Medicines/tablets deteriorated and become ineffective due to heat?

Justsomeguyyy

Hello, I have reason to believe that the medicines that I have been picking up at various pharmacies since June 2022 have deteriorated and were already ineffective and spoiled before I came to get them because they were exposed to heat during the heat wave last summer either at the pharmacy or at the wholesaler.

One of the drugs in question (Mirtazapine) was kept at unsuitable temperatures (+ 25°C) at the wholesaler and the pharmacies where I live (I live in Vaucluse in France one of the hottest towns in France ie .avignon)

I went to 4 different pharmacies here in Vaucluse. The 1st pharmacy is 1km from my home so I went by foot (it was in July so it was much more than 25°C whereas it is noted on the box and the instructions to keep the medicines at a temperature below 25°C)

IT was around 38°C (I live in the hottest region of France: the Vaucluse) so I went to get the medicine at the pharmacy, carrying it in a normal bag and I put it in the cupboard at home

But the drugs/meds (the drug in question Mirtazapine) had already deteriorated and become ineffective due to the heat because I did not feel any sedative effect and I could not sleep while this drug relaxes me, has an effect sedative and makes me sleep (it's not like anxiolytics such as Valium which you become tolerent, is addictive and becomes ineffective after several months)

I have been taking Mirtazapine since 2014 (8 years!) and each time I take it it relaxes me (sedative state) and makes me sleep (I have insomnia related to depression)

So I went to the same pharmacy a 2nd time next month (in August) this time by car and with an insulated bag (which keeps the drugs between 2°C and 8°C)

I transported the meds home by car in the insulated bag (because it was + 25°C in my car and outside also i.e 34°C) and I put them in the fridge immediately when I got home ( so it's impossible that the drugs have deteriorated or become ineffective between the journey from the pharmacy to my home which is 1km away)

So I am sure and certain that the medicines in the pharmacy were exposed to extreme heat due to the heat wave of this summer in France and were kept for months at temperatures above 25°C (even with the air conditioning in the pharmacy, if it is 38 °C, it is necessarily more than 25°C (28°C or 29°C for example depending on what temperature they put the air conditioning on) and have become damaged, spoiled and inefficient due to the heat at the pharmacy

Or maybe at the wholesaler because I don't think ALL the wholesalers in each department in France (there are 96 departments seriously!) are controlled by the ANSM to be honest. So the wholesalers do what they want and keep the drugs at any temperature i.e 28°C or 34°C when they have to be kept at less than 25°C

Because on the box of Mirtazapine, it is noted I quote "no particular conservation" so instead of keeping them at a temperature of - 25°C, the pharmacists keep them on the shelves at room temperature (above 25°C C) while on other drugs i.e levothroyxoine (it is noted to keep at a temperature of - 25°C)

So I think the manufacturers of these drugs have it all wrong! Because the drugs where there is noted "no particular conservation" must in reality be stored at less than 25°C

In short, I went to this same pharmacy for the third time in October and I explained everything to them. I asked them if they could order a box of Mirtazapine for the next day because the boxes of Mirtazpaiine they have they told me have been kept for several months since June

So by ordering the box of Mirtazapine for the next day, the medicine should not be ineffective, spoiled or damaged because it was - 25°C the day I went in October (it was 14°C) and the next day it was 21°C (so less than 25°C)

So I went to pickr up medications and brought them home, but these medications were also already detoriated and spoiled! I know because as I said the Mirtazapine has a sedative effect, makes me sleep but there was no effect at all! Placebo effect!

The pharmacist explained to me that even if meds was kept at - 25°C in their pharmacy, it is possible that at the wholesaler, the medicines were kept at a temperature above 25°C for several weeks/months especially from June to August the hottest months of the year! Especially this year when there was a heat wave during the summer of 2022

So I don't know what to do anymore? I'm trying to find a solution but I can't find one?

Where I lived before (in Aubagne near Marseille) for 17 years, NOT ONCE did this happen. Tablets/medicines were never detororiated or did they became ineffective or spoiled due to the heat

But since I live here in the Vaucluse ( since 2021), at all the pharmacies where I went the tablets were clearly exposed to a temperature above 25°C whether in their pharmacy (those with or without air conditioning) or at the wholesaler of the Vaucluse

And I went to several pharmacies in several towns in Vaucluse i.e Monteux, Carpentras, Cavaillon, Orange, Bédoin, etc.

Although I went to pharmacies in neighboring departments i.e Drôme, Gard, Jura, Ardeche, and the medicines (especially Mirtazapine tablets) were already deteriorated, degraded, spoiled and become ineffective due to the heat and last summer's heat wave

How can we solve this problem? I don't think there is a solution because it's the same everywhere in France. At least in the southern half of France (In the North it is a colder climate so less than 25°C all year round so the drugs/tablets have probably not deteriorated or become ineffective)

I bet this type of thing would NEVER happen in the USA or in countries in Europe like Ireland, Germany, Scandanvia, Poland, Austria,etc since not only are cold countries with cold climates but with stronger regulations and are more professional where they store meds at the right temperature they have to stored at i.e 2-8°C ( diabetic meds), 20°C, 25°C, 30°C

The manufucturers are controlled monthly or even weekly by the ANSM ( I don't know the equivalent association in those countries)

:Even in hot climates similar to France i.e Spain, Romania, Czechia,etc, I'm not sure if this would happen although it's unlikely that the meds would detoriate in those countries

I hope something will be done because it's been since July (9 months) that I have been going to pharmacies in Vaucluse and neighboring departments to pick up my medications only to realize that they were already detororiated, spoiled and become ineffective before bringing them home!

I think someone should contact the manufacturer of Mirtazapine and other meds btw in France and instead of noting "no special storage", he should modify it and write "to be kept at a temperature below 25°C"

This will solve the problem because I don't see any other solutions!?

Even on most brands of Mirtazapine i.e Sandoz, Mylan, Zentiva. There is no particular conservation noted, whereas in reality it is necessary to store Mirtazapine at less than 25°C!

So the French manufacturers have it all wrong! They're stupid if they think pills don't detororiate due to the heat when in relaity they do.

Pills deteriorate, become spoiled and ineffective if stored in the heat during the summer (or during a heat wave) if the temperature is above 25°C (31°C for example)

There are only TWO brands of Mirtazapine where it is noted on the leaflet that Mirtazapine tablets should be stored below 25°C (Almus brand, orodispersible tablets) and below 30°C (Norset brand, coated tablets) but even those have detororiated & become ineffective since I have to take 1,2,3,4,5,6 pills to feel an effect or sedated or tao make me sleep! When in the prvious pharmahy where I used to live 1 pill would make me sleep

All the other brands of Mirtazapine (i.e Sandoz, Teva, Mylan, EG, etc) it is noted and I quote "no special storage which is wrong! Because if the tablets (coated) of Mirtazapine ( just like any other pills) are stored at a temperature higher than 25°C ( 29°C or 34°C for example) the tablets deteriorate and become ineffective due to the heat (I know what I'm talking about because it happened to me. The deteriorated tablets of Mirtazapine that I take do not have no sedative effect and don't make me sleep when usually they do)

So the ANSM should contact the manufacturers of Mirtazapine & other meds in France and advise them to store these drugs there at less than 25°C and to note it on the box or the leaflet

There was the Norset in liquid/oral solution which could be kept at any temperature (i.e. + 25°C) but unfortunately it is no longer marketed in France.

Due to the Mirtazapine tablets which are ineffective, spoiled and detororiatd due to the heat and the temperature to which they have been exposed either at the pharmacy or at the wholesaler, I can no longer sleep (I have not been sleeping well since July )

Finally I sleep but as I have insomnia linked to depression, I fall asleep and get up at abnormal hours

I go to sleep around 6 a.m. and get up at 2 p.m.

This is ruining my life! I need this problem rectified with the conservation of medicines which must be kept cool and not room temperature but they are not doing this either at the wholesaler or pharmacies here in the Vaucluse

Every month it's going to be the same, I'm going to pick up spoiled medication/pills and it won't have any effect on my anxiety, depression and insomnia.

Because I feel very depressed having a major depression, I have a lot of anxiety and sleep only 4-5 hours a night!

Something must be done! What can I do? What do you recommend that I do?

Thank you for reading me and I hope that the ANSM can solve this serious problem

Am I the only one in France who noticed this? That the drugs/pills have deteriorated?

Because it's not only Mirtazapine that has detoriated due to thz heat but also other most ther meds such as anti depressants (i.e Citalopram, Sertraline, etc.) anxiolytics (i.e Xanax, Prazepam), painkillers (i.e doliprane, paractemol, tramadol) and many other meds!

Has anyone else experienced this? Consuming detoriated meds that have been ineffective due to the heat?