Burning Sulfa? Freezing Sulfa? Striking a happy medium...

April 18, 2011 5:08 AM

My RA medication (sulfasalazine) seems to work less well after I am about halfway through a bottle of tablets (i.e. about halfway through each 30 day supply). How do I keep the tablets at a defined (warmer than average) temperature, in case storage conditions are an issue? Details inside.

Suggested storage conditions are 77 deg F with brief excursions to 59 - 86 deg F permitted.
1) How likely is it that storage conditions (a kitched cabinet) are causing an issue?
2) How would you suggest keeping tablets at 77 deg F?
Our house, FWIW, is generally heated to 70 deg F in the daytime, and 62 deg F at nighttime.

posted by blue_wardrobe to Health & Fitness (8 answers total)

Best answer: An insulated storage bag might help with temperature swings. Sulfasalazine can also be affected by exposure to light and moisture. You could do a couple things to address this:

• Ask the pharmacist to split your 30-day supply into two or three bottles
• Store the unopened bottles in a bag with a desiccant to absorb moisture

Keep the second (and third) bottle closed and stored in a Ziploc baggie with a desiccant packet until you need to open them up later in the month.
posted by Blazecock Pileon at 5:25 AM on April 18, 2011

I'd start hunting around your house for warm spots. (Possible ideas: by the hot water heater. Next to the fridge. Next to the fancy coffee machine that's always plugged in. The cat. Etc.)

Then I'd take a room thermometer (not one you stick under your tongue) and set it up in each of these places for a couple of hours to monitor the temperature swings. Find out which place gives the most consistent, near-77 degree temperature.

Do what Blazecock Pileon suggests and store the drugs in a ziplock with a desiccant pack (possibly inside of another, opaque bag) in your newly-found warm spot.
posted by phunniemee at 7:47 AM on April 18, 2011

Best answer: I'm pretty sure that storing your supply warmer at 77° won't help whatever is going on. Generally speaking, drugs are more stable at lower temperatures (above freezing), and PubMed Health says to store sulfasalazine at room temperature away from heat and moisture. I suspect the package instructions just chose 77°F as some kind of "typical" room temperature for the USA, but your cooler home should be even better.

A kitchen cabinet, however, is probably exposed to too much moisture (PubMed says no bathroom storage, and kitchens are about the same), so move the bottles to a room with no plumbing. Maybe a linen closet out in the hallway? (Upper shelf if you have kids or pets) Or a bedroom closet?

This may be enough, but to really play it safe I think BP has the right idea: protect your supply from moisture. Dessicants, splitting into smaller airtight bottles, maybe putting all the bottles inside a ziplock bag to be extra sure. Keep 'em dark while you're at it.

"Store in a cool dry place" - there's a reason it's a cliché!
posted by Quietgal at 8:19 AM on April 18, 2011

My pharmacy will happily provide me with a week or two weeks of medication rather than a month. I generally need to ask due to financial concerns, but if your meds aren't working because of your storage environment, just refill more frequently.
posted by freshwater at 12:22 PM on April 18, 2011

Temperature can vary inside any room depending on different factors. In my case, living on the top floor of an apartment, my kitchen cabinets near the ceiling tend to get warmer than those on the floor. Now that I think of it, those are the ones above the refrigerator, which definitely generates heat.

Get an insulated lunchbag, as Blazecock Pileon suggests. Actually, talk to the pharmacist as well for ideas.
posted by ZeusHumms at 1:26 PM on April 18, 2011

Could this be related to something else? Do you get, for example, a monthly treatment that could be wearing off around the same time as your sulfasalazine loses its effectiveness?
posted by walla at 2:57 PM on April 18, 2011 [1 favorite]

Response by poster: @walla: thanks for the thought, but no - I did wonder if it is was a purely subjective thing, as I seem to go through a rough patch just before the tablets start to run low, but it could be a selection bias thing. Maybe I have more rough patches but don't attribute them.
@others: thanks for the focus on moisture as a potential culprit - I will deal with this.
posted by blue_wardrobe at 3:39 PM on April 18, 2011

Ask the pharmacist. They're highly trained, and may be able to address a problem you haven't considered.
posted by theora55 at 7:34 PM on April 18, 2011