Can you use expired medicines?

Can you use expired medicines?

I don’t know about your medicine cabinet, but mine is a hodgepodge of drugs that have largely expired: the muscle relaxants I got when I stuck my back out a few years ago; the anti-nausea medicine I never took during my stomach upset last summer; the Xanax to occasionally help me cope with the dizzying state of the world.

I’ve often wondered what to do with these expired drugs – if and how to dispose of them, if they are unsafe to use or if some of them still work perfectly. For this week’s newsletter, I dug into the research and reached out to three leading pharmacists, one of whom has studied expired drugs, to gain some insight.

Under the guidance of the U.S. Food and Drug Administration, manufacturers determine the expiration dates of drugs based on tests they’ve conducted to determine how long the medication will remain safe and effective.

An expiration date “represents a promise that the drug will be good for at least as long, if stored properly,” explains Dan Sheridan, a drug safety pharmacist at OhioHealth Marion General Hospital. Many expiration dates are between one and five years after the drug is made.

However, for many prescription drugs, what you see on your bottle is not an expiration date, but a date when you can no longer use it. (On my prescriptions, this date is after the words “Discard by.”) The expiration date is usually earlier than the drug’s original expiration date, explained James Stevenson, a pharmacist at the University of Michigan College of Pharmacy and the chief clinical officer at the healthcare technology company Omnicell. That’s because a pharmacist often has to handle a drug, mix it with other ingredients, and move it to a new container to give it to you, and this reduces the amount of time it will be usable, he said.

For some drugs, the expiration date is only a few days or weeks after the drug is released. “A powdered antibiotic suspension may be good on the pharmacy shelf for two years, but only 14 days if the pharmacy adds water and gives it to the patient,” explains Mr. Sheridan out.

While expiration dates and dates provide useful information – you can rest assured that your medicine will last at least as long if stored properly (more on that later) – medicines don’t necessarily become dangerous or less potent after that date has passed, said Lee Cantrell, a clinical pharmacist with the School of Pharmacy at the University of California, San Francisco.

In a small 2012 study, tested Dr. Cantrell and three colleagues found eight drugs, containing 14 very different active ingredients, that had been sitting unopened in a pharmacy cabinet with an expiration date that had passed between 28 and 40 years earlier. They found that 86 percent of the drugs’ ingredients were still present at the concentrations they should have been. The findings suggest that some drugs, such as acetaminophen and the opioid painkiller hydrocodone, retain their potency “for a long, long time,” he said.

dr. Cantrell pointed out, however, that he and his colleagues didn’t actually test the drugs in humans. “I can’t say it’s OK to take expired drugs,” he said. The FDA too advises against taking expired medications. However, he has worked at the California Poison Control Center in San Diego for nearly 30 years and said people called the center regularly after realizing they had taken expired medications, concerned about what might happen. As far as he knows, nothing bad ever happened, he said.

The study of Dr. Cantrell is one of the few published studies that has evaluated the chemistry of expired drugs. In a study published in 2006, researchers from the FDA and drug company Sandoz tested 122 different drugs and found that 88 percent were still safe to use, an average of 5.5 years after their expiration date.

In fact, the FDA sometimes tests expired drugs needed for public health emergencies and… extend their expiration date if they are found to be working and safe. You can check if the expiration date of any of the drugs you own has been extended by: search here.

Use common sense when considering whether to use an expired medication. It’s safer to take an expired drug to treat health conditions — such as ibuprofen to help headaches or an allergy medicine to treat mild hay fever — than to take one to treat a serious medical condition, said Dr. cantrell.

One class of medications that you shouldn’t use past their expiration dates are antibiotics, said Dr. Stevenson. If you take an antibiotic that isn’t as strong as it should be, “that could actually be harmful,” he said, because the drug may not fight your infection effectively. Research From the 1960s, expired tetracycline also linked to kidney problems, perhaps because the antibiotic produces dangerous chemicals when it breaks down, but it’s unclear whether current formulations pose this risk.

Mr Sheridan also warned against using expired eye drops – they can become contaminated with microorganisms; and expired nitroglycerin, because the explosive also used to treat chest pain in people with heart disease loses its potency over time. The American Diabetes Association does: not recommended also use insulin that has passed its expiration date.

Most drugs can be thrown in the trash, but the FDA recommends that you mix them with coffee grounds, soil, or cat litter to make them less attractive to children or pets who might eat them, and that they should be sealed in a bag or container. Some drugs of abuse, including those containing opioids, should not be thrown away.

According to the FDA, these drugs can either be flushed down the toilet or placed in safe drug containers found at pharmacies. Also, the Drug Enforcement Administration works with local governments to collect drugs at designated”National Day for Take Back Prescription Drugsevents.

In order for your medicines to work until — and perhaps beyond — their expiration date or after the use-by date, you need to store them properly. “Ironically, a medicine cabinet in a bathroom is not a good place to store medicine,” said Mr. sheridan. “The high temperatures and humidity can cause the medication to break down faster.” He suggested keeping medicines in cool, dry places, out of direct sunlight (and children’s reach). But if there are different storage directions on the bottle, you should of course follow them. For example, some medications need to be refrigerated.

Obviously I need to make some changes at home: I keep my meds in the bathroom and I’m pretty sure I have expired antibiotics hiding somewhere in my stash. But I may not throw away all my expired meds — or at least not yet. I will keep my lightly expired ibuprofen close by for emergencies. And maybe my Xanax.

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