Highs in the triple digits are common in Arizona during the summer months. As the mercury rises, we’re often reminded about the things we need to do to stay healthy in hot weather, like avoiding dehydration, heat exhaustion, and sunburn. Those tips are important — and can even be potentially life-saving — but what’s often missing from summertime health advice is information about using medications and contraceptives safely and effectively when a hot environment can quickly diminish their integrity. That’s a serious omission when Americans buy about 5 billion over-the-counter drug products annually and nearly half of all Americans use one or more prescription drugs.
Heat can alter the molecular structure of oral contraceptives or shorten a condom’s shelf life.
Extreme heat and cold can cause medications to change physically, and those changes can make medications less potent — and for some medications, unsafe to use. Oral contraceptives and other medications that contain hormones are especially susceptible, since the proteins they contain can change their properties during heat exposure.
The labels on medications, whether over-the-counter or prescription, typically recommend storing them in a cool, dry place and keeping them away from excessive heat and humidity, or might give a specific temperature range, commonly 68 to 77 degrees Fahrenheit (20 to 25 degrees Celsius). That’s an ideal range, but most medications are still usable after storage in temperatures as low as 32 to 58 degrees Fahrenheit (zero to 14 degrees Celsius) and as high as 80 to 86 degrees Fahrenheit (27 to 30 degrees Celsius). Advice varies, so it’s always best to consult a physician or pharmacist when less-than-ideal storage has already happened or is anticipated. Help is also available at Planned Parenthood health centers, where staff can answer questions about general health care and about using contraceptives safely and effectively.
Moisture can also damage medications, so it’s generally best to keep them tightly sealed in their original containers and avoid storing them in a bathroom or kitchen cabinet, where moisture is more common.
Traveling Wisely with Medications and Contraceptives
In the case of anticipated storage problems, such as during travel, a physician or pharmacist can often recommend a cool pack to keep medications at the correct temperature. Summer is a travel season for many, and travel with medications and contraceptives requires its own precautions. Car travel can be especially damaging to medications. Within a short amount of time without air conditioning, a car’s interior can soar to around 50 percent above the outside temperature. Medications are safest during car travel if they are kept in the air-conditioned passenger compartment (not in the trunk) and carried with you whenever you leave your car. Air travel also requires precaution, since luggage compartments are not temperature-controlled. Keeping medications in carry-on baggage is best.
For condoms, much of the same advice applies. Extreme heat and cold can shorten the shelf life of a condom, so condoms should be stored and transported much like medications. Shopping for the right condom is a good idea when you anticipate traveling, or carrying condoms while you’re on the go. In the case of latex condoms, researchers at the Washington State Board of Pharmacy in Seattle have found that their stability in hot and humid environments is improved by pre-lubrication with a silicone lubricant and packaging that provides an oxygen barrier, such as foil-laminated plastic. Carrying condoms in your pockets should be avoided, but if necessary, keeping them in a hard case like a business card holder or a compact can protect them from friction and punctures before use.
Dealing with Damaged Medications
If it’s too late for storage precautions with medications, damaged medications should always be disposed of instead of used. Not all damage is perceptible, but signs of damage can include changes in color, smell, hardness, and smoothness.
How medications are disposed of is important. The Arizona Department of Environmental Quality recommends mixing your damaged medications “with an undesirable substance like coffee grounds or kitty litter, and put[ting] them in impermeable, nondescript containers such as empty cans or sealable bags” before throwing them away, so that they won’t be consumed by children or pets. More information about how and why medications should be disposed of properly is available in their brochure “Prescription Drug Disposal … a Pain in the Drain.”
Most condoms are made primarily with biodegradable materials, and used, expired, or damaged condoms can be put in the trash like other waste. Flushing condoms down the toilet is never a good idea, since they can clog pipes and won’t biodegrade underwater.
I’m also wondering how safe it is for folks with outdoor mailboxes to get their medications mailed to them in the summer. I’m lucky enough to have insurance, but I’d end up paying a lot less for my own BC if I used my insurer’s preferred mail order pharmacy. That said, my (group) mailbox is metal and in direct sunlight.** And I can’t think the money saving is worth it if it means my medications are compromised by the time they actually get to me.
** Fun fact: When I was in Girl Scouts and went away to summer camp, we called a metal box in direct sunlight an “oven.” 🙂
Good point! I mail order baking supplies sometimes, and last summer I abstained from some very tempting chocolate that was on sale. Even if I managed to retrieve the package from the mailbox immediately, it’s still been cruising around in a mail truck all day — and I believe those vehicles aren’t even air conditioned!
And what’s worse than melted chocolate? Unintended pregnancies. Or, you know, the deterioration of any important medication.
Do you have any advice for those of us that don’t live in cool or air conditioned places? I’ve been aware of the risks to my pills, but I simply don’t have access to anywhere that stays within the stated range of temperatures. Everything in the house is 100 degrees – we just leave during the day if it gets too hot.
That’s a great question. I think your best bet is to check with a pharmacist. Perhaps (s)he could recommend a solution, such as a container with a reusable refrigerant pack that you could refreeze every night.
If your pills look different in any way, I would get new ones. If you’re not sure about wether your birth control pills have been stored safely, you may want to use a back-up birth control method to prevent pregnancy until you can store them in a cooler place. If you are not sure about which medications may have been compromised by the heat, your local Poison Control Center may have access to more drug data information to help you.
I’m actually not at risk of pregnancy personally, but I need hormonal birth control to handle certain medical problems. Hence the special concern – if my pills go bad I can’t function at my job.
I was just wondering this myself, I just got my first BC prescription and had a bit of a panic when I realized that my apartment gets much above the recommended 77*F (let’s say 90* as a max, though it’s usually between 80-86, with 88* being the highest I’ve ever seen it.) I’m not keeping them in the sun, or in a car, or anything like that.
I don’t have decent AC and only run it when I’m home and it’s very uncomfortable.
There’s really no cooler place in my apartment at this time. I called the pharmacy and they gave me the standard non-answer of “well you really should store it at the correct temperature…high temperatures (I don’t consider 85* to be all that “high” but at any rate…) could reduce the efficacy.” Which I guess they’re legally required to say. But it doesn’t really help me much in how to store my BC pills.
The best place I can think to put them in in my desk drawer (wooden, not humid, near the floor) but I don’t actually have a thermometer that can measure the temperature in there so I still don’t know.
My question is, do I need to be overly concerned about the ambient temperature in my apartment affecting my pills? The most I can honestly see having on hand at a time is a 3 month supply.
And if I do need to be concerned, is there any way I can keep them safe without running my electric bill through the roof with the clunky old AC?
The B.C in question is Kariza.
Thanks so much!
~Kelly
It’s best to play it safe, although that’s often easier said than done. Did you try calling the makers of Kariva to see if they could give you more advice?
No, but I did call my gyno’s office and speak to a nurse. She said it was fine but to avoid storing it in the sun, in my car, anywhere like that. She said temps in the 80’s were no problem. 🙂
That’s good to know! Thanks for passing along what you found out!
My girlfriend left her new prescription of birth control in the trunk of her car for 8 days. Peak temp outside was 84 degrees for four days in a row. After her placebo/diff colored pills she started the new pack thay had been in the trunk. Had a lot of unprotected sex. Could the heat have rendered the pills useless?
It’s possible — heat can alter the chemical structure of medications, but we can’t give you a definitive answer over the Internet.
If you had unprotected sex recently — like in the past several days — your girlfriend can consider emergency contraception. She should do that ASAP, as emergency contraception’s effectiveness decreases with time. She can get it at a Planned Parenthood health center or most pharmacies.
Plan B One-Step and Next Choice One Dose are up to 89 percent effective when taken within 72 hours (3 days) after unprotected sex. Another brand of emergency contraception, called ella, is 85 percent effective if taken within 120 hours (5 days) after unprotected sex. Plan B works by inhibiting ovulation, so your girlfriend would be less likely to release an egg. If she is already pregnant, the pills won’t affect the pregnancy. You can find more information here.
In the meantime, use a back-up method like condoms. Hopefully she can store her next pack at room temperature. Good luck!
Thank you. If those pills were bad then it would have been like 15-18 days with no protection. Plan b not an option.
And It would have been roughly 110 degrees in the trunk for around five hours a day for four days at that heat.
Well, if the pills weren’t working, she still wouldn’t have been fertile that entire time. If you had unprotected sex in the last several days, emergency contraception could be an option, as it might reduce risk of pregnancy. Assuming the pills aren’t working, you don’t know if they stopped working right away or if they gradually lost effectiveness, and where in her menstrual cycle she currently is.
However, it’s also not a foregone conclusion that the pills weren’t active. Their chemical structure could still be enough intact to do the job. If it were me, I would take emergency contraception and use condoms until it was time to start the next (properly stored) pack.
OK. We had unprotected sex a day before she began to ovulate. 11 days after her period. I keep track of these things.
Well, when oral contraceptives are working properly, a woman doesn’t have a menstrual cycle at all — the Pill inhibits ovulation by “tricking” the body into thinking it’s pregnant, and the hormonal cycles cease. Additionally, if the pills were sufficiently effective for the first few days and then started losing effectiveness, it’s possible that she would have ovulated later than expected. So you might not be able to know when exactly she was ovulating, if she was ovulating.
In any case, even though the pills baked at high temperatures for many hours, they still might be active; and even if they weren’t, it still doesn’t guarantee that your girlfriend is pregnant. Whatever happens, good luck!
And the four days at that temp were the first four days. The next four it would have been, low ball estimate around 95 to 100 degrees as wee. So they baked for awhile. I know that the pill contains hormones and high heat temps can mess with them.
I have left my depo injection in my hot car for like 5 hours (give or take) and I want to know if I can still use it?
Hi Angie! That’s a really great question, and it might be best to ask a pharmacist or the doctor who prescribed it. If you’re at risk for pregnancy, you might be advised to replace it, as the manufacturer instructs that this medication be stored at room temperature (68° to 77°F).
Hi, Angie! Did you use the injection? Also had a similar case where I had the injectable in the same bag with hot food for an hour. And worried because it’s not like with pills where no harm in digesting, but injectables are much more prone to endagering the human.
Thanks!
So I have to keep my medication below the temperature of 25C, yet my body runs at 36.9C.
What the heck happens when I ingest my medication? Does it chemically alter before my body assimilates it?
I call bull crap on those instructions.
I agree that making sure your contraceptive medications are kept at the right temperature can help them stay effective when you take them. Many medications are heat sensitive and will not have the same effect when you expose them to too much heat, I can see why someone using them would have to pay attention to this as they travel or stay in hot places. I will make sure to ask my wife about this, it can save us a lot of money since any birth control can be very expensive.
I was initially unaware of storing my medication away from the sun. I left my birth control pills (microgestin) on my night stand which was slightly next to the window so am I worried the sun has ruined their effectiveness?
Where do I begin…I was on the demo shot for about a year and a half, then immediately started birth control pills the day of my next shot. I was not informed by my doctor to store my birth control pills in a certain temperature. In other words, I kept a 3 month supply in my house and a 3 month supply in my car, once I was out a bit later than usual and had to take one of the pills that I left in my car for that one day (these pills have been in my car for 2.5 months) in a shaded area in my car. And then I read a forum about this and immediately got new pills. On day 5 of my new pack I had unprotected sex, I’ve been taking my pills gracefully but I am now worried about this one day that I probably took an ineffective pill. They were still in their sealed container bag and looked no different when I opened the pack.
I liked that you pointed out that extreme heat and cold can cause the medication to change physically. That is good to know if you have people in your life that needs to take a lot of pills. It seems like it would be best to keep your pill organizer in a temperature controlled area.
What about Wet boxes which store the BC until I need them?