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These Common Medications May Cause More Side Effects When It’s Hot Out

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Fact checked by Nick BlackmerFact checked by Nick Blackmer Key TakeawaysSome medications can cause new side effects when you take them and are exposed to extreme heat.These side effects include dehydration, electrolyte imbalance, skin rash, and more.It's important to know whether any of your medications may work differently in extreme temperatures so you can monitor your outdoor time appropriately, experts said.
Heat waves bring many health risks like heat stroke, heat exhaustion, and dehydration—but your medications may also cause issues on extremely hot days.“Many medications are impacted by heat,” Michael Redlener, MD, medical director of Mount Sinai West emergency department in New York, told Verywell.Some medications affect your thermoregulation—or the process by which your body maintains a steady temperature—and your fluid balance. For this reason, when temperatures rise and you start sweating more than usual, these medications can cause unpleasant side effects.It’s essential to understand whether any medications you take can cause these side effects since they can worsen if you spend excess time outside. “Increased exposure [to heat] brings increased risk,” Nicholas Kman, MD, FACEP, an emergency medicine physician at The Ohio State University Wexner Medical Center, told Verywell.Medications That Can Cause Side Effects During Hot WeatherHeat can affect various medications in different ways, experts said. In addition to affecting your thermoregulation and fluid levels, some medications can cause you to be more sensitive to sun exposure, Kman said. It’s also worth noting that some medications are degraded by heat—meaning they may not work as they should if they’re left in very hot temperatures—Redlener said.Disrupt Thermoregulation and Fluid BalanceMedications that affect your thermoregulation and fluid balance “can amplify the risk of harm from hot weather,” Kman said, explaining that they include the following drugs:Some antipsychotic medicationsSome antidepressantsSome antihypertensive agentsAntipsychotic medications are often recommended for people with schizophrenia, major depressive disorder with psychotic features (such as delusions and hallucinations), acute mania, borderline personality disorder, and more. Examples of antipsychotic medications that can cause side effects in extreme heat include Haldol (haloperidol), Zyprexa (olanzapine), and Seroquel (quetiapine).Tricyclic antidepressants (TCAs) that can cause harmful side effects in the heat include amitriptyline and Anafranil (clomipramine). TCAs are used to treat major depressive disorder.Antihypertensive drugs are used to treat cardiovascular issues, and medications in this category include diuretics, beta-blockers, angiotensin-converting enzyme (ACE) inhibitors, and angiotensin receptor-neprilysin (ARN) inhibitors.In very hot weather, these medications may cause symptoms such as electrolyte imbalance, dehydration, and volume depletion (when you lose too much fluid), Kman said. They can also increase your risk of falls, and some of the above may dilate your blood vessels, worsening dizziness, he added.Consuming alcohol, caffeine, or sugary drinks can exacerbate these side effects since all of these substances can further dehydrate you, Redlener said. GLP-1 MedicationsGlucose-like peptide 1 (GLP-1) medications like Ozempic and Wegovy can cause vomiting and diarrhea; therefore, taking the drugs in extreme heat may lead to dehydration.
Increase Sun SensitivityMedications that can increase sun sensitivity include the following, Kman said:Some antibioticsSome antifungal medicationsAntibiotics that can create uncomfortable side effects in the sun include Metrogel (metronidazole), which is used to treat infections of the gastrointestinal tract, heart, reproductive system, joints, skin, blood, lungs, and more.Tetracycline is an antibiotic medication used to treat pneumonia and some other respiratory tract infections, as well as infections caused by ticks, lice, and more.Antifungal medications that can cause side effects in the sun include Ancobon (flucytosine) and Grifulvin V (griseofulvin), which are used to treat athlete’s foot, ringworm, and other infections caused by candida and cryptococcus fungi.When you use these medications and spend time in the sun, you may develop a rash similar to sunburn.Become Less EffectiveHeat can damage the following medications, Redlener said:EpiPensInsulinInhalersEpiPens can deliver less epinephrine—the agent that treats allergic emergencies—in hot temperatures. Insulin, a medication that helps people manage diabetes, is intended to be stored in a refrigerator and can become less effective in the heat. Inhalers, used to treat asthma, can burst when exposed to heat.The above aren’t the only medications that can increase the risk of side effects on hot days; high temperatures can affect a range of drugs, including some anti-seizure medications, antiretrovirals, analgesics, antihistamines, and more.If you think a medication you’re taking is causing side effects in the heat, it’s important to speak with a healthcare provider like a doctor or pharmacist, experts said.What to Do If You Experience Heat-Related Side Effects of MedicationsSome people are more likely to experience these side effects. “Older adults, the very young, and people with mental illness and chronic disease are at highest risk,” Kman said. “That said, even young and healthy people can be affected if they participate in strenuous physical activities during hot weather.”Because risk increases with heat exposure, “we get concerned about athletes, [people who are] homeless, and people who work in hot environments,” Kman added.Health issues caused by heat contribute to many emergency department (ED) visits, and there’s reason to believe this problem may be getting worse: From May to September last year, ED visits “substantially increased across several U.S. regions compared with previous years,” according to a report from the Centers for Disease Control and Prevention (CDC).It’s difficult to say how many of these visits are prompted by heat-related side effects of medications. Regardless, it’s important to know the heat-related warning signs that should signal you to get help from a medical professional.The following symptoms could indicate that you’re experiencing heat stroke and should prompt an emergency room visit, Kman said:ConfusionDizzinessExtremely high body temperature (above 103 degrees Fahrenheit when taken orally)Rapid pulseRed, hot skin (that may or may not be sweaty)UnconsciousnessAny heat-related side effects of medications warrant a discussion with a healthcare provider, no matter the severity, experts said. A healthcare provider may be able to alter your medication regimen during warmer months or suggest ways to manage or treat the side effects.The key to preventing these side effects may be to monitor your time in hot environments. “There is a lot of public health messaging about when to go outside, and there are heat indexes that a lot of public health agencies are promoting,” Redlener said. It’s important to keep up with the weather in your area and follow the guidance of local health authorities, he said. What This Means For YouSome medications don’t work as well when exposed to heat, while others can cause side effects when you take them and are exposed to extreme heat. These side effects range from uncomfortable to dangerous and are caused by some common medications, like beta-blockers and antidepressants. If you live in an area that experiences extreme heat, speak with a healthcare provider about whether any of your medications may be affected by—or work differently in—heat.
Read the original article on Verywell Health.

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