Stay Safe in the Heat: Expert Advice on Medication Risks During High Temperatures

As summer peaks and temperatures soar to record highs in some regions of the U.S., there’s a crucial warning for people on certain medications. Amid the intense heat, one medical expert advises individuals to be proactive, especially if they are on specific medications that could exacerbate potential health risks associated with extreme heat.

Data sourced from the Centers for Disease Control and Prevention (CDC) shows that over a thousand people lose their lives annually due to extreme heat in the United States. The agency’s April 2024 report also brought to light the escalating incidences of heat-related illnesses over recent years as a result of climate change, which has led to increasingly prolonged, hotter, and more frequent periods of intense heat.

“Heat-related illnesses, like heat exhaustion or heat stroke, happen when the body is not able to properly cool itself,” the CDC states. “While the body normally cools itself by sweating, during extreme heat, this might not be enough. In these cases, a person’s body temperature rises faster than it can cool itself down. This can cause damage to the brain and other vital organs.”

Prescription drug use is one of several factors that could heighten the risk of these heat-induced illnesses, the CDC warns. But the question persists: Which drugs should merit concern?

Mount Sinai West’s Emergency Department Medical Director, Michael Redlener, MD, shares in a New York Times interview some of the medications that could potentially increase your risk in the face of a heatwave.

Redlener has highlighted medications for high blood pressure such as angiotensin-converting enzyme (ACE) inhibitors, beta-blockers, and calcium channel blockers as some of the key groups to keep an eye on.

Notably, ACE inhibitors can heighten the chances of fainting and falling in extreme heat, and they can also suppress the feeling of thirst—making it more challenging to realize when you need to drink more water.

“Drinking enough fluids is one of the most important things you can do to prevent heat illness,” the CDC advises.

Beta-blockers can also enhance the risk of fainting and falling while simultaneously making it harder for you to sweat, which makes it difficult for your body to cool down. Furthermore, calcium channel blockers can complicate body temperature regulation by causing electrolyte imbalances, as added by Redlener.

“Some medications interfere with thermoregulation and/or fluid balance, amplifying the risk of harm from hot weather,” the CDC confirms.

Redlener also warns that specific antipsychotic medications like haloperidol, olanzapine, and risperidone have an impact on your ability to sweat. “Your body temperature has a higher likelihood of getting hotter when you’re on those medications,” he explains.

Contrarily, other medications, including specific antidepressants, can increase sweating and repress thirst, potentially leading to dehydration amid extreme heat. According to a paper published in the Annals of Pharmacotherapy, “Excessive sweating has been associated with antidepressants including tricyclic antidepressants, selective serotonin-reuptake inhibitors, and venlafaxine.”

Furthermore, Mahesh Polavarapu, MD, the medical director of emergency medicine at NewYork-Presbyterian Westchester, points out that stimulants, such as those used to treat attention deficit hyperactivity disorder, also belong in the group of drugs that can elevate body temperature.

Polavarapu also noted that over-the-counter antihistamines, including diphenhydramine (Benadryl), promethazine, and doxylamine (Unisom), should be used with caution during high heat periods, as they can inhibit sweating and impact temperature regulation.

These are just a few examples of commonly prescribed medications that could raise your risk in hot weather. Hence, the CDC urges healthcare providers to collaborate with patients to formulate a plan in “advance of hot weather to adjust medication regimens as needed on hot days and for when to seek medical care.”

The CDC further stresses on its website, “Many medicines can make you dehydrated or overheated on hot days. Don’t stop or change your medicines until you talk to your doctor.”

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