Extreme heat can be taxing on the body, causing mild fatigue and headaches to severe dehydration and heat stroke.
Hot weather in Hampton Roads often sends hundreds of people to local urgent care or emergency rooms with heat-related illnesses.
What many patients don’t realize is that their medication may have played a role, said Sarah Dawson, a clinical pharmacist at Sentara Virginia Beach General Hospital.
“It's something not a lot of patients are aware of, that some of their medications can actually predispose them to heat-related illnesses,” Dawson said.
That can happen in several different ways, she said.
Some prescriptions shrink blood vessels, which makes it harder to dissipate heat, or impairs sweating, which hinders the body’s ability to cool down.
Others can make people more sensitive to sunburn, increase sweating, cause fluid imbalances or decrease the sense of thirst.
The list of medications that can have these effects is broad and common, including antidepressants, antipsychotics, diuretics, beta blockers, stimulants and over-the-counter allergy pills. (You can find more details about specific medications’ interactions on the Centers for Disease Control and Prevention website.)
“What can be really dangerous is patients can be on multiple medications in these classes,” Dawson said. “So they can be on multiple medications that can predispose them to these side effects.”
Dawson said people with these additional vulnerabilities should try to avoid significant time outdoors in extreme heat or take periodic breaks in air conditioning, stay in the shade, avoid sugary drinks in favor of water, wear protective clothing and use sunscreen with SPF 30 or higher.
Watch out for early signs of feeling lightheaded, disoriented or sweating excessively.
Heat can also reduce the effectiveness of medications and devices, particularly those that include fluids, such as inhalers, EpiPens and insulin.
“The biggest thing you don't want to do is be outside and leave the medication exposed to the direct sunlight for a long period of time, or leave your medications locked in a hot car for a number of hours,” she said.
Pharmaceutical companies test their drugs under specific conditions, usually at room temperature. They’re not intended to face temperatures in the 90s or above.
Inhalers that are pressurized could explode. Many medications can degrade, a particular concern for those meant to be used in an emergency, such as EpiPens.
“That of course would be dangerous, if you're relying on a medication in an anaphylactic situation and that medication would no longer work,” Dawson said.
People who get medications delivered should bring them inside as quickly as possible, she said.
So, what happens if you forget, and your prescription has been sitting in a hot car all day?
For injectable medications, inspect the fluid for discoloration or abnormal floating particles.
Dawson recommends talking to your pharmacist to see if insurance could be billed for a replacement or if the drug company has data indicating the medication has been tested in extreme conditions.
