be kept in a cool, dry place unless they need refrigeration, which can be tricky when traveling.

Before a summer road trip, check labels for storage requirements for your medications. Carry medications in a cooler when traveling by car, even if they do not require refrigeration. The trunk or glove compartment of the car may become too hot to store them, even at room temperature.

Traveling by plane? It is always best to carry medications in carry-on luggage if checked luggage is delayed or lost, and it may be too cold in the cargo hold.

What about mailed prescriptions?

Mail-order pharmacies are responsible for keeping medications at safe temperatures during storage and transport. The best practice is to ship sensitive medications in special containers with ice packs and temperature monitors.

But that doesn’t always happen. Or delivery can come at a bad time, said Ren, who recently helped his vacationing mother by bringing her shipment of supplements to her Houston home as the region faced sweltering heat.

“If you know you’re going to be at work all day or if you’re on vacation and you’re having medications delivered to your home, you definitely don’t want them outside in the scorching 38-degree sun,” Ren said. If you think the heat has damaged your mail-order medication, call the pharmacy to report the problem.

Is more research needed?

Yes. Researchers in the U.S. and Australia say some of the usual warnings about heat and medications don’t have much scientific evidence to back them up. Ollie Jay of the University of Sydney found support for only four of the 11 categories of medications that the World Health Organization lists as of concern in relation to intense heat.

He suggests changing behaviors, not medications, such as not exposing oneself to heat. “You have to be a little more cautious,” he said.

Dr. Renee Salas, an emergency physician at Massachusetts General Hospital, said that as climate change accelerates, there is a need to know which medications are the most risky in the heat.

“We don’t have that answer yet, and it’s one we need to figure out quickly. Some medications (antibiotics, antifungal and acne medications) can increase sensitivity to the sun, leading to rashes and burns.ente,” Salas said.