Expired Drugs- Are They Safe?

Like food, medications have expiration dates. The expiration date means the medication will be effective until that date, if stored under the proper conditions of light, temperature, and moisture. If not stored under suggested conditions, medicine may even expire before the expiration date. The expiration date on most medications is two years after the drug is manufactured.

Is medication safe to take after that date?
Even the experts disagree. Sondra May, the Medication Safety Coordinator at University Hospital compares taking expired medication to eating expired food. “You have certain foods that you can eat that you know you’ve eaten intentionally and you haven’t experienced any symptoms whatsoever; however, you could eat expired meat and become very, very sick. You’re taking a risk if you use a product past that date.” She also warns that medication can actually make the situation worse, “Unfortunately there are situations when you could take a medication that’s expired and have worse symptoms.”

The Pittsburgh Poison Control Center of The Children’s Hospital of Pittsburgh further warns, “Medications that have passed their expiration can pose a significant risk to children.” It is extremely important to properly dispose of expired medications to avoid serious injury, such as falls or poisonings for older adults and children,” says Public Health Nurse Marnie Garrett.

In Southern Arizona, the community is promoting a drive to collect and properly dispose of expired medications. Kathilee Champlin, project organizer and founder, began a similar campaign in Colorado in 1991. More than six tons of unused and expired medications have been collected, some dating back to the 1940’s. “But once the container is opened and exposed to an unpredictable environment, it is difficult to predict the drug effectiveness,” Dr. Robbe C. Lyon, deputy director of product quality research at the FDA, said consumers should pay attention to expiration dates on their drug bottles because the shelf-life program’s findings apply to drugs stored in the original containers under ideal conditions. Lyon said. “For patients who rely on medications to stay alive, like heart medications, expired drugs can be dangerous because they may not be getting the full effectiveness of the drug.”

However, not everyone agrees that expired medications are unsafe. The Medical Letter, a respected source of independent information about drugs, stated in a 2002 article that certain medicines, stored in high humidity and other bad conditions, stayed good to use for 1 1/2 to nine years after their expiration dates.

“For instance, Symmetrel (amantadine) and Flumadine (rimantidine), anti-viral drugs used to prevent and treat influenza, withstood 160-degree temperatures and were good after the equivalent of 25 years of ordinary storage,” the reports states. “Many drugs stored under reasonable conditions retain 90 percent of their potency for at least five years after the expiration date on the label, and sometimes much longer.”

No one knows for sure if expired medications are safe. A consumer-oriented version of the Pentagon shelf-life program – which would check the actual life span of prescription drugs stored in bathrooms, kitchens, purses and cars – has never been done. “Currently, I am not aware of any programs that focus on drug stability in the consumer environment,” said Dr. Claudia Okeke, an associate director at the U.S. Pharmacopeia in Rockville, Md.

So how does a consumer know what to believe? There are some guidelines. If the medication has been opened, or stored in a high temperature or high humidity environment (like your bathroom medicine cabinet), it is wise to dispose of it. Tetracycline type antibiotics and some seizure medications can cause serious toxicity if taken beyond the expiration date. Liquid drugs are less stable than tablet/powder/capsule medications. Some medications are especially affected by age. For example, taking oral contraceptives that have expired may produce an unexpected pregnancy. Some drugs obviously disintegrate, such as acetilysalycilic acid, that develops an acidic smell when it is old.

If you have a question about the safety of a particular drug, take the medication to show to your physician and get his advice. With the cost of drugs skyrocketing, taking expired drugs may be tempting, but it’s better to be safe than sorry.

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