You might be having a lot of expired drugs in your drugs cabinet. Maybe you haven’t thrown them away because you haven’t gotten around to checking all the expiry dates. Well, you needn’t throw away all expired medications, as some expired medications can be used even if their ‘Use by’ date has come and gone. If the medicine has been stored properly, then some of your expired medicines will not do you any harm, especially if you know which ones you should use and those which you should throw away. Here is a small guide to taking expired medications:
Brief guide to taking expired medications
If you’re wondering is it safe to use expired medications, in some cases it is safe, according to doctors. First, let’s understand what the expiry date means, and also, whether some medicines can turn into harmful medicines post expiry.
What does the expiry date mean
The expiry date means that it is the date till which the manufacturer of the medicine guarantees the safety and full potency of the medicine. Expiry dates are a must on almost all medications including OTC drugs and herbal supplements, all over the world. Manufacturers usually test for the medicine’s efficacy and stability for about 2-3 years. The stability might be longer, but manufacturers do not test for this. Some studies have shown that some medicines are safe to be used even after their expiry date.
Are expired medicines potent enough?
According to the AMA, the actual life of some medicines is longer than the expiry date. The study SLEP, conducted by the FDA found that some drugs could be used upto 15 years after expiry. Amoxicillin, diphenhydramine, ciprofloxacin, morphine sulfate were included in the study, but biologics was not included in the SLEP study.
According to guide to taking expired medications, liquid medicines, after opening, lose their potency and are prone to contamination to bacteria. These should therefore not be used after being opened. This is why eye drops should never be touched to the eyes after they are opened.
With time, some drugs may lose their potency, especially life-saving drugs will not be effective if they are used after expiry.
For example, if you’re thinking is it safe to use your expired EpiPen, they can be used past expiry date upto one year, but the efficacy might be reduced by about 30-50%. This might put you at risk of your life, so it means that you should not use EpiPens beyond expiry dates.
Similarly, if you use OTC painkillers after the date of expiry, these can lose potency, and you may not get the same effect. These become harmful medicines, especially if you increase the dosage, and might potentially damage the liver or kidneys.
Which medicines should you discard after expiry date?
There are some medicines which are essential for chronic and life threatening diseases such as heart disease, cancer or serious allergies which should always be used fresh. Some medicines which according to the guide to taking expired medications, should be discarded after expiry are:
- Oral NTG (nitroglycerin), a medicine which is prescribed for angina/chest pain, as it may lose potency after opening the bottle
- Insulin, which is used to regulate blood sugar in diabetics, can degrade after expiry
- Vaccines and biologics (blood products) can lose potency and become ineffective after expiry
- Tetracycline, which might release a harmful metabolite
- Medicines which look old – they might be crumbling, dried up ointments or medicines with a very strong smell
- One of the most important things to remember according to guide to taking expired medications is to discard all expired or unused controlled substances such as acetaminophen (Norco, Lotab, Vicodin), hydrocodone, or oxycodone (Oxycontin). This is because there is a risk of overdose, diversion and misuse of these substances.
Where and how to store to keep medicines potent
Properly storing medicines can extend the potency. Your medicine and bathroom cabinet are not the ideal places for storing medicines, due to humidity and heat. You should also not store medicines in the glove box, hot cars or in frozen conditions. Store medicines in cool and dry spaces; close them tight and keep them away from pets and children.
Can you use antibiotics after their expiry date
It seems that there are very few antibiotics, such as tetracycline, which break down into toxic substances. You can use some antibiotics after expiry date, but if the potency has decreased, you may find that your bacterial infection is not getting cured. Using expired antibiotics may favor the emergence/growth of resistant bacterial strains. In other words, you will be ill, and also have mutant bacteria. What’s worse is that your family members too can catch the strain of antibiotic resistant bacteria.
How to tell if an antibiotic has gone bad?
The guide to taking expired medications will help you know whether you can use antibiotics after expiry date. There is no straight answer – there are some signs for some antibiotics to tell whether they are safe for use, and there are none for others.
Looks, taste and smell will not reveal whether the stability of the capsule/tablet has degraded. Sometimes, a liquid antibiotic suspension will change color with age, but mostly liquid antibiotics lose potency much before expiry. Altered appearance is usually a sign to discard any medicine, antibiotic or not!
Pessaries, suppositories, ointments and creams which have melted should definitely be thrown away.
So, should you use expired medications?
To sum up, most medicines are unsafe to be used after expiry, whereas some can be used for a long time after expiry. Any medication which has an altered appearance either before or after expiry date should not be used. Blood products (biologics), vaccines, insulin, EpiPen, life saving medicines should be avoided after expiry. Antibiotics too should be discarded after expiry.
Most medicines can be used a day or even a week after expiry, but you should try to buy new medication as far as possible. Even in a survival situation, where you cannot get hold of fresh medication, you have to use your judgment whether to use expired antibiotics/medicines and take your chances. The best course of action is buying only the exact quantity of medicine you need, so that they finish well before the expiry date! And do check the expiry date on the medicine before buying it.