Extreme heat and some medications can be a risky combination. Here’s what you need to know

Extreme heat can increase the danger of heat-related illness and threaten health in a more subtle way – by increasing the side effects of common medications.

Hot weather can also damage medications, such as insulin, that require refrigeration. Inhalers can explode. Epinephrine injectors such as EpiPens can malfunction. Medications delivered by mail may deteriorate.

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

Which medications can cause problems with heat?

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

Some antidepressants can hinder your ability to stay cool. Aspirin and other over-the-counter pain relievers reduce fluid and sodium levels, making it harder to cope with high temperatures.

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

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

Or talk to your doctor or pharmacist, Phillips said. Ask how much water you should drink if you are taking medications that increase dehydration.

He recommends staying hydrated and “don’t rely on your body’s ability to tell you you’re thirsty.”

Some medications (antibiotics, antifungals, and acne medications) can increases sensitivity to the sun, causing rashes and sunburn. If you use them, stay under an umbrella or wear sunscreen and sunscreen, said Dr. Mike Ren, a family physician at Baylor College of Medicine in Houston.

“Maybe take antibiotics, don’t think about it too much, go to the beach and then come back with no less than sunscreen,” Ren said.

How should medications be stored for travel?

Medications should generally be stored in a cool, dry place unless they require refrigeration. That can be a challenge when traveling.

Before a summer road trip, check labels for your medications’ storage requirements. Store medications in a cool box when traveling by car, even if refrigeration is not required. The trunk or glove box of the car may even become too warm for room temperature storage.

Traveling by plane? It is always best to keep medications in your carry-on bag in case your checked baggage is delayed or lost, and it may become too cold in the cargo hold.

What about prescriptions delivered by mail?

Mail order pharmacies are responsible for keeping your medications at a safe temperature during storage and transportation. The best practice is to ship sensitive medications in special packaging with cooling elements and temperature monitors.

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

“If you know you have to be at work all day, or you’re on vacation, and you’re getting medication delivered, you definitely don’t want to be sitting outside in the hot, 100-degree sun,” Ren said. If you think your mail order medication has been damaged by the heat, call the pharmacy to report the problem.

Is more research needed?

Yes. Researchers in the US and Australia say some of the common warnings about heat and drugs don’t have much scientific evidence. Ollie Jay of the University of Sydney found support for only four of the eleven medication categories listed by the World Health Organization as concerns about high heat.

He suggests behavior modification, not medications, such as staying out of the heat. “Be a little more careful,” he said.

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

“We don’t have that answer yet, and it’s one we need to figure out quickly,” Salas said.

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