Hot Temperatures May be Hazardous to Your Rx Prescription Drugs & Medications

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Warning: Hot Temperatures May be Hazardous to Your Drugs
Your Medication Can be A Casualty of Heat Waves and Power Outages

By Mary Shomon,
Summer heat can degrade many common prescription medications
One casualty of heat waves and summer power outages that you may not realize is your prescription medication.

If you take any prescription drug, you need to be aware that storage at high temperatures can quickly degrade the potency and stability of many medications.

Most drugs are recommended to be stored at what's known as "controlled room temperature" -- an average of approximately 77 F. Some permit what are known as "controlled excursions" -- short periods to accommodate shipping, for example -- at temperatures up to 86 F for shorter periods.

For example, here are the storage recommendations for the nation's top four most-prescribed drugs (as defined by RxList.com):

•     * Lipitor (atorvastatin calcium): Store at controlled room temperature
•     * Toprol (metroprolol succinate): Store at controlled room temperature.
  
  • Excursions permitted to 59 to 86 F (15 to 30 C).
•     * Norvasc (amlodipine besylate): Store bottles at controlled room temperature.
•     * Synthroid (levothyroxine): Store at controlled room temperature;
  
  • excursions permitted to 59 - 86 F (15 - 30 C)

Controlled room temperature is defined by the U.S. Pharmacopeia (USP) as:
"A temperature maintained thermostatically that encompasses the usual and customary working environment of 20 to 25 C (68 - 77 F) that allows for brief deviations between 15 - 30 C (59 - 86 F) that are experienced in pharmacies, hospitals, and warehouses."

Summer heat, however, can expose your medications to dangerous temperatures that can potentially degrade your drugs -- and often, without your knowing.
For example:

•     * Your medication is stored in your home, and you are in an area of 90-degree plus heat and do not have air conditioning
•     * Your medication traveled in the airline luggage compartment
•     * Your medication was stored in a hot automobile
•     * You have experienced an extended power outage at your home
•     * Your pharmacy lost power for an extended period during a storm or power failure
•     * Your pharmacy turns off air conditioning when the store is closed
•     * You get your medications from a mail order pharmacy that ships regular mail, and drugs spend time in postal trucks, and in your mailbox

During summer, if you take prescription medications, pay particular attention to any unusual symptoms that may suggest your medication isn't working properly. These sorts of symptoms may be a sign that your medication has lost potency due to heat.


How to Protect Your Medication

To ensure that your medication is fresh, and fully effective, here are some summer pointers:

•     * Check the storage information for any medications you take so that you are aware of any temperature restrictions
•     * Carry medications on the airplane with you, instead of storing them in your checked luggage. (Always a good idea because of the risk of lost luggage). Note, however, that to avoid problems for domestic travel, the Transportation Safety Administration (TSA) recommends, but does not require, that your prescription medications be labeled to assist with the screening process. International travelers should travel with medicines in their original containers with pharmacy labels, so you can more easily pass through Customs checkpoints.
•     * If you are traveling by car, do not store medications in the trunk. Keep them in the car with you. Do not leave them in the car for extended periods.
•     * If you have experienced an extended power outage at your home, contact your pharmacist to find out whether your medication should be replaced.
•     * Ask your pharmacy what sort of plan they have in place to protect medications in the event of a power failure. Ensure that they do not turn off air conditioning when the store is closed
•     * If you have the choice, have mail order medications or Internet pharmacies ship to you by overnight delivery methods, and be there to accept the package.

What Should You Do if Your Medication Has Been Exposed to Excessive Heat?

1. Your first step? Talk to your pharmacist and see what he or she recommends.
2. Your next step should be a call to your health insurance company or HMO, who may be able to replace your medication, or reimburse you for a replacement prescription.
3. Finally, if your pharmacy and insurance company are unable to help you, contact the manufacturer.

According to drugmaker Abbott Laboratories' consumer hotline, it's possible -- not guaranteed however -- that Abbott and other drug makers may be able to offer some form of reimbursement for heat-damaged medications.


Note for Thyroid Patients
The consumer medical hotline for Synthroid's manufacturer, Abbott Labs, recommends that patients replace their thyroid medication if the pills have been stored at temperatures above 86 degrees for any length of time.

All the levothyroxine drugs -- such as Synthroid, Levoxyl, Levothroid, Unithroid, and generic levothyroxine -- should be stored away from light and moisture, and at a temperature no higher than 86 F.
This temperature guideline also applies to Cytomel (liothyronine), Armour (desiccated thyroid), and the antithyroid drugs PTU and methimazole. (NOTE: The synthetic T4/T3 drug Thyrolar (liotrix) should be refrigerated, at a temperature no higher than 46 F.)

Sources:
Rxlist.com
Synthroid Consumer Hotline call, August 2006
Transportation Safety Administration: Permitted and Prohibited Items/Air Travel
Transportation Safety Administration: Travelers with Disabilities and Medical Conditions
U.S. Pharmacopeia, "USP Quality Review No. 40, Revised 6/94, Storage Definitions" Online.

Mary Shomon, About.com's Thyroid Guide since 1997, is a nationally-known patient advocate and best-selling author of 10 books on health, including "The Thyroid Hormone Breakthrough: Overcoming Sexual and Hormonal Problems at Every Age," "The Thyroid Diet: Manage Your Metabolism for Lasting Weight Loss," "Living Well With Hypothyroidism: What Your Doctor Doesn't Tell You...That You Need to Know," "Living Well With Graves' Disease and Hyperthyroidism," "Living Well With Autoimmune Disease," and "Living Well With Chronic Fatigue Syndrome and Fibromyalgia."