Heat Alert: Medications That can Cause Problems in Hot Weather

As a second amber heat health alert takes effect,pharmacists are warning individuals taking specific medications to take precautions as temperatures rise,with Monday potentially marking the hottest day of the year. Certain commonly prescribed drugs can interfere with the body’s natural cooling mechanisms, increasing the risk of heat-related illnesses [1].

Medications and Heat Intolerance

Dipa Kamdar, senior Lecturer in Pharmacy Practice, highlights that several medications can disrupt the body’s ability to regulate temperature through sweating, blood flow, and fluid balance. It’s crucial to continue taking prescribed medications but to implement strategies to mitigate potential issues.

did You Know? The human body uses several mechanisms to regulate temperature, including sweating and blood flow to the skin.

Antidepressants

Selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs) may exacerbate heat intolerance by affecting the body’s ability to sweat. These antidepressants influence neurotransmitter levels, potentially blocking acetylcholine, which is vital for sweating.Disrupted sweating can lead to heat-related illnesses and dehydration if fluids are not replenished [2].

Antipsychotics

Antipsychotics, used to treat psychosis, can disrupt the hypothalamus’s ability to sense and respond to body temperature changes by blocking dopamine. This can result in a reduced awareness of overheating and thirst, potentially causing low blood pressure and reduced heart function. Antipsychotics also have anticholinergic properties, further hindering sweating.

Heart Medications

Beta-blockers, commonly prescribed heart medications, lower heart rate and reduce the force with which the heart pumps, which can limit blood flow to the skin and impede the body’s ability to release heat. Diuretics, often used for high blood pressure or heart failure, increase urine output, potentially leading to dehydration and electrolyte imbalances. Ramipril and losartan, also used for blood pressure management, can increase dehydration risk by blocking systems that control blood pressure, fluid balance, and thirst.

Stimulants

Stimulants, such as amphetamines used for ADHD, affect brain chemicals like dopamine and noradrenaline, which can increase body temperature, boost metabolism, and alter sweating patterns. this can make it harder to cool down, potentially leading to dehydration, overheating, or heatstroke.Stimulants may also mask tiredness, causing individuals to overexert themselves.

Insulin

In warm temperatures, blood vessels dilate, causing insulin to be absorbed into the bloodstream faster, which can lead to hypoglycemia (low blood glucose level). heat can also degrade insulin, reducing its effectiveness. Insulin should be stored in the refrigerator until use. Damaged insulin may appear cloudy or change color [3].

Protecting Yourself During Hot Weather

Individuals taking these medications should take the following precautions:

• Check medication labels for storage instructions.
• Stay hydrated,unless advised otherwise by a doctor.
• Avoid peak heat hours and stay in cool environments.
• Watch for warning signs of heat-related illness, such as dizziness, confusion, or excessive sweating.
• Do not stop taking prescribed medication without medical advice.

Pro Tip: Dehydration can worsen the effects of many medicines. Such as,anti-inflammatory painkillers are more likely to cause kidney problems and bipolar medicines can become toxic if you’re dehydrated.

Medication and Heat Risk Factors

Health

Medication Safety: What You Need To Know

by Dr. Michael Lee – Health Editor June 28, 2025

written by Dr. Michael Lee – Health Editor

FDA Drug Approval Process Under Scrutiny: Are Medications Safe and Effective?

Table of Contents

• FDA Drug Approval Process Under Scrutiny: Are Medications Safe and Effective?
  • The Accelerated Approval Program: A Shortcut with Potential Risks?
  • Examples of Questionable Drug Approvals
  • the Role of D-U-N-S Numbers in FDA regulation
  • Podcast Highlights Concerns About Medication Safety
  • The Future of Drug Approvals
  • Evergreen Insights: The FDA’s Historical Role and Current Challenges
  • Frequently Asked Questions About FDA Drug Approvals
    • What is the standard FDA approval process?
    • How does the Accelerated Approval Program differ from the standard process?
    • What are the potential risks of the Accelerated Approval Program?
    • how can patients make informed decisions about prescription medications?
    • What is the FDA’s role in monitoring drugs after they are approved?

A new analysis is questioning the rigor of the Food and Drug Governance’s (FDA) drug approval process, specifically highlighting concerns about the safety and effectiveness of some prescription medications reaching consumers. This comes as healthcare costs continue to rise, with the U.S. spending over $4.5 trillion on healthcare in 2022, representing 17.3% of the nation’s GDP [[1]].

The Accelerated Approval Program: A Shortcut with Potential Risks?

For over a century, the FDA has been a key protector of public health, ensuring the safety and efficacy of drugs. However, Harvard university physician-researcher Jerry Avorn argues that the FDA’s once-rigorous “gold standard” approval process has been impacted by the Accelerated Approval Program. This program, initially intended for patients with desperate conditions like AIDS and cancer, has become a common pathway for drug approvals.

Avorn,in his new book,Rethinking Medications: Truth,Power and the Drugs We Take (Simon & Schuster,2025),suggests that this shift,which began in the 1990s,has resulted in over half of all new drugs entering the market before companies fully demonstrate their benefits to patients. he provides examples ranging from ineffective cold remedies to expensive cancer treatments with limited impact and the controversial Alzheimer’s drug Aduhelm, approved despite questionable cognitive improvements.

Did You Know? The FDA’s Accelerated Approval Program was designed to speed up the availability of drugs for life-threatening illnesses.

Examples of Questionable Drug Approvals

Avorn’s work highlights specific cases where the effectiveness of approved drugs is debated. These include:

• Cold medicines that fail to provide notable decongestion.
• Billion-dollar cancer treatments that only show tumor shrinkage in laboratory settings.
• Aduhelm, an Alzheimer’s drug approved despite a lack of clear evidence of cognitive benefits.

These examples raise concerns about whether the current approval process adequately protects patients from potentially ineffective or even harmful medications.

the Role of D-U-N-S Numbers in FDA regulation

The FDA also uses the D-U-N-S (Data Worldwide Numbering System) number to identify businesses at specific locations.The FDA mandates that companies it regulates have a D-U-N-S number [[1]]. This unique identifier helps the agency track and regulate businesses effectively.

Pro Tip: If you are involved in a business regulated by the FDA, ensure you have a valid D-U-N-S number to avoid compliance issues.

Podcast Highlights Concerns About Medication Safety

In a recent podcast episode, Avorn further explores whether the prescriptions in your medicine cabinet are truly safe, effective, and worth the money. He argues for a strengthening of the FDA’s approval process to ensure that medications meet rigorous standards before reaching consumers.

Read the transcript for this episode.

The Future of Drug Approvals

The debate surrounding the FDA’s approval process raises important questions about the balance between expediting access to new treatments and ensuring patient safety.As medical technology advances and healthcare costs continue to rise, a thorough and transparent drug approval process is crucial for protecting public health.