Methotrexate users issued caution by UK government — 'requires particular care' this week

Methotrexate users issued caution by UK government — 'requires particular care' this week Official government advice has flagged this medication taken by more than 1 million people. "Essential advice" has been issued by the UK Government which is particularly relevant again this week. The advice affects millions of people who take common medications. Among the medications highlighted by the Medicines and Healthcare products Regulatory Agency (MHRA) are inhalers, insulin and EpiPens. There is also key advice on ramipril and bisoprolol, as well as other common medications. 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. This week, temperatures are once more anticipated to reach the high 20Cs in several parts of the UK. Having reached a high temperature of 31C on Monday, London was forecast to reach 28C on Tuesday, cooling off slightly from Wednesday to Friday, before hitting 28C again through the weekend. Early forecasts show it exceeding 30C again next week. This makes proper care and storage of your medication essential once again. Most medicines need to be stored at temperatures below 25C, which can be tricky in cars or on public transport, as well as in homes and workplaces. Even bags and pockets can get warm enough to cause problems, especially if you’re out all day or at a festival, sports event, or the beach. 'One medicine that requires particular care' The MHRA says: "Some common medicines can make your skin much more likely to burn, even in mild sunshine. This includes some antibiotics, diuretics, antidepressants, or skin treatments for acne or eczema. Painkillers such as ibuprofen or naproxen are also known to sometimes cause mild sun sensitivity, but this is less common and usually only a concern with frequent or long-term use. "One medicine that requires particular care is methotrexate, used to treat conditions like rheumatoid arthritis, psoriasis, Crohn’s disease and cancer. It can cause extreme skin sensitivity to the sun – even at low doses. This can lead to painful rashes, blistering, or swelling that looks like severe sunburn. In rare cases, these reactions have led to serious infections." Why heat affects medications The MHRA warns: "Heat can break down the active ingredients in medicines, meaning they might not work when you need them. That includes tablets, inhalers, hormone patches, insulin, and EpiPens. Some packaging will give clear storage instructions, but not all medicines come with a visible warning." It adds that "medicines that need to be kept in the fridge – such as insulin or certain liquid antibiotics – are especially vulnerable to heat" and that if they’re left out too long or stored incorrectly "they may not work properly when you take them". How do you know if heat has affected medication? One key sign, according to the the MHRA is if your medicine has changed colour, developed an unusual smell, changed texture, or looks different in any way, this could signal heat damage. It advises you to ask your pharmacist for advice. But changes might not always be detectable in this way and the MHRA warns that heat damage can also affect how much medicine your body absorbs, potentially making your usual dose too strong or too weak. So it advises: "If you notice any changes in how you feel or how well your medicines seem to be working during hot weather, speak to your pharmacist or doctor." 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.