ChicagoCraig's reminded that I had to throw away medication because I unwittingly took it out during a winter camping trip. From my understanding, nearly all of our over-the-counter medicine doesn't like to go below freezing, so I threw it out (most within 6 months expiration anyway). I've had Wilderness First Aid training, and planned on taking an EMT course some time in the future. Pretty much for both of these, I wouldn't be giving medication to others. I think I know the limits of most of this type of medication (I read the box, and read other things online. Above all, if I screw up, it's my fault).

So, the question I have: How can I take "simple" medications with me when I'm going to be out during below 40F weather? Things like triple anti-biotic cream, anti-diarrhea, and pain meds.

Y'know, I don't know that this is researched well, or if it is, it's not dissiminated well.

I would assume most tablets/capsules are fine in cold weather.

I have heard some liquid meds do poorly in heat (denaturing proteins, things like that). I would assume problems with freezing liquids would occur if you're using vials and such.

My gut instinct, with absolutely no scientific proof, is you'll be fine for a while, for most meds, for a couple days anyway. where did you hear about freezing and OTC meds?

It's a reasonable question to ask. But I have frozen OTC meds of all sorts and they worked fine for weeks/months afterwards. As with excessive heat and excessive humidity it may reduce the shelf life, but that's assumed with all med's in portable kits.

BTW, I chat up the pharmacist (not the assistant) and make sure I get their newest stock. They never give me a hard time when I explain the intended use. (The pharmacists are almost always intelligent, engaging females; but that has no bearing on the issue, or the chatting up. ;-)

I agree that OTC pills probably are not harmed by occasional freezing temps. I don't know about ointments or liquids (eye drops) but they would obviously be difficult to use while frozen. I keep all my meds in a small zippered pouch so that in cold temps I can remove it from my pack and carry it in my pocket. Just remember to put the ointments in individual, sturdy zip locks (sunscreen as well) because they absolutely will leak eventualy.
leo

If you want to be absolutely sure of liquids not freezing you need to wear it under all major insulating layers. My contact lense liquid (essentially just salty water for cleaning the lenses) froze in the inner pocket of my snowmobile suit. That pocket is on the INSIDE of my snowmobile jacket. You should think that my snowmobile suit should be warm enough, but beneath that layer was several more layers of insulation (my snowmobile bib, my fleece sweather as well as wool underwear). . I was snug and warm in -30 C, the contact lens fluid was evidently not. Since then I've always carried essential can't-freeze items in a small pouch under my middle layer.

The OTC medications in my FAK are frozen and unfrozen repeatedly over several months every year where I live. Advil, Benadryl, Pepto-Bismol and decongestants all continue to work, without any noticable loss of efficacy. Neosporin-treated boo-boos don't get infected.

I wear disposable contact lenses, and I'd really like to stick a spare pair and some solution in my BOB, but I doubt they'd survive the frequent freeze/thaw cycle.

What's the risk of using expired or frozen OTC meds? Is it that the med won't be as effective, or can some turn dangerous over time? I tell you the truth I've never thought about that. I even still take Advil that's 2 years expired.

Don't forget that the tapes on most bandages don't work well in the cold.

ki4buc, unless you're going by something authoritative you read, I don't believe that short-term freezing would harm most of the meds in pill/tablet/capsule form that we'd carry, like pain killers, decongestants, anti-diarrheals, etc. Ointments/gels, I don't know, depending on the ingredients. Anything injectable should be kept from freezing due to the high water content. I know for a fact that insulin can't be used if it has ever been allowed to freeze, so definitely protect that from freezing.

MDinana is right, this is a topic that hasn't really been researched that well, at least publicly. I don't doubt that the pharma manufacturers themselves have more data on this topic than is generally known. It was only recently that DoD contracted with the FDA to test the condition of its stockpile of expired meds, particularly those stored under adverse conditions (usually excessive heat, like over in the sandbox, not excessive cold). Freezing could also affect the consistency of a product, even after thawing out. Ingredients could separate during freezing that might not mix together again when thawed, although I doubt that it would affect the actual potency of the active ingredients.

There are actually a few different considerations to storing meds outside the recommended temp range:
* Has the medication become less potent?
* Has it become more toxic?
* Has freezing physically compromised the sterility of the product?

The first two things would seem to be more affected by heat than cold. Freezing would likely tend to significantly slow down any sort of degradation or chemical reactions that affect either the potency or toxicity of the meds. Freezing any solutions could certainly affect its packaging as the ice swells in volume, especially any rigid containers, so the last item would certainly be a consideration in the cold but few of us probably carry anything injectable.

Just a random tidbit, but I suppose condensation is another consideration that could affect the long-term stability of meds when you bring them back into warmer environments from the cold. But short term, it's probably not much of a consideration. I mean, how many people keep their meds in their steamy bathroom medicine cabinets for years?

Anyway, I don't have any more definitive knowledge than anyone else, but that's my take on it. ki4buc, if you've got a reference, I'd be interested in reading up on the issue in case I'm actually way off in my opinion here.

Slightly off topic, I have a friend that used expired sun screen at high altitude and paid the price. His face burned, blistered and peeled 3 times. His lips seven times.

When in doubt, replace. Especially if it's a critical med.