Sunshine on my shoulders: Impact on medications

By Karen Kier
Pharmacist on behalf of the ONU HealthWise team

In 1971, songwriter and recording artist John Denver released an album titled Poems, Prayers & Promises.  On this album, he had a release called Sunshine on My Shoulders. The length of this song on the album precluded its play on the radio so the single was remixed with one less verse and released in 1974.  The song hit number one on the U.S. and Canadian charts.   

John Denver was known for his acoustic folk music and was one of the best-selling artists in this genre.  He recorded over 300 songs in his lifetime with approximately 200 being written by the artist himself.  Denver’s songs transcended multiple genres and he could be heard on different types of radio stations. Many of his hits are still played today such as Take Me Home, Country Road and Rocky Mountain High. Country Roads was adopted in 2007 as the official state song of West Virginia, while Colorado legislated Rocky Mountain High as one of their official songs in 2007.  

In 2011, John Denver was the first inductee into the Colorado Music Hall of Fame.  He was never inducted into the Country Music Hall of Fame or the Rock and Roll Hall of Fame. The world lost an icon in music with his plane crash and death in October 1997 near Monterey Bay, California. 

Even though we are heading into the fall season, being cautious about exposure to the sun can be important.  The sun can have adverse effects on the skin, the eyes, and the body’s ability to control temperature.  Medications can cause photosensitivity, which is a medical term for a chemically-induced change in the skin making someone unusually sensitive to light.  

There are 2 types of photosensitivity including photoallergy and phototoxicity.  Photoallergy is an allergic reaction of the skin to the sun.  This reaction is often called sun poisoning or photodermatitis. This reaction can result in red bumps on the body and often requires medical treatment.  Phototoxicity is an irritation of the skin after exposure to ultraviolet (UV) radiation from natural or artificial lighting such as tanning booths.  

Besides the impact of photosensitivity of the skin, exposure to UV light when combined with certain medications can increase the risk of skin cancer, skin aging, skin and eye burns, cataracts, and blood vessel damage.  

Common pain relievers including ibuprofen (Motrin, Advil) and naproxen (Aleve) increase the risk with sun exposure.  Antihistamines used for allergies purchased without a prescription can cause photosensitivity. Supplements like St. John’s Wort have been reported to increase the risk of sun damage. 

Other medications to consider include birth control pills which have an increased risk of photosensitivity.  Sulfa antibiotics as well as blood pressure pills containing hydrochlorothiazide (HCTZ) will increase one’s risk.  Tetracycline and fluoroquinolone (ciprofloxacin and levofloxacin) antibiotics are known to have significant photosensitizing effects with damage to both skin and eyes. Many drugs used for mental health including antidepressants can cause photosensitivity. Amiodarone, a drug used for heart rhythm control, can cause the skin to turn a permanent grayish blue color when exposed to the sun.

Topical medications applied to the skin can increase the risk of sun damage.  Common medications used to treat acne or anti-aging creams both over the counter and prescriptions such as benzyl peroxide, retinoids, and alpha hydroxy acids can increase the risk for sunburn.  

Some drugs known to have adverse effects on the eyes include tamsulosin, amiodarone, topiramate, corticosteroids, hydroxychloroquine, and gabapentin.  The mechanism for these changes is often different based on the type of drug and the part of the eye affected by the medication.  The nonsteroidal anti-inflammatory drugs such as ibuprofen and naproxen increase the risk of eye photosensitivity.  

While some medications increase the risk of photosensitivity, other medications can increase your sensitivity to the heat, which can increase your risk of heat stroke or heat exhaustion.  Drugs can decrease your body’s ability to sweat and naturally help cool the skin.  Other medications can increase your risk of becoming dehydrated or increase your body temperature even without a hot day.  

What is the best way to protect yourself?  Find out if your medications could be photosensitizing or change your body’s temperature control.  Make sure to wear sunscreen and sunglasses. Stay hydrated. Protect from UV rays whether natural or artificial.  Wear hats and protective skin coverings.  No matter the age, it is vital to protect and prevent sun damage.

It is important to talk to your pharmacist or healthcare professional about medications and photosensitivity before the sunshine hits your shoulders!

ONU HealthWise is offering the flu vaccine Monday through Friday from 10:00 a.m. to 5:00 p.m.

ONU HealthWise Pharmacy
419-772-3784

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