Can extreme weather affect how your medications work?

When looking at your medication, packaging and labels will say how it should be stored. But, how important can the storage place of your medication be? How you store your medication – whether it’s in your home or while you’re traveling – can affect its effectiveness.
How does the temperature affect medications?
When medication is stored at an extremely hot or cold temperature, it can become compromised or degrade more quickly. Each medication is different. The impact of temperatures outside of the range recommended by the manufacturer varies by each drug and dosage form. By not storing your medication at the correct temperature, it can potentially lead to loss of potency or even reduce the effectiveness of the medication.
Do we need to worry about temperature with over the counter (OTC) medications?
When it comes to medications, each drug and dosage form is unique in its tolerance for extreme temperatures. Way back in the day, “pills” used to be made as rolled dough, clay or semi-solid material mixed with a powder or liquid drug product. You can imagine how well some of those might do on a hot summer day or cold winter night. We’ve come quite a long way with modern commercial pharmaceuticals and industrial methods.
Generally, solid dosage forms like tablets and hard-shell capsules are more resilient to fluctuation in temperature. However, liquid and injectable medications can be very susceptible to temperature extremes and even a relatively short time at a very cold or warm temperature can harm the drug product. Prescription biologic medications, such as monoclonal antibodies, are the most susceptible and worrisome with temperature extremes. Insulin is a common medication that can be impacted quickly by temperature. The expected impact of temperature extremes on medications is potential reduction in effectiveness. It’s also not just temperatures – light exposure, humidity and the storage container itself can sometimes cause problems with medications.
As chemical properties and drug formulation determine how susceptible the product may be, OTC medications can be just as easily affected by temperature extremes. Luckily, most of these products are dosage forms that are less likely to be impacted by temperatures. Most of the concern will be with prescription and specialty medications, particularly injectables and biologics.
Where is the best place to keep medication in your home and why?
Three factors are of the utmost importance in selecting a good spot: access, climate and personal routine. Always check medication packaging or labels for the recommended storage temperature. Due to the impact of temperature, light and humidity, it’s recommended to store non-refrigerated medications in a cool, dry place, like a kitchen cabinet away from heat sources such as the oven. Any storage place should prevent access to medications by children or pets. Contrary to popular belief, the bathroom medicine cabinet is often not the best place for most medications, as the humidity and moisture from showers and baths can be problematic. If you struggle to remember to take medications on time, consider keeping it in an obvious location that matches your routine – the bottle can act as a visual reminder.
How should you travel with medications?
A lot may depend on the method of travel and distance or time spent on the road. I recommend keeping medications in a carry-on or personal bag that you’ll have in your possession during the entire duration of the trip and will keep in controlled climate areas. Don’t leave these products in your checked luggage or a car overnight. Prescription medications should remain in their labeled container and OTCs can remain in their original packaging to ensure maximum protection from climate and the elements.
What if I get my medication shipped to me?
Increasingly, specialty pharmacies and insurance providers require patients to use mail order services. While there is a convenience in having medications delivered right to a patient’s door, this means that medications are spending more time in transit, where they can be exposed to inadequate storage conditions. Instead of just a supply chain from manufacturer to a brick and mortar pharmacy, there is now a second supply chain leg from the mail order pharmacy to the patient residence. This longer supply chain increases the amount of time that medication is exposed to some of those temperature extremes.
Mail order companies don’t always package medications consistently in order to protect them, meaning patients may not always see the same level of care of temperature protection. Attempt to minimize the time delivery packages remain outside, especially during winter months.  If you plan to be out of town, make sure a friend or neighbor can collect delivery packages and keep at a safe temperature as soon as possible to avoid extreme weather conditions.
If you notice that your medications look damaged or there is any concern that a medication may have been affected by something like extreme temperatures, you should contact a pharmacist who can provide information on whether it’s safe and effective to use the product.
Jeff Pilz is a specialty practice pharmacist at The Ohio State University Wexner Medical Center.

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