Every owner of a home first aid kit knows this dilemma: what to do with out-of-date medicines? Do tablets that have just expired lose their effect? Specialists respond to these and other doubts.
Most of the medications in my husband’s bathroom cabinet have expired. There is chloroquine that expired in June 2009, a potent prescription naproxen that has just expired, and hydrocodone that should have been discarded over a year ago. The only remedy still usable is nasal spray drops. The information on the box shows that they can be standing for a month more. The bottle is almost full, so there is no chance that my husband will empty it during this time. When I asked him about his reserves of old medications, he started laughing and said I hadn’t discovered the worst anyway. Drug expiry dates are not a cause for concern for him, as none of these drugs cure chronic health-threatening diseases. He does not mind that he will take old naproxen on his sore arm, and that he will use an expired malaria remedy before his next business trip to Africa.
Is it good idea? “I don’t think so,” says Shelly Burgess, a spokeswoman for the US Food and Drug Administration (FDA). According to her, neither the FDA nor pharmaceutical companies can guarantee that taking drugs after the expiry date is safe. “The preparation may still work, or lose its properties and become non-toxic but ineffective, or turn into a harmful substance,” explains Burgess. Either way, a representative of the agency does not recommend taking drugs beyond the expiration date, even if only a few months have passed since that date.
However, there are studies that suggest that in some cases some deviations from this rule may be allowed. The analysis, which appeared in 2006 in the Journal of Pharmaceutical Sciences, shows that in the case of 88 percent. emergency medications as part of US strategic stockpiles, the shelf life has been extended by at least one year. Tests conducted by the FDA have shown that they can still be taken safely. Among these substances were painkillers, antibiotics, antiviral drugs, and malaria remedies.
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The conclusions that can be drawn from these experiments support the thesis that many drugs – provided they are properly stored – can be used after their original expiry date.
According to Desmond Hunt, an expert from the United States Pharmacopeia, an organization that sets standards for preparations used in the United States, we should not directly transfer these observations to our home first-aid kits. – State reserves are carefully controlled: it is known who they come from, how they are transported and stored. Meanwhile, drugs bought by the average buyer may have passed from manufacturer to pharmacy through multiple intermediaries. It is possible that when they were transferred from hand to hand during transport, they were stored in conditions other than those indicated on the packaging. For example, they could have been lying on the asphalt in the wet or in the rain, explains Hunt. – If we have a choice, it is better not to use overdue drugs – warns the specialist.
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To obtain FDA approval, manufacturers must demonstrate that their drugs are retained throughout the shelf life indicated. Scientists expose the formulation to different temperatures and levels of humidity, and then check that the packaging withstood these conditions and that the appearance and smell of the drug has changed.
The tablets are dissolved in the chemical solution to separate the ingredients. Experts check whether the strength of the action of the substance has remained unchanged. Liquid medications are also subjected to similar treatments. “Most specs extend the shelf life of two years, but we test them every year to make sure that the one-year extension is safe,” said Mansoor Khan, director of FDA Product Quality Research.
Experts agree that at home, drugs should not be stored in the bathroom, where moisture can adversely affect their properties. It should be relatively cool, dry and not exposed to direct light. Linda Thompson, a Maryland state doctor, suggests keeping medications in well-marked plastic containers in the kitchen, away from food and out of the reach of children. We should also be careful that our first aid kit is not exposed to large fluctuations in temperature. Particular attention should be paid to the expiry dates of gel capsules and syrups. – Capsules break faster. They absorb water and moisture and become wet. Doubts arise: are there bacteria there? Explains Thompson. That is why it is so important that the packaging remains undamaged.
The situation is somewhat different with film-coated tablets – these are usually over-the-counter medications such as painkillers. Even if they were bought two or three years ago, they should still be good as long as they were properly stored. – Nevertheless, I would not give them to their children – says the doctor.
Thompson has twenty years of professional experience. She has taken antibiotics that have expired three years ago. “My condition has improved, but I advise my patients against such practices,” he says.
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Text: Laura Hambleton
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