How to Protect Your Mail-Order Prescriptions From Extreme Heat

Every day, millions of Americans get prescription medications delivered to their homes. It’s a convenient option, but rising temperatures can make safe transport challenging and put the drugs at risk.

Temperature and humidity levels can affect drugs all year round, but the likelihood of a problem is highest during the summer. Whether you are enrolled in a mail-order pharmacy program or are ordering over-the-counter pills from Amazon, it’s important to consider how compounds could be affected on their way to your doorstep.

Are my medications really being exposed to extreme heat?

For many oral medications, the United States Pharmacopeia, an independent organization that sets standards for the nation’s drug supply, recommends keeping medications at temperatures of 68 to 77 degrees Fahrenheit. It allows for an expanded temperature range of 59 to 86 degrees to accommodate for mild “excursions,” as long as the average temperature does not exceed 77 degrees.

Most mail-order pharmacies say that their packaging is weather resistant. But research has shown that packages sometimes spend more than two-thirds of transit time outside the appropriate temperature range.

Which medicines should I be concerned about?

Health experts said liquid and aerosolized medications like inhalers are among the most vulnerable to degradation, since heat exposure can trigger fluid evaporation or pressure changes in canisters.

The potency of many other oral medications, including birth control pills and digestive enzymes, can be compromised, too, they warned.

How can I tell if there’s a problem with my medication?

Melted capsules and discolored tablets are obvious signs, but heat-related drug degradation is often invisible to the naked eye. If customers rely only on glaring signs they could miss a case where their drug potency has lessened, medical experts said.

Often, degradation is evident only when a patient who is on a regimen notices fading side effects or stable conditions that inexplicably worsen.

What can I do to protect my medicines?

To understand the ideal conditions for certain drugs, check out the prescribing information in the medication package insert.

Doctors recommend picking up your prescriptions at a local pharmacy whenever possible during hot summer months, particularly if your medication is liquid or aerosolized.

If you are enrolled in an insurance program that requires using a mail-order pharmacy, ask for an exception during the summer or, at the very least, contact the on-call pharmacist at the mail-order company to get more information about shipping practices and to ask for temperature-controlled packaging. You should do this even if the drug does not require refrigeration.

“Put some pressure on them: How do you ship your insulin? What are you going to do to preserve my EpiPen?” said Dr. Mike Ren, a primary care physician and an assistant professor in the department of family and community medicine at Baylor College of Medicine in Texas.

When your medication is finally in your hands, he said, do your part to preserve it: Store it in a cool, dry environment, away from direct sunlight. If you’re flying, keep prescriptions in your carry-on bag. Never leave medicine in a parked car. And if you notice any changes in your health that you think could be linked to a weakened medication, speak with your doctor right away.