Risks of getting medicines by mail

CONSUMERS are advised to be careful when buying medicines online or through mail order, as some medicines may become unsafe or ineffective after exposure to extreme temperature or humidity while in transit.

Many pills and capsules need to be kept away from heat, air, moisture and sunlight because they can be damaged or lose their potency after exposure to these elements.

Variations in temperature and humidity can accelerate the ageing of certain medicines. Some thyroid drugs, for example, lack stability and can cause major changes in the body’s response with only very small differences in the amount taken. There were more than 70 recalls by the United States Food and Drug Administration for levothyroxine products (a thyroid drug) between 2007 and 2012 for this reason.

Antibiotics such as penicillin and cephalosporin are also easily weakened or rendered ineffective if kept in unsuitable temperature.

For patients with chronic illness such as diabetes or heart disease, a compromised dose of a crucial medicine, like insulin or nitroglycerin, can be life-threatening.

But even common medicines can break down with potentially harmful effects if they are not stored in optimal conditions. You can’t always tell by looking at the pill or liquid that a problem has occurred, said Janet Engle, a pharmacist and past president of the American Pharmacists Association.

Some medicines, if repacked (either for sale or home use) and inappropriately stored, undergo chemical changes and can be harmful if ingested. The Centre for Adverse Reactions Monitoring in New Zealand reported a case of haematuria (blood in urine) in a patient who repacked dabigatran (a blood thinner) into a weekly pill box. Dabigatran capsules absorb moisture from the surroundings if removed from their original packaging.

In hot environments, some medicines may change their form and become difficult to use. Gelatine capsules may soften, ointments and creams may become runny (hydrocortisone cream, for example, can separate and become useless in the heat), and suppositories may melt.

Buying pharmaceuticals online or via mail order is becoming more common during the current Covid-19 pandemic as people are confined to their homes due to the movement control order. Good practice protocols on the part of retailers are thus important to ensure the integrity and efficacy of a medicinal product to prevent harm to consumers.

The Consumers’ Association of Penang calls on pharmacists and health retailers to strictly adhere to the recommended storage criteria for medicines when distributing them to patients.

Retailers also have a duty of care to ensure that the delivery service they engage does not expose medicines to unfavourable conditions like extreme heat when transporting them to consumers.

Improper storage at home can also affect the quality, effectiveness and safety of medicines. Always read the instructions on the label for proper storage.

MOHIDEEN ABDUL KADER

President

Consumers’ Association of Penang