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Haqq L, McFarlane J, Dieberg G, Smart N

Hydroxyzine and escitalopram (Lexapro/Cipralex) both independently prolong the QT interval a measure of heart electrical activity and combining them significantly increases the risk of potentially dangerous cardiac arrhythmias

For short trips (day trips or overnight stays): In-use multi-dose pens can be carried at room temperature in their protective case, within their permitted in-use period Unopened pens should generally be kept refrigerated, though some may be kept at room temperature for limited periods (check your specific product information) Use an insulated medication travel case to protect from temperature extremes Avoid leaving medication in cars , particularly during warm weather or in direct sunlight Keep medication in hand luggage when flying, never in checked baggage where temperatures may fall below freezing For longer journeys requiring refrigeration: Use a medical-grade cooling case or insulated travel wallet with ice packs designed for medication transport Avoid direct contact between ice packs and medication pens , as this may cause freezing

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Any medication that reduces appetite and leads to sustained calorie deficit can contribute to feeling cold