When the outside temperature feels like a fever, your medicines are at risk.
As record-breaking temperatures sweep the nation, it's hard to keep anything cool, especially if the power goes out.
And, try as you might, it's hard to find health products — from prescription drugs to over-the-counter pain relievers — that don't caution against storage in high temperatures.
The labels on many products specify storage at room temperature. What does that mean? Well, the Food and Drug Administration has told its inspectors that 75 to 77 degrees is the sweet spot.
Though the future may bring medicines that are resistant to heat, we wondered: What happens if you can't keep medicines at the recommended temperature?
We turned to Dr. Sarah Westberg, associate professor at the University of Minnesota College of Pharmacy, for some answers.
Here are highlights from our conversation, edited for length and clarity.
Q: Where is the best place to store prescription medications?
A: "Any medication, unless it specifies that it needs to be refrigerated, really needs to be kept at room temperature in a dry place away from heat, humidity and light. So the best place to keep medicines is in a medicine cabinet that's outside of the bathroom and not on top of a refrigerator where there's heat."
Q: What happens to medicine in the heat?
A: "You may lose some efficacy of that medication, but it's probably not going to be harmful. But nitroglycerin [used to treat chest pain in people with cardiovascular disease] is an important example. That could be potentially a life-saving medicine, and if it doesn't work that's a big problem, versus if your ibuprofen doesn't treat your headache as well, that's an inconvenience, but you'll survive."
Q: Are there any specific drugs that are extremely sensitive to heat, moisture, or sunlight?
A: "It's not great to leave any medicine in a locked car on a 100 degree summer day. The first one that comes to mind is nitroglycerin. People need to keep it in the original bottle, follow storage instructions, and replace it regularly, especially if it's exposed to heat or light, because it can degrade really quickly. Also, levothyroxine [a thyroid drug], not because it's particularly sensitive, but because people are sometimes sensitive to the dosing. So if they lose some of the efficacy of the drug, a small change in dose can sometimes cause a change in the way they are feeling."
Q: Do you have any advice for people who must carry medications with them in the heat of summer, like insulin, asthma inhalers or EpiPens?
A: "Pay attention to expiration dates. Expiration dates are always important, but especially if drugs aren't being kept at ideal conditions. Those expiration dates are based on storing as recommended. Keep them with you, and try to do the best you can. Don't leave them in your car. Take them with you in the more comfortable temperatures."
Q: What special medication storage precautions should be taken during power outages?
A: "The things to be most cautious with are medications that have to be refrigerated. If someone has rheumatoid arthritis and is on injectible medications that need to be refrigerated and their power goes out for a week, then they should be calling their pharmacy or calling the manufacturer of that drug to see what they recommend, especially because a lot of the injectibles that require refrigeration are really expensive. In some cases they might last longer at room temperature than you might think, in other cases they only have a 24 to 48 hour window before that drug is no longer good."
Q: Are there any drugs that are pretty impervious to summer heat?
A: "There probably are some, but most things are only tested for stability at room temperature. We don't always know how far you can push that one way or another, based on the science because there's not always a need to test it further."