Medications and Extreme Heat: A Dangerous Combination

There are many reasons why older adults flock to Florida in retirement. In addition to the tax advantages and abundance of outdoor activities, Florida has delightful warm weather for eight months out of the year!

Unfortunately, there is also a downside to living so close to the equator. Namely, the summer heat index and threat it poses to older adults.

Age and Hyperthermia

The extreme heat in Florida during the summer months can be especially challenging for older adults. That’s because, as we age, the body’s natural defenses against heat are compromised, increasing our risk of heat-related illness and hyperthermia.

As we get older, it becomes harder to regulate body temperature. Age-related changes to the skin can cause poor blood circulation. Sweat gland shrink and become less sensitive with age. As a result, older adults are more vulnerable to heat-related illness.

Under ordinary conditions, the human body can cool itself by sweating, but extreme heat may rise body temperature too fast, putting older adults in danger of heat stroke and heat exhaustion.

Children and adults aged 65 and older are most at risk for heat stroke, but people taking certain medications are also at a disproportionate risk.

Medications with Thermoregulatory Effects

Medications are meant to help us manage chronic health conditions and relieve unwanted symptoms, yet sometimes create unwanted side effects.

Many older adults take prescription medications, but do not fully realize the impact medications can have on body temperature regulation. This is especially important during extreme heat since certain medications are known to increase the risk of heat-related illness.

For example, some medications reduce sweating, preventing the body from cooling naturally. Others lower blood pressure, which can increase the likelihood of fainting in extreme heat. Still others increase sweating which can lead to dehydration.

The key is to understand the risks associated with your medications and take appropriate measures to stay cool during a heat event.

According to the CDC, heat-related illness­­ may increase among those who use the following medications:

  • Psychotropics such as haloperidol or chlorpromazine
  • Tranquilizers such as phenothiazines, butyrophenones and thiozanthenes
  • Diuretics such as furosemide or hydrochlorothiazide

An article in the Journal of Clinical Pharmacy and Therapeutics point to diuretics as a significant risk factor for heat-related illness, especially when combined with an angiotensin converting enzyme (ACE) inhibitor or an angiotensin II receptor blocker (ARB), anticholinergics and psychotropics.

According to, medications for enlarged prostate and overactive bladder, including tamsulosin, oxybutynin and tolterodine, may also diminish the body’s ability to cool itself, putting seniors at increased risk of heat-related illnesses.

Other medications that interfere with temperature regulation and cause heat sensitivity include antihistamines, beta-blockers and amphetamines, as reported by

Heat-Related illness and Body Thermoregulation

We know certain medicines accentuate the risk of heat-related illness, but how exactly? Oftentimes sweat—or the lack of it—is to blame.

The body relies on the evaporation of sweat to cool itself in extreme heat and a disrupted capacity to sweat—whether caused by diuretics or antiparkinson drugs—is often the cause of illness.

The body has several million sweat glands, but some drugs interfere with the muscarinic nerve endings of the cholinergic nerve fibres that innervate the sweat glands. When you lose the ability to sweat, the body cannot regulate core body temperature

Combined with other side effects, medications can disrupt normal thermoregulatory function in more ways than one:

  • Diuresis and electrolyte imbalance
  • Sedation and cognitive impairment
  • Reduced thirst recognition
  • Reduced sweat production
  • Changes in peripheral vasodilation or hypotension
  • Changes in cardiac output

If you are unsure of your risk, talk to your doctor about the possible interaction between your prescription medications and extreme heat.

Medical Conditions and Heat Safety

Many older adults take more than one prescription drug and manage a chronic health condition like heart disease and dementia, creating an unsafe recipe in extreme heat.

What’s more, some health conditions both increase the risk of heat-related illness and are treated by drugs that impact thermoregulation.

Studies have shown that people with mental illness are at an even higher risk of heat stroke due to psychiatric medications.  Alzheimer’s disease and dementia also place older adults at higher risk of heat stroke. The confusion caused by dementia may impair a person’s ability to recognize warning signs in the body, including dehydration and heat exhaustion. Or, the symptoms and behaviors of dementia may cause someone to wander outside, become lost, or seek shelter in a parked car, which can reach dangerously high temperatures in the heat.

Memory Care and Senior Safety

Wandering is so common among people with dementia that many organizations offer GPS bracelets that can help you locate your loved one if they leave home without your knowledge or become lost.

A memory care community such as Serenades Memory Care by Sonata is the safest option to assure protection in extreme heat. Safety and security features such as monitored entrances and exits are built into the design of memory care communities to prevent a loved one from wandering outside in the extreme heat.

Remember, heat stroke is a medical emergency. If you believe someone may be suffering from heat stroke, call 911 or get medical attention right away.

To learn more about Serenades Memory Care and senior safety at Sonata,
schedule a visit to a community near you.


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