Beat the heat: Summer medication guidance from your pharmacist

Catherine Wymer, PharmD, is a senior clinical pharmacist at Inova 360° Concierge Medicine. As a board-certified ambulatory care pharmacist, she focuses on optimizing her patients’ health outcomes by promoting safe, effective and personalized medication use.

Warmer weather can change how your body responds to medications, and how your medications handle the heat. Here’s some medication considerations to add to your summer checklist.

 Increased sensitivity to sunlight

Some medications make you more sensitive to the sun, a reaction known as photosensitivity. Photosensitivity is different from a typical sunburn. It can cause an itchy, painful or swollen rash on skin exposed to sunlight. Reactions may develop within a few hours of exposure or up to several days later. Over 400 medications can potentially cause photosensitivity including these classes of commonly used medications:

• Antibiotics: tetracyclines (doxycycline), fluroquinolones (ciprofloxacin), sulfamethoxazole-trimethoprim (Bactrim®)
• Acne medications: tretinoin (Retin-A®), isotretinoin (Accutane®)
• Diuretics (water pills): hydrochlorothiazide, furosemide
• NSAIDs (pain and inflammation medications): ibuprofen (Advil®, Motrin®), naproxen (Aleve®)
• Cholesterol medications: simvastatin, atorvastatin, pravastatin, lovastatin
• Birth control pills and medications containing estrogen
• Sulfonylureas for diabetes: glipizide, glyburide

To reduce your risk, minimize time outside during peak sun hours, wear protective clothing and regularly apply broad-spectrum sunscreen with SPF 30 or higher.

 Risk of dehydration

Warmer weather can cause increased fluid loss due to excessive sweating, especially during heat waves or summer travel. Fluid loss may affect how your medications work, leading to dizziness, lightheadedness and an increased risk of dehydration. Examples include diuretics (water pills), blood pressure medications, lithium and some antidepressants such as sertraline and venlafaxine.

Dehydration may also affect medication levels in your body, increasing the risk of side effects or reducing the effectiveness of certain medications used to treat heart conditions, seizures and psychiatric disorders.

Additionally, some medications can affect your body’s ability to regulate temperature or reduce your ability to sweat. Examples include medications used to treat depression, weight loss, ADHD, bladder conditions, allergies, Parkinson’s disease and some psychiatric disorders. Reduced sweating, impaired temperature regulation, and warmer weather may increase your risk of overheating and dehydration.

To stay safe from heat-related illness, stay hydrated, wear loose-fitting, light-colored clothing and take breaks in air conditioned spaces.

 Keep your medications cool, too

Most medications are stored at room temperature between 68°F and 77°F, and kept away from heat, direct sunlight and moisture. Brief exposure to temperatures up to 86°F may be acceptable, but medications can rapidly break down when exposed to heat and humidity, making them potentially unsafe and less effective.

Refrigerated medications such as insulin, certain injectables and some eye drops are particularly sensitive to heat and may be stored at room temperature for a limited time. When traveling with refrigerated medications, use an insulated bag and avoid placing medications directly against ice packs to prevent them from freezing. Never leave medications in your parked car and always keep them in your carry-on bag in their original labeled containers when traveling.

If you have questions about your specific medications or storage requirements, consult your doctor or pharmacist.