The UK is in the midst of its third heatwave of the year, with temperatures consistently rising above 34C.

And while many Britons are focused on avoiding sunburn and staying hydrated, keeping medication at the correct temperature may be just as important.

Health chiefs at the General Pharmaceutical Council say storing medicines at the correct temperature is ‘crucial to maintaining their quality, effectiveness and safety’. 

They advise that medicines that require refrigeration should be kept between 2C and 8C, while most others that are recommended to be kept at room temperature should be stored at temperatures between 15C and 25C.

Once temperatures rise above 25C, some medicines – which people often store in humid areas like cars, kitchens and bathrooms – can become less effective. 

If the drugs become too hot their chemical structure may change, meaning creams can separate, liquids may evaporate and capsules can soften or melt.

Speaking earlier this year, Alison Cave, chief medical officer at the Medicines and Healthcare products Regulatory Agency, said: ‘Let’s face it – when there’s a heatwave, most of us are focused on getting outside and enjoying it while it lasts. 

‘But it’s easy to forget that medicines left in the heat – in cars, bags, or on sunny windowsills – might not work properly when you need them.’

Keeping medication at the correct temperature during a heatwave is crucial (file image)

Proper storage is important for medicines such as weight–loss injections, which should be stored in the refrigerator. 

Jabs such as Mounjaro and Wegovy can be kept at room temperature for up to 30 days, but during a heatwave they may break down when exposed to excessive heat – reducing their effectiveness. 

This is also the case for insulin, the hormone used to treat diabetes by lowering high blood sugar levels.

The UK Health Security Agency has an amber heat–health alert in place for most of England until 9pm on Sunday, meaning Britain is expected to continue sweltering until the end of the weekend.

Other medicines, including inhalers – used to treat asthma and chronic obstructive pulmonary disease – can also be affected by high temperatures, as the gases inside them can expand in the heat. 

The main ingredient in an inhaler for these conditions is hydrofluoroalkane gas, which helps deliver the medicine into lungs and helps patients with their breathing.

Experts also say that blood glucose monitors, used by people with diabetes to measure blood sugar levels, can become less reliable in hot and humid conditions. 

A 2014 study published in the Journal of Science and Technology found that humidity levels of 83 per cent can contribute to these monitors returning false readings.

Humidity levels inside UK homes can exceed that threshold during the summer. 

In July, indoor humidity can climb above 90 per cent in parts of England, including London and Bournemouth, while cities such as Manchester and Birmingham can also experience levels higher than the study’s threshold.

With research showing that many people store medicines in kitchens and bathrooms, where temperatures and humidity fluctuate, experts are urging the public to keep medicines in cool places and ensure they are stored within their recommended temperature range.

The good news is there are simple steps people can take to protect their medicines during hot weather.

As well as moving medicines away from warm areas and direct sunlight, keeping rooms cool by opening windows during cooler parts of the day and using fans to improve air circulation can help.  

If travelling, which can cause medicines to get hot in pockets and bags, experts say they should be packed in insulated pouches or cool bags – but not placed directly next to ice packs because freezing medicines can also damage them.

Anyone who has concerns about whether their medication has changed as a result of being exposed to excessive heat should seek advice from a healthcare professional.

It is crucial to follow the storage instructions for each medication. 

Millions of Americans have experienced it – being awoken in the middle of the night by the familiar sensation of a full bladder. 

Frequent nighttime urination, also known as nocturia, is one of the most common lower urinary tract symptoms in adults. 

Nocturia is often, benignly, caused by excessive fluid intake close to bed and becomes more common as people age. Waking up once during the night is considered normal and occasionally occurs for most people.

But repeated wake ups may be cause for concern.  

Nocturia may be triggered by an overactive bladder, prostate enlargement that prevents complete emptying, reduced bladder capacity from inflammation, infection, prior surgery, or nerve-related bladder problems.

Conditions of the heart or kidneys or diabetes, which can increase sugar in the urine and lead to greater urine production, can also be culprits, according to the American Urological Association.

‘Although it is often assumed to be a normal part of aging, nocturia may have treatable underlying causes,’ said Dr Marisa Clifton, a urologist, associate professor of urology and chief medical officer at Johns Hopkins Bayview Medical Center in Baltimore, Maryland.

Certain medications can also contribute to nighttime urination. ‘These could include diuretics, which are used for treatment of high blood pressure or leg swelling,’ Clifton added. 

Waking up once during the night is considered normal and occasionally occurs for most people

Another culprit affecting the bladder, which is often an underrecognized cause of frequent nighttime urination, is obstructive sleep apnea, a disorder in which throat muscles relax too much during sleep, repeatedly blocking the airway and causing pauses in breathing.  

‘This condition increases production of a hormone, atrial natriuretic peptide, which leads to increased nighttime urine production’ the urologist told Daily Mail.

Atrial natriuretic peptide is a hormone released by the heart. Its purpose is to lower blood pressure and fluid volume by promoting water excretion. However, in doing so, it can cause increased urination. 

How Do Age, Gender and Health Impact Your Risk of Nocturia?

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Clifton told Daily Mail nocturia increases as people age because of changes in sleep cycles, changes in bladder function and capacity and hormonal shifts. 

It is more common in men as they age due to Benign Prostatic Hyperplasia (BPH), also called an enlarged prostate, as well as other prostate conditions, according to the Mayo Clinic. 

For women, a 2019 study cited that menopause causes hormonal changes that may alter the way the bladder functions.

When Should Nighttime Urination Be Discussed with a Doctor?

Waking up just once a night to use the bathroom is generally considered within the realm of normal and rarely requires medical intervention, said Dr Tyler Trump, a urologist in the Glickman Urological Kidney Institute at Cleveland Clinic in Ohio.

‘Where it crosses the line into a clinical concern is when you are waking up multiple times every single night,’ he told Daily Mail. 

‘This is usually the tipping point where sleep fragmentation sets in, causing chronic morning fatigue, brain fog, and a lower quality of life. If it is bothering you, disrupting your sleep, or making you feel exhausted the next day, it is absolutely worth discussing with your doctor.’

If nocturia develops suddenly, or is associated with other new symptoms, evaluation should be undertaken to rule out medical conditions. 

Clifton added: ‘Ultimately, nocturia should be discussed when it is bothersome as there are likely treatments that can improve or treat it.’

Nocturia is often, benignly, caused by excessive fluid intake close to bed and becomes more common as people age

What Lifestyle Habits Can Make Nighttime Urination Worse?

Daily habits play a significant role in how the bladder behaves at night. Trump told Daily Mail the most common disruptors include when and how often you drink, salt intake and medication. 

Fluid Timing and Triggers: Drinking large amounts of fluid right before bed, or consuming ‘diuretic’ fluids like caffeine and alcohol in the evening, actively force your body to produce more urine.

High Salt Intake: A sodium-heavy diet causes your body to retain water during the day, which your body then tries to flush out once you lie down to sleep.

Medication Timing: Taking prescription diuretics (water pills) or certain blood pressure medications too late in the afternoon or evening can cause a spike in nighttime urine production as a side effect.

How is Nocturia Treated?

Treatment for nocturia often starts with restricting fluids before bed, eliminating alcohol and caffeine and timing certain medications carefully.  

If those are unsuccessful, then medications that reduce urine output and relax the bladder muscles can be prescribed. 

Before considering prescription medications, however, Trump suggested several at-home strategies that may help reduce nighttime urination:

Taper Fluids and Reallocate: Cut back on fluids after dinner, moving your liquid intake to earlier in the day. ‘Just be careful not to over-restrict fluids if you are an older adult who already has a low thirst drive,’ he cautioned.

Defy Gravity: If you get swollen ankles or legs by the evening, wear compression stockings during the day and elevate your legs in the late afternoon. This helps move that trapped fluid back into your system so you can pee it out before you go to bed, Trump explained.

The ‘Double Void’ Technique: Right before bed, urinate normally. ‘Then, sit comfortably for 20 to 30 seconds, lean slightly forward, and try to empty any residual urine that didn’t clear the first time,’ he added.

Pelvic Floor Exercises (Kegels): Strengthening these muscles helps all genders send a signal to the bladder to relax, helping to suppress sudden nighttime urination urges.

Bedroom Safety: To reduce the risk of falls while navigating the journey from bed to toilet in the dark, keep the bathroom path clear, use motion-activated night lights and consider a urinal or bedside commode for higher-risk patients.

When Can Excessive Nighttime Urination Signal a Serious Issue?

A 2022 study in International Urology and Nephrology cited that while nocturia is usually a gradual, annoying process, a sudden or acute onset of the condition can be a warning sign that an underlying disease is worsening. 

Trump told Daily Mail you should seek prompt evaluation if nighttime urination is accompanied by blood in the urine, severe pelvic or bladder pain, sudden, unquenchable thirst, which can point to new or uncontrolled diabetes and sudden worsening of leg swelling or shortness of breath, which can indicate heart failure or chronic kidney disease.

The Bottom Line

Nocturia can disrupt sleep and is linked to daytime fatigue, poor concentration, reduced quality of life, depression, falls, and possible dementia risk, Clifton said. 

It is important to note that many individuals may have more than one reason for their frequent nighttime urination, so seeking medical attention should be considered. 

Clifton told Daily Mail: ‘Because sleep quality is so critical to overall health, patients who have significant nocturia that is bothersome should discuss it with their primary care provider.’