Keeping medicines safe in hot weather – a dual challenge for pharmacists

‘How are you coping with the heat?’ It’s a staple phrase in the lexicon of British small talk during the kind of scorching hot summer the UK is currently experiencing. But for pharmacists, the question represents more than just casual conversation; it hits upon the practical and operational considerations that the hot weather demands.

According to the Met Office, compared to the UK’s climate in 1990, it projects that by 2070, summers will be between 1 and 6°C warmer and up to 60% drier, depending on the region. It also suggests hot summer days will be between 4 and 7°C warmer.

As the UK experiences increasingly frequent and severe heatwaves, public safety warnings about staying hydrated and wearing sunscreen are now a regular feature of news bulletins and weather forecasts. However, the risks that heat poses to medicines often fly under the radar.

This means pharmacists are confronted with a dual challenge that demands immediate attention in hot weather: protecting medicines and working conditions within their own premises while guiding patients on safeguarding treatments at home and on the go.

The National Pharmacy Association (NPA) recently highlighted the key role pharmacists play in keeping both patients and their medicines safe amid rising temperatures.

Sukhi Basra, NPA vice-chair, pointed out the importance of reminding patients that: ‘although we can enjoy hot weather, heatwaves can quietly affect our bodies, our breathing, and even the way our medication works’.

The MHRA has also addressed the issue this summer, with helpful guidance that pharmacists can pass on to patients, such as:

• Store medicines below 25°C and keep them in the coolest, driest part of the home, away from direct sunlight;
• Watch for heat damage – changes to colour, smell or texture;
• Follow any special storage instructions, checking the patient information leaflet;
• Be aware of medicines requiring refrigeration, such as insulin and certain antibiotics;
• Take special care when travelling and don’t leave medicines in parked vehicles or warm bags;
• Consider medical devices, as heat and humidity can also affect devices like blood glucose monitors and test strips, leading to less reliable results.

Of course, it’s essential for pharmacists to practise what they preach. Gareth Jones, director of corporate affairs at the NPA, believes the impact of extreme hot weather becoming more common over the coming years will be felt by community pharmacies on an operational level – particularly in relation to the safe storage of medicines.

‘Pharmacists are advised to implement procedures that minimise medicines’ exposure to excessive heat, ensure premises are well-ventilated and cool, and regularly review storage locations to avoid hot spots and direct sunlight,’ he said.

However, he also believes government assistance should be made available in the long term, insisting: ‘If support is being offered to the rest of the NHS family to upgrade facilities in order to mitigate against the effects of extreme heat, this should also be extended to community pharmacy.’

The Royal Pharmaceutical Society (RPS) offers practical guidance on safe and secure temperature control of medicines. Stipulations include that:

• any decision to store a medicine or use a medicine which has been stored outside the manufacturer’s recommended temperature range is fully risk assessed (with specific guidance available for vaccines);
• there is a policy in place, and procedures that outline the actions to be taken if there is a temperature excursion outside the range specified for the medicines being stored and assurance that the procedure is followed;
• for items that require refrigeration or freezing, the equipment used is designed for the storage of medicines and conforms to current guidance;
• the temperature of the refrigerator or freezer is monitored on each working day using a calibrated maximum-minimum thermometer or other approved monitoring device and a recording system is in place;
• staff reading the temperature are trained to ensure correct readings are recorded and that they understand how to reset thermometers where relevant;
• where staff reading the temperature find that it is outside the accepted range they are aware of the actions to be taken to report and address this;
• refrigerators and freezers are not overloaded to allow air circulation and medicines are not stored in contact with the sides or bottom of the refrigerator/freezer;
• refrigerators and freezers are locked when not in use;
• steps are taken to ensure that refrigerators and freezers are not accidentally switched off;
• refrigerators and freezers used for the storage of medicines are not used to store any other items.

Professor Claire Anderson, RPS president, told The Pharmacist: 'Pharmacies should ensure storage areas are cool, well-ventilated, and shielded from direct sunlight.

'Regular checks and heat-mitigation procedures such as reviewing storage locations are central to maintaining safe, effective care throughout a heatwave.'

However, Professor Anderson also acknowledged that the people whose job it is to keep the medicines safe also need careful consideration during hot weather. ‘As heatwaves become more frequent, it's essential that pharmacy teams take proactive steps to protect both medicines and staff,’ she said.

'High temperatures can compromise the effectiveness of medicines and create challenging working conditions. It’s vital that pharmacy facilities are equipped to manage heat risks, both to protect medicines and to ensure safe, supportive conditions for staff.'

By staying vigilant and proactive – both in their own practice and through clear patient guidance – pharmacists can play a crucial role in keeping medicines safe and effective throughout the summer months. And as the climate continues to change, safeguarding the integrity of medicines and the wellbeing of staff will remain an essential part of everyday pharmacy practice.