High temperatures (above 25°C) can affect the efficacy of your medication, so it is important to ensure you store it correctly in hot conditions.  Be particularly vigilant with medication stored in emergency injection kits that you would usually store in the car, where temperatures may get high.

If your medicine has changed colour, developed an unusual smell, changed texture or looks different, this could signal heat damage. Order replacements and discard the degraded medication when you have new stock available.

Preventing heat damage
  • Check the manufacturer's instructions to see if your medication needs to be kept at a certain temperature. Solid medicines (tablets and capsules) are usually stable for a short time above 25°C – just store them somewhere cool, dark and shaded. 
  • In extreme heat, some medication may need to be refrigerated to keep cool.  In the short term, blister packaging should protect from the risk of any moisture damaging the medication. Refrigeration can help during heatwaves, though we wouldn't recommend it long-term. Be aware of any change to your medication.
  • Check how your medication should be stored (e.g. in a sealed container, to block out light). Cool bags or pouches designed for items like insulin can also help keep medication cool in summer and are available online or speak with your pharmacist.
  • Emergency injection medication: Hydrocortisone sodium succinate (previously known as Solu-Cortef) is more stable in hot weather than hydrocortisone sodium phosphate (liquid hydrocortisone, which was discontinued in the UK in May 2026), so it is a good option for when going abroad.

    If you are still worried, you may be able to contact individual manufacturers for additional and specific advice on your situation.

Managing your Salt/Fluid Balance

  • Stay well hydrated by drinking plenty of water, plain or sparkling
  • Start as you mean to go on, with drinking plenty on a flight when you can get dehydrated more easily
  • Be aware that bottled water is often very low in sodium and other minerals, so it can just go straight through you.
  • In very hot climates, keep your salt levels up by enjoying salty foods and snacks and consider rehydration fluids or salts (available in most chemists).
Fludrocortisone

If you have Primary Adrenal Insufficiency (e.g. Addison's) and take daily fludrocortisone, your usual dose will be based on UK temperatures, mostly under 20/25°C.  You may need to increase the dose in high temperatures. 

  • For temperatures over 30º, it’s usually recommended to increase the fludrocortisone dose by half. Your endocrinologist can give personalised advice if you are prone to high blood pressure.
  • A reliable sign you need more fludrocortisone is feeling light-headed, often starting with a washed-out, drained feeling. Don’t be afraid to top up your dose if you feel you need to (see our "Why Salt?" blog).

Why Salt?

Listen to your body

  • Stay cool and keep out of the sun.
  • Dress sensibly – long, light, loose clothes and a hat in direct sunshine.
  • Hot weather on holiday: It is easy to want to do everything when you’re travelling: You want to pack all the sights and experiences in, with early starts and late nights.  Addison's and adrenal insufficiency have a knack of catching up with us when we overdo things, so watch for the signs that you need a rest, or for low cortisol symptoms that signal a need to updose.

Thank you to Matthew Heppel, endocrinology pharmacist and Clinical Advisory Panel member, for clarifying the guidance on medication storage.

You may also be interested in:

Translated Adrenal Crisis Guidelines

Heading abroad? Ensue you get the best care when you need it - print off adrenal crisis guidelines in the language you need.

Managing Travel & Holidays

Read our advice on how to best manage your adrenal insufficiency, including Addison's, when you are on holiday or travelling.

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