SHARES
“They look the same, just like new. I didn’t see any change in color, texture, taste or smell. At least, I can tell if my bread or meat is still good after the expiry date. But, there’s no way I can tell how long my medications are going to work pass expiration date.” Betty is mindful of reducing waste to conserve the environment. But, she finds it very dangerous to take risks without the needed knowledge.
What is Expiration Date on Medication?
The law requires all drug companies to label expiration date on their products. This protects the consumer by making sure that manufacturers take full responsibility for their product quality within the stated period of time. Therefore, medications that past their expiry date are not guaranteed to be safe, stable and useful.
Also, some medications may spoil or lose its effectiveness quickly after opening the packaging. Hence, the safety label will tell you how long your medications can last before and after opening the packaging. Note that the storage environment may be different for your medication after opening (eg. insulin pen). Follow instructions given by your pharmacist or refer to the information leaflet that comes with your medication.
Photo by the U.S. Food and Drug Administration’s photostream from Flickr
Are Expired Medication Still Useful?
The truth is, quite a number of drugs are still in good condition long past their expiry date. For instance, in an attempt to reduce waste, the U.S. Department of Defence undertook a project called “Shelf Life Extension Program” (SLEP) to assess the stability, safety and usefulness of more than 100 types of expired drugs. Surprisingly, majority (88%) of these drugs are still in good condition long past their expiry date. Some even last up to 15 years.
The reason behind this is because testing for actual shelf life of manufactured products will take a long time and costs a lot of money. In this sense, most of the labelled expiry date are arbitrarily stated. This commonly spans about 1 -3 years of shelf-life. And it is up to this date that the manufacturer guarantees the potency of the medication.
It is worthwhile to note that most of the drugs tested in SLEP were stored properly with intact packaging. These results may not apply to the medications distributed all the way to your bathroom cabinet.
Many medications are in dry forms. Exposure to water or even water droplets in the air can reduce the amount of active ingredient. Besides, heat and cold can also alter the drug stability, causing them to lose effect. Some drugs deteriorate faster due to sunlight exposure. In time, repeated exposure to minimal light can render the medication useless.
Baring all these considerations, hence the expiration date is not the absolute point beyond which the drug is no longer usable or safe. Most drugs are still safe to use, many years after the expiry, as demonstrated in the SLEP study.
Is is Safe to Use Expired Medication?
Generally no. Without expert knowledge, using expired medication can be dangerous. Most liquid formulation of medicine (eg. eyedrops, cough syrup) do not last long. The same goes for injectable drugs (eg. insulin). This is because bacteria can grow quickly in moist environment at room temperature. Your medication can lose its effect and become harmful.
Also, drugs tend to lose their potency over time even for tablets and capsules. In this context, do not use expired antibiotics. This is because improper dosage of antibiotic do not kill bacteria effectively. As a result, you are giving your body bacteria a chance to develop antibiotic resistance. These resistant bacteria can even be passed on to people around you. The next time when a person falls sick due to infection by this bacteria, the same antibiotic will not be effective against the infection.
Avoid using expired life-saving medicine such as insulin, or short shelf life medications such as liquid antibiotics. Another common example is nitroglycerin, a common group of drug use for chest pain. This medication is volatile and loses its potency every time you open the bottle. Potency of this type of medication can be a matter between life and death.
In summary, important life saving drugs requiring 100% potency or less stable drugs like nitroglycerin or injectables, discard once past their expiry. As for other drugs, with knowledge gained here, if stored in a proper condition may still be effective for a couple of years past the expiry. If in doubt, check with your doctor or pharmacist.
Photo by Pacific_PaHS_Alumni from Flickr
Conclusion
Lately, studies show that many types of drugs are still retain high potency despite long past its expiry date. However, this is largely dependent on storage condition, type of drugs and their formulation. For that reason, more studies may help determine the actual shelf life of drugs and reduce waste. Therefore it is not advisable for the general public to use expired drugs due to the risks and uncertainty involved, unless you are confident of being able to make informed decisions applying what you have learnt here.
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References
- Anderson LA. Drug expiration dates – are expired drugs still safe to take [Internet]? Drugs.com. 2020. (Available from: https://www.drugs.com/article/drug-expiration-dates.html; last updated on 2018 Jun 11; last accessed on 2002 Jan 14)
- Cantrell L, Suchard JR, Wu A, et al. Stability of active ingredients in long-expired prescription medications. Arch Intern Med. 2012;172(21):1685-87.
by Chang Xian
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