Expired Medicines – Are They Safe?

| Posted On May 25, 2017 | By:

Many of us keep unused medicines in our homes, whether left over from a prescription or purchased over-the-counter for some future need. All medicines will eventually expire –what do you do then?

First let’s step back and take a look at what expiration dates mean.

For over-the-counter medicines, you’ll find an expiration date printed on the packaging by the manufacturer. This date refers to the time beyond which the manufacturer says the medicine should no longer be used. This date assumes proper storage, which may not hold true if a medicine is exposed to extreme heat, cold, moisture or too much light, or is stored at room temperature if it is supposed to be refrigerated. If an expiration date is printed as only a month and year (e.g., 08/19), that means it expires on the last day of the indicated month.

For medicines filled in a pharmacy, an expiration date (actually more appropriately called a “beyond-use” date) is provided on the pharmacy label. Generally, this date is 1 year after the prescription is dispensed, but the actual medicine may have come from a stock bottle with a manufacturer’s expiration date further into the future. This 1-year expiration date printed on the label indicates that the pharmacy can only vouch for the medicine’s “freshness” for 12 months from when it left the pharmacy. Some medicines have much shorter “beyond-use” dates, such as an antibiotic suspension that is dated for 14 days after dispensing.

So do the dates really matter? An expiration date stands for the last day on which the drug is guaranteed to be safe and effective if stored properly. But in reality, medicines are often still safe for many years beyond these dates. Theoretically, medicines could become dangerous over time – breaking down into another substance in normal storage conditions; however, tetracycline is the only drug known to cause harm over time, and only very rarely and with older manufacturing processes no longer in use.

More important to note is the idea of loss of effectiveness, or potency. The potency of most medicines declines gradually. A drop in potency for some medicines can be concerning – such as for medicines that require a very specific dosage to work properly or that require refrigeration or protection from light – although for most medicines a small reduction in potency will not be important. The problem is that we usually do not know how many months or years it takes for potency to be “too low.” A lower potency acetaminophen tablet taken for a headache may simply mean less effective pain relief; a lower potency antibiotic can fail to treat an infection; a lower potency birth control pill may mean a pregnancy!

We recommend the following when it comes to a medicine’s expiration date:

 

 

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About Amy Vachon, PharmD

Amy Vachon, PharmD is Director of the Atrius Health Clinical Pharmacy Program and co-chair of the Atrius Health Pharmacy & Therapeutics Committee. She joined Harvard Vanguard in 1996 and has worked to grow the Clinical Pharmacy Program which provides services to patients at many of our Atrius Health locations. Prior to working at Atrius Health, Amy was the Assistant Director for Clinical Pharmacy Services at Beth Israel Hospital, and before that, she worked in the operating room at Tufts Medical Center as a Clinical Pharmacy Specialist in Anesthesia and Operating Room Pharmacy. Amy graduated with a Doctor of Pharmacy from the University of Michigan, and completed a residency in pharmacy practice at Tufts Medical Center in Boston. Amy is also passionate about creating the opportunity for work/life balance that allows every employee to be his or her best contributor to the workplace, and is the author, together with her husband, of Equally Shared Parenting: Rewriting the Rules for a New Generation of Parents (Perigee Penguin 2011). She’s the mother of two children and an avid amateur violinist in her spare time.

Comments

  1. This article is enormously helpful! I just finished a round of our house discarding far-out-of-date medicines, and I wish I had been aware of this suggestion for proper disposal. Also it’s great to see “expiration date” more meaningfully and usefully defined. Thank you for this excellent post.

    Comment by Joe Blatt on June 21, 2017 at 10:50 am
  2. Although disposal in the trash is easy and convenient, we have – lately – tried to dispose of expired pills – medications and even old dietary supplements at the police station, where we hope they eventually get incinerated, as opposed to ending up in a land fill and then groundwater. For us, we pass the station often enough…

    Comment by Mike on June 21, 2017 at 11:38 am
  3. Many communities have drop off bins at local police departments for expired prescriptions. Avoids putting drugs into landfills and water supply.

    Comment by Lynn Gervens on June 21, 2017 at 11:45 am
  4. Great advice, thanks!

    Comment by Ron Cisneros on June 21, 2017 at 12:34 pm
  5. I have disposed of old medicines at the Police Station. Many towns have a special collection bin for all drugs.

    Comment by Theresa M Souza Esper on June 21, 2017 at 2:38 pm
  6. Add water to the baggie so people cannot pick out pills and use them.

    Comment by Alan Murphy on June 21, 2017 at 6:22 pm
  7. This article on the expiration dates of medicines was very helpful and practical. Thank you! One question…I cannot find a place that will accept my expired epi-pen. Do you have any suggestions about that?

    Thanks again.

    Lorraine

    Comment by Lorraine Tower on June 21, 2017 at 8:32 pm

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