How to manage medications in the heat

Summertime presents many opportunities for outdoor activities, from completing backyard projects to taking children or grandchildren to the playground. Yet if you are one of the millions of Americans who take prescription medications, all that fun in the sun can put your health at risk.

“It’s important to be aware of how heat and sunlight might affect medications you’re taking,” says Michelle Signs, DO, an internal medicine physician at MultiCare Advanced Primary Care – Spokane Valley. “Many common medications, even over-the-counter drugs, can make you more vulnerable to heat-related illnesses or increase your chances of experiencing a sunburn.”

Medications can lower your heat tolerance

When temperatures tick up, your body keeps cool in two ways. The first is sweating — as the sweat on your skin evaporates, it has a cooling effect. The second method is through dilating, or widening, blood vessels just underneath your skin. This allows your body to pump more blood closer to the skin’s surface, where it can release excess heat.

“There are a lot of medications that can interfere with these cooling processes,” Dr. Signs says. “They may restrict blood flow or make it harder for you to sweat. Some medications, like diuretics, will also make you pee more often, affecting your ability to stay hydrated. Some may also suppress feelings of thirst.”

Medications that can put you at risk for heat-related illnesses, such as heat stroke or heat exhaustion, include:

• Blood pressure and heart medications
• Antihistamines, such as Benadryl
• Decongestants, such as Mucinex and Sudafed
• Stimulants, such as Adderall
• Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs)
• Antipsychotics, such as haloperidol and risperidone
• Anticholinergics, which are used to treat a variety of illnesses including bladder problems, lung conditions, Parkinson’s disease and digestive health issues
• Diuretics, such as hydrochlorothiazide

Medications can increase skin sensitivity

Some medications can increase your skin’s sensitivity to the sun, putting you at risk for a severe sunburn, rash or other skin problems.

“This can happen for different reasons, but the most common is a phototoxic reaction — when ultraviolet light from the sun interacts with a drug in your body, causing an inflammatory response,” Dr. Signs says. “And it may not take much sun exposure for this extreme reaction to happen.”

Medications that can increase your sensitivity to the sun’s rays include:

• Antibiotics
• Oral antifungal medications
• Acne medications
• Diuretics

“It’s common for people to overestimate their physical abilities and underestimate how much high temperatures can affect them. If you’re outdoors and you start to feel dizzy, nauseous or faint, don’t push through it. It’s time to stop what you’re doing and go inside or seek shade.”

How to store medication safely

Intense temperatures or direct sunlight may cause some medications and medical products to break down and become less effective or lose their potency — a potentially dangerous situation.

“Insulin is a medication that should always be refrigerated,” Dr. Signs says. “The heat can also degrade some medications that you may be inclined to carry around with you in a pocket — like nitroglycerin tablets or albuterol inhalers.”

Other medications or medical products that may be affected by the heat include:

• EpiPens
• Antiobiotic suspensions (antibiotics mixed with liquids)
• Aspirin
• Birth control pills
• Glucose test strips

Dr. Signs and MedlinePlus recommend following these safe storage tips for medication:

Find a cool, dry place. Closely follow storage instructions for your particular medication, typically listed on the label. For medications that don’t need to be refrigerated, find a cool, dry place in a closet, cabinet or drawer. Don’t store medications in the bathroom — the constant heat and moisture can be harmful.

Don’t leave medications in the car. The interior temperature of a car can quickly rise to levels that are unsafe for storing medications. If you need to take temperature-sensitive medications with you, then you may want to use a cooler or some other type of insulated container. However, your medications should not come into direct contact with an ice pack, as extremely cold temperatures can also cause medications to degrade.

Don’t put medications in checked luggage. If you are traveling by plane, pack temperature-sensitive medications in your carry-on. A plane’s cargo hold is not temperature controlled.

Don’t take damaged medication. Avoid taking medications that look, smell or feel different than normal. Call your pharmacy, doctor or other health care provider to get a replacement refill.

Tips for managing your health in the heat

When the temperature rises, know how to protect yourself, particularly if you’re taking medications that increase your vulnerability to heat or sunlight.

Know your limits. It isn’t just medications that can put you at higher risk for experiencing a heat-related illness. Some conditions, including cardiovascular disease and diabetes, can make it harder for your body to cool off. And if you have suffered a heat-related illness or injury in the past, you’re more likely to have another occurrence.

“It’s common for people to overestimate their physical abilities and underestimate how much high temperatures can affect them,” Dr. Signs says. “If you’re outdoors and you start to feel dizzy, nauseous or faint, don’t push through it. It’s time to stop what you’re doing and go inside or seek shade.”

Stay hydrated. It isn’t just about drinking water — your body needs minerals called electrolytes to stay properly hydrated. Plain water does not contain these, and bottled water may not contain them in sufficient amounts.

Dr. Signs recommends drinking low-sugar electrolyte drinks or other beverages, such as iced tea or lemonade, along with water. One study found that beverages containing low amounts of sugar, fat or protein are likely to keep you more hydrated for longer than water alone.

Wear sunscreen and sun-protective gear.  The American Academy of Dermatology recommends wearing a broad-spectrum, water-resistant sunscreen (SPF 30 or higher), a wide-brimmed hat, loose-fitting clothing, sunglasses with UV protection and shoes that fully cover your feet. If possible, avoid or limit outdoor activity from 10am-4pm, when the sun’s rays are strongest.

Call your provider or pharmacist with concerns. If you have questions about what heat- or sunlight-related health effects a medication may have, call your pharmacist, doctor or other health care provider. Don’t stop or cut back on a prescribed medication without consulting your provider first.