Ramipril and bisoprolol users issued UK government caution relevant this week

Ramipril and bisoprolol users issued UK government caution relevant this week 'Essential advice' for millions of us. Millions of individuals taking commonly-prescribed medications across the UK should take on board "essential advice" from the UK government which is again particularly relevant in the coming days. Among the medications highlighted by the Medicines and Healthcare products Regulatory Agency (MHRA) are ACE inhibitors and beta-blockers. Numerous other medicines are also referenced by the agency, which are detailed further below. Ramipril is an ACE inhibitor extensively prescribed to treat high blood pressure and heart failure. Meanwhile, bisoprolol ranks amongst the most frequently-used beta blockers, prescribed to treat angina, high blood pressure and heart failure, amongst other conditions. On 26 June, the MHRA re-issued guidance on safeguarding your medicines during extreme heat and remaining safe as the UK experienced a heatwave of severe temperatures which peaked at a record 37.7C and resulted in school closures. Temperatures are once more anticipated to exceed 30C in some parts of the UK on Monday and remain in the mid-to-high-20Cs for the rest of the week. This makes proper care and storage of your medication essential once again. Alison Cave, chief safety officer at the MHRA, stated: "It's easy to forget that medicines left in the heat – in cars, bags, or on sunny windowsills – might not work properly when you need them. Some medicines can also make you more likely to burn in the sun, feel dizzy, or get dehydrated, especially if you're taking diuretics or have a condition like asthma, heart disease, or diabetes." Why heat affects your medication The MHRA states that most medicines require storage at temperatures below 25C, a threshold that homes, workplaces, cars and schools have frequently surpassed this summer and may well do again in the coming days. Heat "breaks down the active ingredients in medicines", the MHRA explains, cautioning that medicines requiring refrigeration "are especially vulnerable to heat". Should medicine be affected by heat, it may no longer function correctly. How medicine changes how your body copes with heat While it is widely understood that the body loses greater amounts of water through perspiration in warm conditions, the MHRA notes that "some medicines can make this worse, or make it harder for your body to cope with heat". It specifically highlights some medicines, saying: "Blood pressure medicines such as ACE inhibitors, beta-blockers, or calcium channel blockers can also make it harder for your body to regulate temperature, especially during sudden hot spells. ACE inhibitors can even suppress your natural thirst response." Frequently prescribed ACE inhibitors in the UK include ramipril, captopril, enalapril and others. Widely used beta-blockers include atenolol, bisoprolol, propranolol and others. The NHS also highlights important considerations for ramipril users in hot weather, noting that ramipril can cause dizziness, particularly when standing up quickly — a risk that increases in hot conditions due to lower blood pressure and dehydration. The British Heart Foundation (BHF) also urges heart patients — many of whom are prescribed both ramipril and bisoprolol — to take extra precautions during hot spells. The BHF advises that people with heart conditions are at greater risk of heat-related illness because their cardiovascular systems are already under strain, and that high temperatures can place additional pressure on the heart. The charity specifically recommends that heart patients keep cool indoors during the hottest parts of the day, drink plenty of fluids, and consult their GP or pharmacist if they are concerned about how their medication may be interacting with the heat. The MHRA also notes that individuals taking the following medications should likewise be mindful of a potentially heightened impact during hot weather: - "Some diabetes medicines, including insulin and metformin, also increase the risk of dehydration or make early symptoms harder to spot." - "Antipsychotic medications, such as olanzapine or quetiapine, or stimulant medications for attention disorders can increase your body temperature, making you overheat more easily." - "People taking diuretics, or ‘water tablets’, such as furosemide, are already losing more fluid through urination." It further adds that certain common medicines can increase your susceptibility to sunburn, amongst them some antibiotics, diuretics, antidepressants, or skin treatments for acne or eczema. Signs and symptoms of dehydration Dehydration can trigger dizziness, headaches, fatigue, confusion, and dark-coloured urine. This poses a particular risk to elderly people, young children, and those with heart or kidney conditions. Should you begin feeling unwell in the heat, move to a cooler location, drink water gradually, and seek medical attention if your condition fails to improve promptly. Keep medicines safe in hot weather The MHRA advice on keeping medicines safe in the heat includes: - Store medicines somewhere cool, dry and out of direct sunlight - Avoid leaving them in cars or in bags left in sunlight - Know the signs of heat-related illness - Stay hydrated and listen to your body - Take extra care in the sun if your medicine makes your skin more likely to burn - Read the leaflet and speak to a healthcare professional if you have any questions.