You have probably been there; your sinuses are killing you. Your nose is running, your headache is unbearable, yet you still need to see patients for another five hours. You reach for the bottle of aspirin only to find the expiration date has come and gone by many months.
Do you take the medicine anyway? If you do, what will happen? Most importantly, will it relieve your negative symptoms?
It’s not only good for you to know the answers to these questions, but your patients need to know them also. They are in your care and you want them to be safe when taking medications, especially ones prescribed by you.
Expiration dates on medicines can be controversial, depending on who you are talking to. Some firmly believe a medicine should be thrown out when it expires, like milk from the grocery. Others believe expiration dates are simply recommendations.
Let’s get to the truth of the matter.
Expiration Dates Defined
Many people think a medication expiration date is the day that a medicine becomes harmful or bad. This is not always true, however. The expiration date on a medicine is the date that the manufacturer guarantees full potency of the drug.
This means drugs are still good, but they may not be able to offer full benefits as if before the expiration date. Expiration dates are required on prescription and over the counter medications.
Expiration dates can go by other names, depending on the manufacturer. “Sell by” or “Best Used By” are just two of the labels used. These are followed by an actual date in the form of month and year.
Why Do Expiration Dates Exist?
The expiration date is established through multiple testing by the manufacturer. They use stability and temperature testing using guidelines set forth by the Food and Drug Administration.
To be safe, the makers of the medication often set an expiration date that is shorter than the actual date the medicine loses potency. They do this to avoid any liability issues if a patient were experience negative symptoms from the medicine.
Many arguments support the theory that expiration dates allow for large pharmaceutical companies and our government to make more money. Even though millions of dollars are lost through waste and tossing out expired medications, billions can be earned with every new medication purchased.
Loss of Potency
Medications do lose potency over time. Every medication has a different potency that extends past the expiration date. Most expiration dates range from six months to 3 years. However, many studies have found medications to be potent even after ten years past the expiration date.
When pharmacies dispense medicines, they often repackage drugs from their original packaging into a container of their choice. Many also change the expiration date to one they feel is more appropriate, usually one year from the date of dispensing.
Loss of potency does not mean the medication is ineffective. It seems the government is beginning to understand this as well. The FDA has created a medication extension program for this reason.
FDA Extension Program
This program is a main reference in the argument that medication has life after an expiration date. Officially called the Shelf Life Extension Program, medications of all kinds were studied on behalf of the Defense Department in hopes the military can benefit from use of expired, but still effective, medication. It was also their hope this could save money for the government.
Results revealed close to 90 percent of the drugs tested had a life extension past the expiration date, ranging from one to fifteen years.
It was noted that preservatives and other additives can hinder or assist the breakdown of potency in a medication. These were not part of any study. Another concern is the format of the drug. Whether a drug comes in liquid, powder, injectable, capsules or tablets, the potency can differ.
If you are wondering what medications remain effective after the expiration date, it is probably easier to discuss the medicines that are not to be used.
Medications Not to Be Used After the Expiration Date
Antibiotics have been designated as unsafe to use after the expiration date. Any drug that is dispensed in liquid form should be stored in the refrigerator and should not be used past the expiration date.
There are serious diseases such as diabetes and heart disease that require medications to be at full potency. It is not even worth the risk to take expired medications to treat serious medical conditions. Tetracyclines, vaccines and biologics are also drugs to avoid once they expire. They can create further complications.
Signs of Expired Medications
Before hanging on to all your medicines and saving them for much later use, there are characteristics you can look for to help you decide to keep or toss.
If a drug, in any form, has changed in appearance, smell, or taste, it should not be used because it is likely no longer potent. Using an altered drug could even cause a negative reaction. Look for capsules to be disfigured, pills to be powdery or crumbling, and tablet colors to be faded or non-existent.
Any creams or suppositories that have melted and taken a different shape have suffered from deterioration. This means the medicine inside the product will not be distributed evenly.
How to Prolong the Use of Medications
If you want to get the most shelf life out of your medication, following these simple guidelines. Check with the manufacturing company’s recommendations on storage. Some medications will last longer at room temperature, while others are better when stored in the refrigerator.
Keeping medicine in its original packaging is best. But if you must repackage it, follow the guidelines of the manufacturer to ensure the product is not damaged in any way by the new packaging materials.
As a physician, it’s up to you to continue your research on medication expiration dates so you can be the best resource for your patients.