Can you use expired medicines?

I don’t know about your medicine cabinet, but mine is a jumble of mostly expired medications: the muscle relaxers I got when I threw my back a few years ago; the anti-nausea medicine that I never took during my stomach ailments last summer; Xanax to occasionally help me cope with the dizzying state of the world.

I often wondered what I should do with these expired medicines – if and how I should dispose of them, if they were unsafe to use or if some could still work perfectly. For this week’s newsletter, I dug into research and contacted three prominent pharmacists, one of whom has studied expired drugs, for insight.

With guidance from the United States Food and Drug Administration, manufacturers set drug expiration dates based on tests they have conducted to determine how long the drug will remain safe and effective.

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

For many prescription medications, however, what you see on your bottle is not an expiration date, but an “out of use” date. (On my prescriptions, that date appears after the words “Discard before.”) 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 clinical director. to healthcare technology company Omnicell. This is because a pharmacist often has to manipulate, mix with other ingredients and move a medicine into a new container in order to give it to you, which reduces the duration of use, he said.

For some drugs, the expiry date is only a few days or weeks after the drug is dispensed. “A powdered antibiotic suspension may be good on the pharmacy shelf for two years, but only for 14 days once the pharmacy adds water and dispenses it to the patient,” Sheridan explained.

Although expiration and beyond use dates provide useful information – you can be sure that your medicine will work for at least that long if it has been properly stored (more on that in a minute) – the drugs don’t necessarily become dangerous or less potent once that date has passed, said Lee Cantrell, a clinical pharmacist at the School of Pharmacy at the University of California, San Francisco.

In a small 2012 study, Dr. Cantrell and three colleagues tested eight drugs, containing 14 very different active ingredients, that had been sitting unopened in a pharmacy cupboard with expiration dates that had passed between 28 and 40 years earlier. They found that 86% of the drug ingredients were still present at the concentrations they were supposed to be. The results suggest that some drugs, like acetaminophen and the opioid painkiller hydrocodone, retain their potency “for a very, very long time,” he said.

Dr. Cantrell stressed, however, that he and his colleagues had not actually tested the drugs on people. “I can’t say it’s OK to take expired medicine,” he said. The FDA has also not recommended take expired medication. However, he has worked at the California Poison Control Center in San Diego for nearly 30 years and said people regularly call the center after realizing they’ve taken expired medication, worried about what’s next. To his knowledge, nothing wrong has ever happened, he said.

Dr. Cantrell’s study is one of the few published studies that have assessed the chemistry of expired drugs. In a study published in 2006, researchers from the FDA and the pharmaceutical company Sandoz tested 122 different pharmaceutical products and found that 88% 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 dates if it turns out they are working and safe. You can check if the expiration dates of any of the medications you have have been extended by search here.

When considering taking expired medicine, use common sense. It is safer to take an expired medicine to treat a health nuisance – like ibuprofen to relieve a headache or an allergy medicine to treat mild hay fever – than to take one to treat a serious illness, Dr. Cantrell said.

One class of drugs you shouldn’t use past their expiration date are antibiotics, Dr. Stevenson said. If you take an antibiotic that’s not as strong as it should be, “it might actually be harmful,” he said, because the medicine might not fight your infection effectively. To research from the 1960s also linked expired tetracycline to kidney problems, possibly because the antibiotic produces dangerous chemicals when it breaks down, but it is unclear if current formulations pose this risk.

Mr Sheridan also warned against using expired eye drops – they can be contaminated with microorganisms; and stale nitroglycerin, as the explosive that is also used to treat chest pain in people with heart disease loses potency over time. The American Diabetes Association also does not recommend using insulin past its expiration date.

Most drugs can be thrown in the trash, but the FDA recommended that you mix them with coffee grounds, soil, or kitty litter so they are less appealing to children or pets who might consider eating them, and that they should be sealed in a bag or a container. Some drugs that have abuse potential, including those that contain opioids, should not be discarded.

According to the FDA, these drugs can be flushed down the toilet, but the The Environmental Protection Agency warns this can cause the drugs to contaminate drinking water, rivers and lakes, as many water treatment plants are not equipped to remove the drugs. Mr Sheridan instead recommended depositing medications in secure medication disposal boxes found in pharmacies. Additionally, the Drug Enforcement Administration partners with local governments to collect drugs from designated sites.National Prescription Drug Take Back Day“events.

To ensure that your medications will work until – and possibly after – their expiration date or beyond the use-by dates, store them properly. “Ironically, a medicine cabinet in a bathroom is not a good place to store medicine,” Mr Sheridan said. “High temperatures and humidity can cause the drug to break down more quickly.” He suggested storing the drugs in cool, dry places out of direct sunlight (and children). But of course, if there are different storage instructions on the bottle, be sure to follow them. Some medications, for example, need to be refrigerated.

Clearly, I have some changes to make 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 can’t throw away all my expired medicine – or at least not yet. I will save my slightly expired ibuprofen for emergencies. And maybe my Xanax.

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