The U.S. Food and Drug Administration (FDA) offers the following information on the use of
medications that have been potentially affected by fire, flooding or unsafe water, and the use of
temperature-sensitive drug products when refrigeration is temporarily unavailable.
Drugs Exposed to Excessive Heat, such as Fire
The effectiveness of drugs can be destroyed by high temperatures associated with fires. You should
consider replacing your medications if there’s a possibility that your medication was exposed to
excessive heat, such as fires.
Lifesaving Drugs Exposed to Heat
In a disaster, it is especially important to assure the effectiveness of lifesaving drugs, and
therefore these should be replaced as soon as possible. However, if the lifesaving medication in
its container looks normal to you, the medication can be used until a replacement is available.
Drugs Exposed to Unsafe Water
Drugs (pills, oral liquids, drugs for injection, inhalers, skin medications) that are exposed to
flood or unsafe municipal water may become contaminated. This contamination may lead to diseases
that can cause serious health effects.
We recommend that drug products–even those in their original containers–should be discarded if they
have come into contact with flood or contaminated water. In the ideal setting, capsules, tablets,
and liquids in drug containers with screw-top caps, snap lids, or droppers, should be discarded if
they are contaminated. In addition, medications that have been placed in any alternative storage
containers should be discarded if they have come in contact with flood or contaminated water.
Lifesaving Drugs Exposed To Water
In many situations, these drugs may be lifesaving and replacements may not be readily available.
For these lifesaving drugs, if the container is contaminated but the contents appear unaffected–if
the pills are dry–the pills may be used until a replacement can be obtained. However, if a pill is
wet, it is contaminated and should be discarded.
For children’s drugs that have to be made into a liquid using water (reconstituted), the drug
should only be reconstituted with purified or bottled water. Liquids other than water should not be
used to reconstitute these products.
Drugs that Need Refrigeration
Some drugs require refrigeration (for example, insulin, somatropin, and drugs that have been
reconstituted). If electrical power has been off for a long time, the drug should be discarded.
However, if the drug is absolutely necessary to sustain life (insulin, for example), it may be used
until a new supply is available.
Because temperature sensitive drugs lose potency if not refrigerated, they should be replaced with
a new supply as soon as possible. For example, insulin that is not refrigerated has a shorter shelf
life than the labeled expiration date. (Please see Information Regarding Insulin Storage2 for more
If a contaminated product is considered medically necessary and would be difficult to replace
quickly, you should contact a healthcare provider (for example, Red Cross, poison control, health
departments, etc.) for guidance.
If you are concerned about the efficacy or safety of a particular product, contact your pharmacist,
healthcare provider or the manufacturer’s customer service department
NCPIE encourages healthcare professionals and community groups to foster patient–professional communication about medicines. However, NCPIE does not supervise or endorse the activities of any group or professional. Discussion and action concerning medicines are solely the responsibility of the patient and their healthcare professionals, and not NCPIE.
Please consult a licensed health care professional with questions or concerns about your medication and/or condition.