Extreme heat and some medicines can be a risky duo

WASHINGTON — Extreme heat can threaten your health in more subtle ways, by increasing the risk of heatstroke and amplifying the side effects of many common medications.

Hot weather can also damage medicines that need to be kept refrigerated, such as insulin. Inhalers may explode. Epinephrine injectors such as EpiPens may malfunction. Medicines delivered through the mail may deteriorate.

Let’s look at some common problems and solutions related to fever and medications.

Blood pressure medications that reduce fluid in the blood can lead to dehydration, while beta-blockers for heart disease can reduce blood flow to the skin, making it harder to sense dangerous heat.

Some antidepressants can interfere with your body’s ability to keep your body temperature down. Aspirin and other over-the-counter pain relievers can reduce fluid and sodium levels, making it harder to cope with a high fever.

What’s more, the combination of fever and medication side effects can make you dizzy and fall, and alcohol increases this risk, said Bradley Phillips, a pharmacist at the University of Florida College of Pharmacy.

For information on drug side effects and storage requirements, see the National Library of Medicine’s MedlinePlus website.

Or, talk to your doctor or pharmacist, says Phillips: If you’re taking medications that can make dehydration worse, ask them how much water you should drink.

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

Some medicines, such as antibiotics, antifungals, and acne medications, Increased sensitivity to the sunIf you do take it, make sure you’re under an umbrella or wear sunscreen or sunblock, says Mike Wren, MD, a family medicine physician at Baylor College of Medicine in Houston.

“You might be taking antibiotics, not really thinking about it, go to the beach and come home with a bad sunburn,” Len says.

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

Before a summer road trip, check the labels on your medications for storage conditions. When traveling by car, store your medications in a cooler, even if they don’t require refrigeration. The trunk or glove box of a car may get too hot to store them at room temperature.

Traveling by plane? It’s best to pack your medication in your carry-on luggage in case your checked luggage gets delayed or lost and the cargo hold gets too cold.

Mail order pharmacies are responsible for keeping medications at safe temperatures during storage and transportation. The best way to do this is to ship sensitive medications in special packaging with ice packs and temperature monitors.

But that’s not always the case, or deliveries can come at the worst possible time, said Wren, who recently helped his mother out by delivering a shipment of supplements to her Houston home during a heatwave in the region while she was on vacation.

“If you’re going to be at work all day or you’re on vacation and you’re getting your medication delivered, the last thing you want is for it to be sitting out in the blazing sun at 100 degrees Fahrenheit,” Wren says. If you think heat has damaged medication you bought through the mail, call the pharmacy to report the problem.

Yes. Researchers in the US and Australia have found that some of the common warnings about heat and medicines don’t have much scientific basis. Ollie Jay of the University of Sydney found that of 11 drug categories listed by the World Health Organization as a concern related to high fever, only four had any supporting evidence.

Rather than medication, he suggests behavioral changes such as avoiding hot places. “Just be a little more careful,” he said.

Dr. Renee Salas, an emergency physician at Massachusetts General Hospital, said as climate change accelerates, it’s important to know which medications are most dangerous in the heat.

“We don’t have the answer yet, and we need to find it quickly,” Salas said.