Does your bathroom have a medicine cabinet?

Do you keep medicines in it? Because fun fact: this basic architectural reality of many homes invites us to store our medications in the worst possible place.

Heat and humidity are the enemies of most common medications. Luckily, most of the time  the consequences are mild. Except for that one time when it might have been… really bad.

Like… really bad! We’ll get there. [intro] If you keep medicine in your bathroom, you are not alone. I certainly do Maybe it helps you remember to take your meds if you see them every time you brush your teeth Or maybe it’s just the most convenient place.

But bathrooms are not the best places to store medicine. Lots of drugs degrade when they’re exposed to light, heat or humidity. the light part is actually why medicine bottles are like brown colored So not all the light gets through It’s like they have sunglasses on so that not all the light gets through, it’s like they have sunglasses on If anybody in your household, like I don’t know, takes hot showers The chances are, your bathroom hits at least one of those criteria. Now, it’s not like scientists are not aware of this problem.

It is a stunningly dull job, but there are people who monitor the long-term stability of medicines before and after they hit the market. Basically, you stick the medicine in these big chambers meant to mimic the conditions of your average Florida afternoon, like some dark twisted  reflection of a refrigerator. Then you pull some of it out every now and then and check if the medicine is all still there, or if it’s started to degrade.

And while, yes, this is a boring job, I used to work at a quality control laboratory someone has to do it, because we want our vitamins and pain relievers to still work even if the  AC goes out for a few days. This information is where  expiration dates come from. And what we learn from these kinds of experiments is that storing your medicine under too-warm or too-humid conditions is usually not the end of the world.

Your medicine might go bad  before the expiration date. Or it might lose a bit of potency, but still work ok. Take insulin, for example.

Insulin becomes less effective when it’s stored at temperatures above 30 degrees Celsius. But some sources say you can still use it in an emergency. Lidocaine also remains stable after six months at 40 degrees Celsius!

Most over-the-counter medicines are designed to be stable at or close to room temperature. But… you can’t exactly guess based on the kind of medication. Consider four common pain relievers: acetaminophen aka Tylenol, ibuprofen aka Advil, naproxen aka Aleve, and aspirin.

Aka… aspirin. You’d think that these would be the same, especially Advil, Aleve, and aspirin, because they belong to the same class of drug and they all start with A And yet, Advil and Tylenol work best when they’re kept between  20 and 25 degrees Celsius. Meanwhile, aspirin and Aleve are a little hardier and can tolerate temperatures between 15 and 30 degrees.

And that’s just regular tablets before getting you get into stuff  like liquid capsules and stuff. I know. Just…like… check the label, or ask your pharmacist don’t go based on vibes.

Sometimes, improper storage conditions can have mild downsides. For example, consider aspirin again. Aspirin slowly breaks down  into two other compounds: acetate and salicylic acid.

Acetate plus water makes acetic acid, otherwise known as vinegar, which won’t hurt anything in small amounts but also won’t do much for your headache. Salicylic acid might still  offer some pain relief — ancient Sumerians extracted it from willow bark and used it as one of the first painkillers. But, it can be hard on your stomach.

We also couldn’t confirm whether or not it works as a blood thinner, if you’re on an aspirin regimen for your heart. So if you open your aspirin bottle and get a whiff of vinegar, probably time to toss it out But every once in a while, storing medicine improperly  turns out to be dangerous. Which means we need to talk about ranitidine.

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Ranitidine, which was sold under the brand name Zantac, is a heartburn medicine. If you’re a heartburn type of person, you may have noticed that Zantac disappeared from shelves back in 2020. That’s because the FDA was  informed that a chemical called N-nitrosodimethylamine, or NDMA, builds up over time in medicines  that contain ranitidine.

NDMA is classified as a  probable human carcinogen — a substance that might cause cancer. It also occurs naturally and at low concentrations in water and foods like grilled meat. At low levels, it’s not really a cause for concern.

But at higher concentrations, it could increase your risk of developing cancer. So… Just so we’re clear though: You, the consumer, are not responsible for making sure your medicine doesn’t decay into a carcinogen, even if you do keep it next to the shower. Regulatory agencies like the FDA exist to make sure medicines are safe, and the FDA launched a full investigation once they learned this might occur.

The FDA found that NDMA will  build up in ranitidine medicines over time regardless of temperature. But NDMA accumulates faster when ranitidine is stored at higher temperatures, including temperatures that  it might encounter en route to pharmacies or when stored at home. Several companies issued a voluntary recall on ranitidine while the FDA investigated the issue in 2019.

Then, in April 2020, the FDA asked manufacturers to pull ranitidine off the market. Regulatory agencies in the European Union and  Australia followed soon after. Regulators found that the amount of NDMA that builds up in ranitidine products could exceed the acceptable daily intake limit — the amount that hasn’t been shown to cause adverse effects.

For NDMA, that’s about 96  billionths of a gram per day. There is some good news, though — the FDA pulled ranitidine to be on the safe side, and a 2023 study found that ranitidine use was not associated with higher cancer rates. Now that could change, but no reason to scare ya if we don’t know.

And Plus NDMA doesn’t build up in other heartburn medicines, like Prilosec and Nexium, so there are other options for managing heartburn. Also, Zantac, turns out, is back on the market. It’s just a different drug  with the same brand name, so it should be alright Zantac people, uh… please don’t sue us.

Again, even if you kept your Zantac in the hottest, muggiest, most swamp-like bathroom in your house, it’s not your fault that this happens. We included it because it’s like the exception that proves the rule: Usually, if your meds get a  little toasty, they’re fine. And we know that, because there was a time that it wasn’t fine, and the system in place caught it and stopped it.

If you would like to be extra sure you’re storing your medicines safely, here are some steps you can take. Keep your medicine in a cool, dark, and dry place, out of reach of children and pets Depending on your situation, a closet, dresser drawer, or kitchen cabinet away from the stove might be good choices. If there just isn’t anywhere that works other than the bathroom, run the fan during and after showers to keep the humidity low.

Also, take out any cotton balls that come in your medicine bottle. Cotton soaks up moisture from the air, and that water that gets trapped in the bottle can break down medicines over time. It’s there in the first place so the pills don’t rattle around and break so you don’t need it anymore once it’s at home Dispose of any medicine that has changed color, consistency, or smell.

And check with your pharmacist for instructions on how to safely get rid of old medicines. Sometimes they’ll even let you drop off certain pills with them. And also… if you’re still hanging on to any old Zantac or other medicine with ranitidine, it’s time to toss it throw that out and ask your doctor about alternatives.

It’s probably a good thing that most medicines don’t  turn into anything harmful when you store them under  less-than-perfect conditions. Because humans are often less than perfect. I know I am, that’s just how we are So it’s a big help when  science can cover the gaps. [ OUTRO ]