It’s Summer. Have you taken the temperature of your medications lately? Most folks do not realise that the temperature meds store or travel in can do a lot for and to the pills or salves they use to get and stay well. In fact, most people don’t even bother to read the leaflet which comes when their pills are dispensed and even fewer look at the boxes that things like creams (oft used this time of year for poison ivy, rashes or jock itch) or ointments come in, but it’s vital that you do look and try hard to pay attention to what those directions say. Just as it’s critical to take your medicine or use your cream when the doctor says, it’s also important not to let it get too hot or too cold. And our Midwest Summers are a perfect time to ruin the effectiveness of many of the items dispensed from behind the pharmacy counter.
Items which get too hot can have their potency compromised, so they just don’t work — or they don’t work right. Also, some creams, salves and even other meds can be affected by heat. Capsules can melt and leak. Creams and salves can separate and the medication they contain be weakened or ruined altogether.
So what should you do? Be realistic. Most things come with one of those info sheets or a box with some info on the outside.
First the really easy part: look for the sheet or notice on the box and then read it. See what the manufacturer or pharmacy advise. In most cases the temperatures will be a range. One salve we use says “Store at 20-25 degrees C (68-77 F). Avoid temperature above 30C (86F).” Sounds simple enough, but how many people would read and do it? According to a couple pharmacist and doctor friends we asked, sadly, not many at all.
And if they do read the notices, do you or they understand what the words mean? Again, likely not. So what does the notice above mean? It means long term this product should be kept between 68 and 77 degrees but it also means you can take it into the heat (to 86 degrees) for a brief while.
Some meds call this an “excursion” and the box or sheet would read “excursions to 86 permitted.” Our pharmacist friends told us that means a couple or three hours but not all day and no leaving the tube (even in a bag or suitcase) in the seat or trunk of the car where temps this time of year can easily hit 130 degrees and ruin the medicine.
Drops and pills also have their own limitations as one we checked says “Store upright at controlled room temperature 20 to 25 degrees C (68-77 F) and protect from freezing.” That means again what it says, and note that line about how to store it (not on its side) as well as the caution against freezing it in the cold months. Again, think that suitcase on a trip or even sitting in the bag in your car while you run into the grocery after you stopped at thedrugstore. The value of the pills or drops or salve will be, well, practically nil if kept too hot for too long.
There’s also the matter of what you do with your meds when you get them home. A handful say plainly “Refrigerate.” Others, though — the vast majority — are less clear but what all of the sources we consulted were unanimous on was the answer to this question: Where’s the worst place you can store your medicines?
Their answer: In the bathroom medicine cabinet.
Why? Because the moisture level there is unusually high and often that nice, steamy, warm shower you so love heats things up past 77 in the room, too. This can cause medicines to deteriorate and lose their potency or change composition so they might not work well, might work too well (become too strong) or have different side effects — none of which are desirable. So the best thing to do? Unless you have kids or pets with busy hands or mouths leave your pills on the bedside table and keep the lid securely on the bottle. Did we mention air doesn’t do a thing for pills but ruin their potency, too? For salves, sprays and the like the table or cabinet under work fine. Again, though, skip the “medicine cabinet” because it’s not a good, safe place to store medicines you want to last!
Finally, and we will have more on this in a future column, look for and observe the dates on medications. If they expired in 2007 they should have been recycled ages ago. And if you “always have pills left” as a friend does (He always says “in case I feel this coming on again later”.) then you are not following directions. Almost every medication — save for some people take on-goingly like HIV/AIDS or heart meds — need to be taken until they are gone. This is especially so with antibiotics. You may feel well or like you are “over” what ailed you, but if you quit before the medicine is done, the illness could regroup and hit again — often with increased resistance to the drug you were taking. Remember, too, that the doctor and pharmacist are a team and they know how many and what dose you need. Take the pills until they are finished.
Follow all of the directions given by your pharmacist and doctor, too, on interactions. Using a single pharmacy can make this easier as we recently got a call from our druggist that she was declining to fill a pill our physician ordered because it had a “type one interaction potential” — the most serious kind. Had we taken it, there could have been over a 40% chance of developing a stomach ulcer because of an interaction with potassium we also are prescribed. Instead of dispensing it she sent us back to our physician for a rethink which ended with another drug being used to accomplish the same thing.
Remember, the doctor and pharmacist work together and whether or not you use just one pharmacy or multiples, always keep your family doctor (GP) informed of what you are taking — especially if say a specialist or ER visit added something — as well as any changes in your condition. And above all at this time of year, keep cool and let your pills chill with you.