PubMedCureus2026-10-25
Could Climate Change Be Silently Damaging Medicines We Keep at Home?
Helito Paulo P, Al-Baker Alanoud A AA, Khalil Zeyad Z, Osman Taha T et al.
Climate change is increasing the likelihood of medicines being exposed to temperatures outside recommended storage conditions after dispensing. Unlike controlled pharmaceutical storage and stability testing environments, everyday settings such as homes, vehicles, bags, delivery packages, domestic refrigerators, and periods of power interruption may subject medicines to fluctuating or extreme temperatures. The clinical significance of these exposures, however, remains uncertain and is likely to vary considerably between products. This scoping review maps the available evidence on post-dispensing temperature exposure and medication stability, with particular attention to real-world storage conditions, physicochemical integrity, biological activity, potential clinical consequences, and practical strategies for reducing temperature-related risk. Evidence was considered across a range of temperature-sensitive and commonly used medicines, including insulin, refrigerated biologics, epinephrine, inhaled medicines, nitroglycerin, and oral formulations, together with studies evaluating household refrigeration, vehicle exposure, and low-resource cooling approaches. The available literature indicates that medicines may frequently encounter conditions outside labelled storage recommendations after leaving formal supply chains. Nevertheless, exposure beyond a labelled temperature range should not be interpreted automatically as loss of pharmaceutical quality or clinical effectiveness. Thermal stability varies substantially according to formulation, temperature intensity, duration of exposure, cumulative thermal history, packaging, and storage conditions. Current evidence is strongest for selected temperature-sensitive medicines but remains fragmented across many other drug classes. Overall, the literature supports a plausible climate-sensitive pathway linking increasing environmental heat with post-dispensing medication-quality risk, but evidence is currently insufficient to quantify the associated clinical burden at population level. Important priorities include characterising cumulative real-world thermal exposure, establishing clinically meaningful degradation thresholds, linking temperature histories with patient outcomes, and evaluating feasible adaptation measures. Climate-resilient medication management will require clearer storage guidance, improved patient education, practical cooling solutions, more reliable refrigeration, temperature-monitoring technologies, and stronger surveillance of medicines after dispensing.
