Most homes probably have at least one bottle of expired medication hanging out in the cabinet. And for some of us, that number is much higher. How many people even check the expiration date on a bottle of over-the-counter pain reliever before taking a few pills?
Drug manufacturers, health care providers, and pharmacies have a big responsibility to promote safety when it comes to medication. The whole process of stability testing and requirements to label medications with expiration dates are aimed at keeping end users safe. Taking medication past the expiration date could be risky. Here’s what you need to know.
What Does the Expiration Date Mean?
In the United States, medications are governed by the Food and Drug Administration (FDA), which requires manufacturers to list an expiration date on the labeling. This expiration date is the manufacturer’s claim of the extent of time for shelf stability–or how long the medication is safe and effective under normal conditions.
- It does not account for environmental factors like heat, humidity, or light exposure.
- Some medications may last much longer than their labeled expiration date.
- Many drugs contain preservatives, flavors, coloring, and other ingredients to make them palpable.
Medications that are no longer stable may lose their potency (may not work), become bitter or tasteless, or potentially become dangerous by affecting your bodily functions in unintended ways. For example, some antibiotics or additives can grow bacteria that will make you sick.
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How are Expiration Dates Determined?
Medication manufacturers use FDA-regulated stability testing procedures to determine safe periods of use under controlled conditions. Most drugs are assigned expiration dates that put shelf life between one to five years for the US market. This claim is also dependent on a sealed, environmentally controlled container. Once a consumer purchases the drug and breaks the seal, the date is no longer guaranteed.
Once opened, the actual duration of useability depends a lot on where you keep your medications. For example, it’s common to store them in the medicine cabinet located in the bathroom. But this area is prone to significant moisture and humidity build-up from frequent bathing and may not be the best place to keep ingestible products.
Law and Liability
Manufacturers are not allowed to comment on whether or not expired medications are safe or effective to use. And any health care provider who tends to patients is not legally allowed to dispense outdated, mislabeled, or otherwise unusable drugs.
However, no law prohibits individual consumers from taking expired medications within their possession. And there is no liability for the manufacturers if a consumer chooses to take an expired medication and becomes ill. In this case, the manufacturer has fulfilled its regulatory requirements by prominently posting an expiration date on the label.
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Out of Date Medication and Potency
The biggest concern with old medication, especially more shelf-stable pill forms, is potency. Does a drug lose its ability to relieve symptoms with time? The FDA and the US Military conducted a long-term efficacy study to determine true shelf-life data for various medications that the military can stockpile. It’s important to note that these studies were not conducted with end-consumers in mind. However, the results suggest that most pill-form medications last a little longer than their stated expiration dates, so there is usually a safe buffer.
The majority (88%) of the drugs tested were stable and potent beyond their labeled expiration dates. Many over-the-counter medications remained stable for an average of 4-5 years. And some drugs lasted more than 15 years. Amoxicillin and Ciprofloxacin, two common antibiotics, showed no failures, as did potassium iodide, which is used to treat radiation poisoning.
Are Expired Medications Safe?
The official answer from the FDA, drug manufacturers, and the US government is no. It is not safe to take expired medication of any kind. However, consumers can use their judgment for common over-the-counter medications like pain killers. Avoid taking anything that shows physical deterioration, such as a change in appearance, color, or texture. And always avoid taking high-risk medications past their expiration date.
- Insulin (commonly used to treat diabetes)
- Nitroglycerin (commonly used to treat angina)
- Any Drugs with Biological Components (Vaccines, Blood Products, Etc.)
- Tetracycline
- Any Type of Injectible Medicine
- Eye Drops
- EpiPens
EpiPens are used to inject epinephrine in potentially life-threatening allergic responses. Epinephrine is on the shortlist of components that lose potency with time. One study found that potency levels in EpiPens drop proportionately to the length of time past the expiration date.
What to Do with Expired Medications
Safe disposal of expired medications takes a little thought. You don’t want to flush them down the toilet and introduce potentially toxic drugs into the water system. You also shouldn’t just toss them in the trash. It makes it easy for someone else to get ahold of them. Here’s what to do instead:
- Empty capsules and crush pills. Then, combine the powdered substance with used coffee grounds or dirt.
- Place this mixture inside a sealed plastic bag.
- Toss the bag in the regular household trash for disposal.
- If discarding pill bottles, make sure to black out personal information with a permanent marker.
Final Thoughts on Expired Medication
While you’re likely to get some mixed reviews on the safety and efficacy of taking expired medications, the bottom line is that it is not recommended. While most over-the-counter medications will simply lose potency with time, some can produce toxins or grow bacteria that can make you very sick.
Medications, both prescription and over-the-counter varieties, are labeled with an expiration date determined through shelf-stability testing. However, environmental factors play a big role in the shelf life of medications. Keeping your pills in a humid area can significantly reduce the shelf life of some medications. For best practice, make sure to store medications in appropriate containers inside a cool, dark place like a kitchen cabinet instead.
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