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If you ever pay close attention to your medication labels, you will notice most of it comes with instructions like “Store in a cool and dry place” or sometimes it’ll come with a specific temperature range like “Store in a controlled room temperature between 20-25°C.
Many prescription drugs are very sensitive to changes in temperature and humidity. Even a slight increase may affect their effectiveness and potency if exposed to extreme heat like the heat wave we are currently experiencing.
As discussed in the earlier article, heat waves are prolonged periods of excessively hot weather that can cause significant impacts on human health and well-being. Due to the ongoing climate change, Malaysia is expected to be affected by the unfavorable consequences of heat waves until at least late July. For some this may lead to heat exhaustion or heat stroke if prevention and management is not properly exercised. However, considering the growing aging population that goes hand in hand with the increased medication users population, medication management during heat waves is something worth highlighting. Here are some ways how heat waves can affect medication storage:
Degradation of active ingredients: Elevated temperature can result in the degradation of the active ingredients in most medications, leading to a decrease in their effectiveness or leads to potential harm if the medication is ingested or used. Some examples of medications that are more sensitive to heat than others include insulin, inhalers, eye drops, suppositories etc, rendering them more susceptible to temperature-related degradation.
Loss of stability (chemical degradation): High temperatures can accelerate the breakdown of active ingredients in medications, reducing their stability over time. Degradation may occur through various chemical processes such as oxidation or hydrolysis with any degree of temperature elevation, which can lead to breakdown of the medication’s therapeutic properties. As a result, such medications will have a shortened shelf life and a decreased effectiveness even before the medication’s expiration date. This on the other hand would also result in increased medication wastage and demand for the medications wasted.
Reduced potency: Heat exposure can diminish the potency or concentration of medications, resulting in decreased effectiveness for their intended clinical purpose. This can pose significant challenges, especially true for medications with narrow therapeutic ranges or those that require precise dosing such as Warfarin (blood thinner), Digoxin (heart medication), Phenytoin (anti-seizure) and so on.
Safety concerns: Extreme heat can sometimes also result in the formation of harmful degradation substances or compounds within medications. These byproducts have the potential to pose safety risks and may elicit adverse reactions when consumed.
To mitigate the effects of heat waves on medication storage, the following measures can be taken:
Insulin: Insulin, indicated to individuals with diabetes, is highly sensitive to heat. Exposure to high temperatures can cause it to lose its therapeutic effectiveness, potentially leading to uncontrolled blood sugar levels. Insulin should be stored in a cool environment and protected from extreme heat.
Inhalers: Inhalers containing medications for respiratory conditions like asthma or chronic obstructive pulmonary disease (COPD) can be heat-sensitive. High temperatures may affect the propellant or the medication itself, compromising the effectiveness of the inhaler.
Eye drops: Some eye drops, especially those containing preservatives, can be sensitive to heat. Exposure to high temperatures can therefore alter their composition and potentially reduce their effectiveness in treating eye conditions.
Thyroid Medications: Medications used to treat thyroid conditions, such as levothyroxine, can be heat-sensitive. Excessive heat can degrade the active ingredients, potentially leading to inadequate treatment of thyroid disorders.
Certain Antibiotics: Some antibiotics, such as certain liquid formulations, suspensions, or eye drops, may be vulnerable to heat. It's important to follow the storage instructions provided with these medications and avoid exposing them to high temperatures.
To ensure the stability and effectiveness of your medications, it is vital to carefully read the storage instructions provided on the medication packaging or in the patient information leaflet. If you have specific concerns or questions regarding the impact of heat waves on your medications, it is advisable that you consult your nearest healthcare provider or pharmacists for personalized advice. By exercising proper precautions such as storing them in a cool and dry place, you can help ensure the quality of your medications and ensure they remain safe and potent.
This article is written by Janelle Leong, Bpharm(Hons) (DOC2US),
reviewed by Dr. Nicholas Soh Yee Huang, MBBS (DOC2US).
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