My medications are delivered to my home while I am at work. They look almost melted when the mail order pharmacy delivers them. Is it safe to take them?

The question has become very important this season as record temperatures combined with a greater number of people relying on mail order and specialty pharmacies increases.

There is not evidence that the temporary exposure to heat causes the medication to be ineffective or unsafe. But the questions of "how hot is too hot?" and "how long is too long?" have not been answered. Almost all clinical trials involving medications require that the medication be maintained, stored and shipped in temperature controlled environments. Some exceptions are made for brief excursions when being shipped, moved, stored or dispensed. And it is these stringent clinical trials that our current knowledge of medication storage and shipping practices and recommendations is based.

There are pharmacists and clinical researchers at the major drug companies and mail order pharmacies who are attempting to answer the question now, but we don't have the necessary answers yet.

What can you do? You should submit a request in writing to the company that ships your medication, for the drug(s) to be sent in a protective container with a freezer pack or cold pack. If any medication shows signs of melting, sweating, cracking, discoloration or other physical change to the outside of the pill or capsule, you should not take the medication. If you have any concerns that the effectiveness of the medication you have taken has been compromised, please share those concerns with your hematologist, oncologist or CML specialist. They will be able to arrange more frequent testing to confidently determine if your condition has changed in any way.

Strategies you can use during warm weather months:

1.  Have your medications delivered to your office or workplace, instead of to your empty front porch.

2.  Request in writing that your mail order pharmacy pack the medication in a layered or insulated container or cooler, with the addition of a freezer pack or cold pack.

3.  Request in writing that your mail order pharmacy send your shipment overnight to avoid long layovers in warmer climates.

4. If there is any delay in getting your medication on time, please contact your CML specialist, hematologist or oncologist so that they can help you make arrangements to obtain your drug on schedule. Skipping doses is NOT an option.