It's already looking like an unseasonably hot summer. Several parts of the U.S. are slated to reach record-high temperatures this week, and it's unlikely this will be the last heat wave of the season. But as you prepare to battle the blazing sun, one doctor is warning that you may need to take extra precautions if you use certain medications.
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More than a thousand people die in the U.S. each year due to extreme heat, according to the Centers for Disease Control and Prevention (CDC). In an April 2024 report, the agency warned that heat-related illnesses have been increasing over the last few years "as climate change results in longer, hotter, and more frequent episodes of extreme heat."
"Heat-related illnesses, like heat exhaustion or heat stroke, happen when the body is not able to properly cool itself," the CDC explains. "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."
According to the agency, there are many factors that may increase your risk of developing a heat-related illness—including the use of prescription drugs.
But exactly which medications should you be concerned about? In a new interview with The New York Times, Michael Redlener, MD, medical director of the emergency department at Mount Sinai West, opened up about some of the medicines that may raise your risk.
According to Redlener, medications prescribed to treat high blood pressure—including angiotensin-converting enzyme (ACE) inhibitors, beta-blockers, and calcium channel blockers—are among the most important groups to watch out for.
As he explains, ACE inhibitors can increase the risk of fainting and falling, especially in extreme heat, and suppress the feeling of thirst—which may make it harder to tell 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 blocks can increase your risk of fainting and falling, too, and they can also make it difficult for you to sweat, which makes it harder for your body to stay cool. Meanwhile, calcium channel blockers can make body temperature regulation difficult by causing electrolyte imbalances, Redlener added.
"Some medications interfere with thermoregulation and/or fluid balance, amplifying the risk of harm from hot weather," the CDC confirms.
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Specific antipsychotic medications like haloperidol, olanzapine, and risperidone also impact your ability to sweat, according to Redlener. "Your body temperature has a higher likelihood of getting hotter when you’re on those medications," he explained.
Other medications have the opposite effect and increase sweating. As The New York Times explains, this includes certain antidepressants, which can also repress thirst, possibly leading to dehydration during 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."
Mahesh Polavarapu, MD, the medical director of emergency medicine at NewYork-Presbyterian Westchester, told The New York Times that stimulants, such as those used to treat attention deficit hyperactivity disorder, are another group of medications that can increase body temperature.
Polavarapu added that over-the-counter antihistamines, including diphenhydramine (Benadryl), promethazine, and doxylamine (Unisom), should also be used with caution during a heat wave as they can prevent sweating and affect temperature regulation.
These are just some of the commonly prescribed medications that can increase your risk from heat. That's why the CDC says healthcare providers can work with patients to make a plan in "advance of hot weather to adjust medication regimens as needed on hot days and for when to seek medical care."
"Many medicines can make you dehydrated or overheated on hot days," the CDC notes on its website. "Don’t stop or change your medicines until you talk to your doctor."
