Drug Expiration Dates

[imoldernu]

Few health subjects produce more controversy than that of the cost of drugs, and the protective shield that the pharmaceutical companies place around the efficacy and safety of their products. The warnings and disclaimers that accompany the advertising are required to absolve the companies from legal responsibility as determined by the FDA.

With the advent of Medicaid D, and private insurance that covers a major part of the expense, there is a tendency to forget the total actual cost, and to accept whatever the "common knowledge" is about drug safety.

Instead of citing articles on the subject, I'd suggest googling "drug expiration dates", and perhaps Military (Army and Airforce) studies from 2009 that showed that 90% of drugs that were beyond the expiration dates were in fact safe, some with a shelf life of ten years or more.

Erring on the side of safety is always best, but often at a significant cost. The question is does anyone care?

Back in the 1990's, my doctor prescribed naproxen (Naprosyn) for what we thought was arthritis, but was actually caused by the the cholesterol drugs I had been taking... statins and lipitor... Since the pills were essentially free (co-pay $2) I continued to get 60 pills/mo... for several years, even though I wasn't using them every day. Now, nearly 20 years later, I still have a goodly supply, and with a touch of arthritis, still take these old pills... with good results, and no side effects. The expiry date on the pill bottles go back to 1996.

A second, common drug... bought, but not commonly used is epinepherine (EpiPen). For those of us with severe allergies (mine to bee stings)... the epipen is a potential lifesaver. Every year since 1965, I have bought two new injectors... currently full cost about $80+... The printed expiration date is about a year from purchase. A recent (2009) study indicates that the injector is relatively safe to use (in case of an emergency) as long as the color has not changed. I found an old, forgotten Epipen in my glove compartment that was 4 years old, and the color was still clear.

Most of the articles on the subject seem to indicate that generally, solid tablets or pills have a longer shelf life, than do liquids, though even that is dependent on the drug. The Army study of 100 drugs indicate that 90% were still effective and safe several years after the expiriation date.
Here's a year 2000 WSJ report on that.
http://online.wsj.com/news/articles/SB954201508530067326

Not meant to change any minds, but I've decided to take a chance on my Epipen purchase this year, since I haven't had to use even one in the past 49 years.

Hmmm... thinking about risk... reminds me that I'll be needing new brakes on my car this year.

 

[braumeister]

IMHO, people get way too anal about these things.

The rules for expiration dates (or best by, sell by, use by, etc.) on packaged products, whether drugs, food, or something else, are set up so the manufacturer can promise that it retains x% of its original potency until that time.

In some cases, it will retain all or nearly all of that level for much longer, but testing only went that far so that's all they can legitimately claim.

Common sense and your own experience are usually the best guides to when you need to discard something.

 

[Sue J]

I keep tablet medications past their expiration date. It's things like Tylenol, Ibuprofen or naproxen. I also have some old Vicodin or Percocet leftover from a years ago outpatient surgery. Came in very handy to use once when I had a back spasm.

DH is also allergic to bee stings and wasp stings. He does not have an Epipen but instead keeps Benedryl capsules or a store brand equivalent in his car or in a pouch if he's out. These are cheap to keep a fresh supply on hand so we buy new ones when they get near their expiration date.

In a stinging emergency a less than optimal effectiveness could be important!

 

[JoeWras]

I just noticed my bottle of rubbing alcohol "expired" 6 months ago.

Oh no! Oh no!

 

[jerome len]

I think the expiration date on all my prescriptions is a year after they are issued.....I've taken many of them well after the expiration date and never had a problem. I do throw milk and eggs away after expiration dates, however.

 

[Midpack]

Is there any known drug that becomes harmful after expiration? I would assume the worst that could happen would be the drug would be less effective, or not at all. In which case taking the drug to see if it's still effective would be little if any risk. If it works great, if not you need "new"(er) drugs. I've taken drugs behind expiration date many times. I am not a medical professional, so YMMV.

Like the earlier thread on expiration/use by dates for food, people may be needlessly discarding perfectly useable products.

 

[Moemg]

I just noticed my bottle of rubbing alcohol "expired" 6 months ago.

Oh no! Oh no!

On rubbing alcohol who cares but if I was allergic to bee stings there is no way I would have an expired epi pen.

 

[cocobird]

Is there any known drug that becomes harmful after expiration? I would assume the worst that could happen would be the drug would be less effective, or not at all. In which case taking the drug to see if it's still effective would be little if any risk. If it works great, if not you need "new"(er) drugs. I've taken drugs behind expiration date many times. I am not a medical professional, so YMMV.

Like the earlier thread on expiration/use by dates for food, people may be needlessly discarding perfectly useable products.

I've read several articles indicating that most drugs are still effective after the expiration date for an extended period of time. I don't recall the name of the drug, but one article did state that one drug became "stronger" over time so that could be an issue. However, the name of that drug was unfamiliar to me, so probably not a commonly prescribed one.

 

[jon-nyc]

The fact that the expiration is almost always one year from dispensing can only mean its bogus. How odd would the universe be if chemical compound stability had such a high correlation with one planet's revolution around a star.

 

[Redbugdave]

I would think if you kept the drugs in a cool place and away from light they would expire much later than the date on them. What if you keep them in the fridge?

 

[Midpack]

Most of what is known about drug expiration dates comes from a study conducted by the Food and Drug Administration at the request of the military. With a large and expensive stockpile of drugs, the military faced tossing out and replacing its drugs every few years. What they found from the study is 90% of more than 100 drugs, both prescription and over-the-counter, were perfectly good to use even 15 years after the expiration date.

Drug Expiration Dates — Do They Mean Anything?—The Family Health Guide

 

[imoldernu]

Re: EpiPen safety... From the National Institute for Health abstract.
Outdated EpiPen and EpiPen Jr autoinj... [J Allergy Clin Immunol. 2000] - PubMed - NCBI

excerpt:
RESULTS:

Twenty-eight EpiPen and 6EpiPen Jr autoinjectors were studied 1 to 90 months after the stated expiration date. Most were not discolored and did not contain precipitates. Epinephrine bioavailability from the outdated EpiPen autoinjectors was significantly reduced (P <.05) compared with epinephrine bioavailability from the in-date autoinjectors. The inverse correlation between the decreased epinephrine content of the outdated autoinjectors, assessed with an HPLC-UV method, and the number of months past the expiration date was 0.63.
CONCLUSIONS:

For prehospital treatment of anaphylaxis, we recommend the use of EpiPen and EpiPen Jr autoinjectors that are not outdated. If, however, the only autoinjector available is an outdated one, it could be used as long as no discoloration or precipitates are apparent because the potential benefit of using it is greater than the potential risk of a suboptimal epinephrine dose or of no epinephrine treatment at all.

The full article has more information.

 

[JoeWras]

On rubbing alcohol who cares but if I was allergic to bee stings there is no way I would have an expired epi pen.

Right, that's my point. Some of these expiration dates are bogus. Alcohol has an effective nearly unlimited life.

Now, for a LIFE SAVING drug, I wouldn't mess around. imoldernu, you concerned me when you said you checked on the one in your glove box. That's an environmentally tough storage area due mostly to the heat that can occur there. I wouldn't mess with an epi-pen stored in the glove box for over a year.

For other over the counter stuff, I'd push it. Ibuprophen seems pretty stable. I do notice that old aspirin gets that acetic acid smell after 2 years or so. Probably time to toss it.

And strange as it sounds, I've also noticed that bandages need to be cycled after 3 to 5 years or so. Not sure if they have expiration. Once they get past 5 years, the adhesive gets bad and they don't hold very well.

 

[prototype]

I would think if you kept the drugs in a cool place and away from light they would expire much later than the date on them. What if you keep them in the fridge?

+1 (Although the fridge is generally below the temperature and humidity storage temperature for recommended for most medications). Left in hot cars during the summer is definitely is a medication killer!!

Store them in the sock drawer in your dresser (if you don't have anyone around that may be at risk of helping themselves to what you are storing).

It does seem any prescription I get filled always has an expiration date on it of one year. A RN friend of mine told me prescription medications are usually good for 2 to 5 years (if stored correctly) depending on the medication and manufacturer (what fillers/binders the manufacturer uses). So I generally keep prescription meds for about 1 to 2 years after expiration if for some reason I haven't used them all, which generally is not the case.

OTC items like cold and flu medications seem to run about 2 years for expiration dates (have to check at CVS or WalMart to confirm). I can't remember ever seeing an actual manufacture date on an OTC medication (than I am not sure I ever looked, I just look at the expiration dates).

Anyway, my rule general of thumb is to trash anything that has hit about 30 months after being filled for leftover prescriptions, and 6 months after expiration on OTC items (easy and cheap enough to just buy new if I cold or whatever).

 

[iac1003]

The fact that the expiration is almost always one year from dispensing can only mean its bogus. How odd would the universe be if chemical compound stability had such a high correlation with one planet's revolution around a star.

One year from the time of when the prescription was written usually indicates that the pharmacy won't dispense more meds without a new prescription, also good for one year with refills. The expiration dates on the meds themselves are not always exactly one year. I had many drug samples when I had an office practice and the expiration dates were all over the place depending on when the samples were packaged.

IIRC those studies showed that most solid tablet pills still had the same strength and efficacy up to 5 years after dispensing if kept under normal conditions (no excessive heat or wetness). For liquid meds the strength of the meds was about 1 year.

I have taken some pills that were much older than that.

 

[Ronnieboy]

One year from the time of when the prescription was written usually indicates that the pharmacy won't dispense more meds without a new prescription, also good for one year with refills. The expiration dates on the meds themselves are not always exactly one year. I had many drug samples when I had an office practice and the expiration dates were all over the place depending on when the samples were packaged.

Most state laws will not let the pharmacy put more than one year expiration on dispensed prescriptions. While the big 500/1000 count bottle that it is coming out of may have a 2, 3 or 4 year expiration date. You also have to consider that the packaged bottle on the pharmacy shelf is based on optimal temperature and storage guidelines. (i.e. controlled room temp not exceeding 87 degrees, desiccants in the bottle, etc) Not where patients tend to keep meds: in the humid bathroom, glove box, heat baking in the car, etc.

Typically the expiration date is arrived at with a mathematical formula and it is an educated guess, it should be 90% effective up until the expiration date on the packaged bottle, but it could be 100, 80, 50 who knows, after that date.

Drug manufactures don't usually come out with data after the fact saying, 'oh yes, it is still 100% ok after 4 years, it will probably last another 4 years, we'll check back then' as it is a hinder to sales if the drugs don't ever expire or took too long to expire. On another note, I have seen medications recalled if they expired sooner than their stated expiration date. (thyroid medications)

I believe one of the more common drugs that can become toxic after expiration is tetracycline and that is slowly being reintroduced to the market.
I personally have no problem taking expired meds, OTC or rx, if I notice that my stomach acid, allergy, headache meds aren't working as well, discard and get new.

I guess I should add, I am talking about tablets/caplets/capsules/creams/ointments. I wouldn't use eye drops (preservatives degrade), insulin (need tight control on blood sugar), injectables (Enbrel/Humira) past their expiration, with the exception of the Epi-Pen quote that imoldernu posted above - in a life threatening situation something, even if it is not as potent, is better than nothing.