Several common drugs reduce the body's ability to cope with heat. Diuretics and drugs that lower blood pressure can worsen dehydration and low blood pressure. Anticholinergic drugs, including some antihistamines, antipsychotics and tricyclic antidepressants, reduce sweating. Beta-blockers can limit the heart's response to heat stress.
For patients on several of these, particularly older people or those who work outdoors, a short review before summer is worthwhile. Check whether each drug is still needed, whether a dose can be lowered, and give a plan for fluids, rest and when to seek help. Do not stop a drug such as a beta-blocker without a clear reason.
- List diuretics, antihypertensives and anticholinergic drugs in each patient at risk.
- Check whether each is still needed before the hot season.
- Give a plan for fluids, rest and warning signs of heat illness.
- Do not stop cardiac drugs abruptly without a clear plan.
Why it matters
Medicines that were safe in cool months can contribute to heat illness in summer.
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