mailboxes on a country road

Have you ruined your medicine? Are your heart pills ineffective? Is your anti-seizure drug almost worthless? Have your birth control pills lost their punch?

Heat and humidity are the enemies and unless you are careful, your medicine could lose potency.

How Heat Poses Danger for Your Medicine and You:

Margaret had a nasty cough that wouldn’t go away. Finally, in desperation, she went to her physician who gave her a prescription for a powerful new antibiotic. Margaret was flabbergasted by the price. Because Margaret has trouble swallowing pills he offered her a specially compounded liquid formula which was outrageously expensive.

She figured it was worthwhile if the medicine could clear up the infection in her lungs. The pharmacist stuck a label on the bottle reminding her to store the medicine in the refrigerator. But before Margaret could get home and put it away she ran a few other errands.

While she went to have her hair done she left the medicine in the car. The temperature soared to well over 100 degrees and the antibiotic began to deteriorate.

Margaret’s cough did not get better, even with the antibiotic treatment. There’s no way to tell if the trouble she had getting rid of her bronchitis was due to the heat damage done to her medication. Her cough might have been caused by a viral infection that wouldn’t have responded to any antibiotic. However, there’s no doubt that allowing her medicine to sit in a hot car undermined its effectiveness.

Don’t Leave Your Medicine in the Car:

A hot car holds danger for your medicine as well as for your children or your pets. Anyone who leaves medication on the seat or in the glove compartment at this time of year could be wasting money and inviting trouble. Not only might the chemical ingredients begin to decompose, they might be converted to toxic byproducts.

Even if you don’t allow your medicine to overheat in an automobile, that doesn’t mean you are home free. Ultraviolet rays from the sun can also harm some medicine.

Be Wary of Free Samples:

Free samples provided by a physician may also be suspect during the summer. Sales representatives from pharmaceutical companies usually supply doctors with these freebies.

We’re all for giving people a sample to determine if the medication will work or cause intolerable side effects. But we do worry about samples that have ridden around in the trunk of a salesperson’s car from one doctor’s office to another.

Some companies require that the reps use cooler chests to store samples, but there are no uniform standards and the Food and Drug Administration does not supervise shipping or storage.

What About Mail Order Medicines?

Mail order pharmacy services are also vulnerable to climatic conditions. No one likes to talk about this dirty little secret, especially the major insurance companies that now require many clients to purchase their drugs via mail order. But consider this: neither the United States Postal Service nor parcel delivery services have refrigerated trucks. Consequently, many medications shipped during the hot months may be exposed to dangerously high levels of heat and humidity. This holds a danger for your medicine.

Most prescription medicines call for storage at room temperature (68 to 77 degrees F). Temporary fluctuations ranging from 59 to 86 degrees are considered acceptable.

Most delivery vehicles well exceed that on a hot day. Just ask your UPS driver how hot it gets in the back of the big brown truck. We are willing to bet that many USPS delivery vehicles also reach 100 degrees or higher during the summer. By the way, this problem also applies to deliveries to wholesalers, pharmacies and health food stores.

From a Hot Truck to a Roasting Mailbox:

But wait, the problem doesn’t end with the delivery truck. If the mailman puts your medicine in a mailbox it is likely to sit there for hours. In that hot metal box the temperature could soar to over 120 degrees or more. In some cases that poses serious danger for your medicine.

Not all drugs are sensitive to deterioration during shipping. But you will have no way of knowing whether the pills you remove from your hot mailbox this summer retain the same potency they had when they left the factory. Storing your pills on a kitchen table or window sill where sunlight can reach them may also be a danger for your medicine.

Is the Medicine Chest a Safe Spot to Store Your Drugs?

And if you think you will be safe putting the bottle in the medicine chest, think again. This is about the worst place in the house because the heat and humidity from your shower can ruin medicine. Pill bottles are not air tight so moisture can work its way in and speed deterioration.

Ask your pharmacist about proper drug storage, especially for heart pills, antibiotics, epilepsy medications and all liquid medicines. If you are required to buy via mail order, contact the company and ask about the effect of shipping on shelf life.

In our opinion, the FDA, the pharmaceutical industry and mail order pharmacies have not addressed this issue adequately. If medications are supposed to be stored at temperatures between 68 and 77 degrees, why allow drugs to be shipped during the summer when everyone knows these guidelines will be violated for hours or even days at a time?

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  1. Frank

    Great information to be aware of, especially during the hot months. FYI, I obtain my scripts from my local pharmacy and pick them up in person. If I have to make any subsequent stops, I bring along a cooler with an ice pack or two. That should address any concerns.

  2. Laurie
    san antonio

    I too am concerned about the heat damage that could be done to products bought through the mail and sitting in a hot mailbox. I really don’t know what the answer is. It would seem that even if you pick them up locally from an air conditioned store, those items have arrived there by way of a hot truck.

  3. A Guy

    I live in the Texas Gulf Coast area and get an EXTREMELY expensive medicine shipped from Kansas. Lately, it has been packed in ice in a styrofoam box, but the ice packets were melted in the last shipment. I was told to tell the supplier to add additional ice packets with the next shipment. I just ordered again this morning and we’ll see how they ship it!

  4. Larry
    Raleigh, NC

    I’ve ordered Latanoprost (prostaglandin eye drops for glaucoma) from mail order pharmacies many times when required to do so by insurance companies. It has always been shipped in a styrofoam box that also contains frozen–at least when shipped–gel packs.

    The internal temperature when opened has always been reasonable.

    The eye drops have not lost effectiveness. My tests always show pressure of 14-15 vs. 20.5 prior to treatment.

    This suggests that at least the mail order pharmacies I’ve used are taking proper precautions.

  5. Ann

    I am so happy to hear these problems being addressed. Unfortunately, most people are conditioned not to think outside the box. Another problem I have is I have yet to meet my primary care doctor. She keeps sending her “assistant” to relay messages and we play telephone

    Doctor put me on a drug 2 days ago, which sent my heart rate up to 99. This is without even knowing who I am. I’m on metoprolol to keep my heart rate down. I sat in her office for 5 hours. I’m frightened to death of these folks. Now, I must wait days before I can see the new primary physician. Please stay vigilant people.


    • Karen W
      St Paul, MN

      Did you call your pharmacist and tell her about the increase in heart rate? She can look to see if there is an interaction between the two.

  6. David
    Arlington, Texas

    Health plans continue to require one to get mail order prescriptions if one wants the “best” price. I refuse to comply because of your stated concerns. I’ll pay the difference. Living in Texas where the temp has been around 100 degrees multiplies my concern. I am a pharmacist.

  7. ARD

    This issue has concerned me for quite some time. I’m glad to see that it is finally starting to be addressed. As usual, thanks Graedons, for being on the forefront of health issues that are often overlooked!
    I order many supplements from a company which says that it keeps its stock in a climate controlled warehouse. (Of course, the shipping conditions from the manufacturers to their warehouse is unknown.) They have an overnight shipping option which adds an extra $12.00 to the price. I always take this option as I live in south Louisiana where it is very hot and humid. This company’s prices are very reasonable, and I order a large amount at a time, so it is affordable. I just consider it well worth it to increase the chances that a supplement will be effective.

    • chris E
      San Diego, CA

      The problem with medications being transported in dangerously hot vehicles also impacts deliveries for pharmacies. I spoke to an employee in CVS today because I have been negatively impacted – which bloodwork confirmed by the first mail order patches I received through Optum RX. She told me CVS meds also arrive hot sometimes when delivered. VERY scary!

      FDA needs to enforce transportation standards to ensure us patients are not financially and physically not injured from this lack of care of transportation of medications. Southern California reached over 100 this summer when my meds were sitting in a non air-conditioned 100 vehicle with USPS. Now I know why I became symptomatic because my meds are not working like they usually do.

      i do usually buy from CVS but United Health care DOUBLED my copay if I don’t buy from THEIR pharmacy OPTUM RX. It is actually a criminal arrangement, and I intend contacting various departments in government to file complaints starting with my California congressman. I would do the same before this all gets completely out of hand.

  8. JBG

    Temperature can be an issue in the wintertime too, especially in northern parts of the country. Gels, creams, etc can separate, liquids freeze, with unknown effects.
    But yes, heat is worse and way harder to avoid.

  9. HN

    I order many of my vitamins and supplements from online sellers to save a lot of cost over the local health food stores. When the UPS driver handed me my delivery last week at 3PM here in Central Florida, I brought it inside, cut the packing tape, lifted the flaps and was hit with a rush of very hot air. I quickly closed it back up and put a temperature probe into the box. It registered 91.5 degrees! I looked at the bottles of supplements and one recommended storing at no higher than 75 degrees. I contacted the company I ordered from to ask if these were now damaged. Their product specialist assured me that the temperature limit is because the gelatin capsules will start to melt and stick to each other. He said that, even if they did that, the ingredients would still be okay at 91 degrees.
    I’m no scientist, so I can’t say if that’s accurate or not. The company was willing to exchange them, so I asked if they ship any other method–the only option was USPS and the hot mailbox, as mentioned in your article. I then contacted UPS to ask if they can do anything about the heat in their trucks and they responded that the shipper knowingly takes on the risk of exposing their products to high temperatures during shipment. I kept the supplements and hope they’re okay.

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