WHEN SHOULD I WORRY ABOUT...

Can Expired Medication Be Harmful?

Jan. 11, 2021 - Katie McCallum

A lot of our medicine cabinets are like the Wild West — a sort of dumping ground for every medication we've ever purchased or been prescribed. If you're like me, there's often very little order to it. You may even have several bottles and packs of some medicine-cabinet staples, like pain relievers and cold medicines, and one or two of them are probably expired.

So, is it safe to use that expired medication sitting in your medicine cabinet?

The short answer: No...maybe...it depends on who you ask...it, technically, varies by medication...

It's time to clear up some of the confusion.

Why medications have expiration dates

The U.S. Food & Drug Administration (FDA) began requiring expiration dates to be listed on all over-the-counter and prescription medications in 1979.

The need for expiration dates is rooted in the fact that medications degrade over time, as well as when exposed to external factors like light and humidity. It's important to know how long and under what conditions a medication remains both safe and effective.

As a result, drug manufacturers are tasked with testing a medication's longevity and determining an expiration date accordingly — and there's no guarantee that a medication is still safe or effective beyond this date.

The FDA takes a very firm stance on expired medication, stating that "using expired medical products is risky and possibly harmful to your health" and providing advice on how to properly dispose of expired medication.

The three primary reasons the FDA strongly discourages the use of expired medications are:

  1. The chemical composition and potency of a medication can change over time.
  2. Holding on to unused drugs may promote prescription drug misuse and abuse, a dangerous practice that is growing at an alarming rate in the U.S.
  3. A well-managed medicine cabinet reduces the risk of a child or pet mistakenly taking medications.

So, when it comes to expired medication, the FDA's message is clear: If your medicine has expired, do not use it.

The true shelf life of a medication is complex, however

Several studies, including ones conducted by the U.S. Department of Defense (DOD) and the FDA's Shelf Life Extension Program (SLEP), show that some medications remain effective well beyond their expiration date — with 88% of the 128 drugs tested through the SLEP remaining stable at least one year beyond their original expiration date.

The story of why some drugs may be effective beyond expiration dates is layered and complex.

Ultimately, though, it comes down to the fact that testing the longevity of a drug for decades is costly, and drug manufacturers have no financial incentive to do so. As a result, manufacturers are permitted to choose an arbitrary time frame in which to test and establish a drug's expiration date — whether that be one year or five. This often means that the true shelf life of a particular drug is often never determined.

However, there are some medications known to be less stable over time, and these medications should not be taken beyond the expiration date. These medications include:

  • Insulin
  • Nitroglycerin
  • Liquid antibiotics
  • Epi-pens

Context is critical with expired medication

The catch with the murky shelf life of medications is just that — it's murky.

Despite the fact that some medications may be effective beyond their expiration dates, studies also conclude that the true shelf life of a medication varies by the:

  • Medication itself
  • Particular batch of the medication
  • Storage conditions, including heat, humidity and length of time the container has been open

Determining whether an expired medication is still stable requires laboratory-based chemical analyses, which means you can't know how long that expired cold medicine sitting in your medicine cabinet at home will actually be effective.

For this reason, the FDA discourages you from taking it.

That being said, some argue that the details matter when it comes to considering expired medications. The rationale being that occasionally turning to expired medications for inconvenient, uncomfortable symptoms carries less risk than relying on expired medication for a serious health condition you may have.

For instance, taking an expired antihistamine to fight a bout of seasonal allergies or a pain reliever to relieve a headache may be harmless, with the worst case scenario being that the medicine just doesn't help you feel better.

On the other hand, relying on expired heart medication could lead to a dangerous and even life-threatening heart problem or complication. In this case, you should never take expired medication and call your doctor immediately when a refill is needed.

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