Dr. Richard Hoffmann, Ask the Pharmacist, 01/15/13

Q: What medication concerns should I have in case of a flood or other natural disaster?

A: This is a good question, especially during hurricane season. The FDFA recently (2012) issued a consumer bulletin for the safe use of drugs that have been potentially affected by fire, flooding or unsafe water, and lack of refrigeration after a natural disaster.

+ Drugs Exposed to Excessive Heat, such as Fire: The effectiveness of drugs can be destroyed by high temperatures. You should consider replacing your medications if there’s a possibility that your medication was exposed to excessive heat, such as in a fire. It is especially important to assure the effectiveness of lifesaving drugs and these should be replaced as soon as possible.

However, if the lifesaving medication in its container looks normal to you, the medication can be used until a replacement is available.

+ Drugs Exposed to Unsafe Water: Drugs (pills, oral liquids, drugs for injection, inhalers, skin medications) that are exposed to flood or unsafe municipal water may become contaminated and lead to diseases that can cause serious health effects.

The FDA recommends that drug products — even those in their original containers — should be discarded if they have come into contact with flood or contaminated water.

In the ideal setting, capsules, tablets and liquids in drug containers with screw-top caps, snap lids or droppers should be discarded if they are contaminated. In addition, medications that have been placed in any alternative storage containers should be discarded if they have come in contact with flood or contaminated water.

In many situations, these drugs may be lifesaving and replacements may not be readily available. For these lifesaving drugs, if the container is contaminated but the contents appear unaffected (i.e., if the pills are dry) they may be used until replacements can be obtained.

However, if a pill is wet, it is contaminated and should be discarded.

+ Reconstituted Drugs: For children’s drugs that have to be made into a liquid using water (reconstituted), the drug should only be reconstituted with purified or bottled water. Liquids other than water should not be used to reconstitute these products.

+ Drugs that Need Refrigeration: Some drugs require refrigeration (for example, insulin, somatropin and drugs that have been reconstituted). If electrical power has been off for a long time, the drug should be discarded.

However, if the drug is absolutely necessary to sustain life (insulin, for example), it may be used until a new supply is available. Because temperature sensitive drugs lose potency if not refrigerated, they should be replaced with a new supply as soon as possible.

For example, insulin that is not refrigerated has a shorter shelf life than the labeled expiration date.

If a contaminated product is considered medically necessary and would be difficult to replace quickly, you should contact a health care provider (for example, Red Cross, poison control, health departments, etc.) for guidance.

If you are concerned about the efficacy or safety of a particular product, contact your pharmacist, health care provider or the manufacturer’s customer service department.

Richard P. Hoffmann, Pharm.D., has been a pharmacist for more than 40 years. Send questions to him at 2960 E. Coventry Court, Hernando, FL 34442.