Tag Archives: Outdated Medications

Dr. C's Journal, Medicine, Rx

Dr. C’s Journal: Expired Medications – What To Do

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Not too long ago, US government required pharmaceutical manufacturers to place an expiration date on their medications. The drug manufacturers embraced this requirement, since it added to their bottom line.

There are three cogent questions that should be asked:

  1. Can outdated medications cause direct harm?
  2. Do medications become ineffective after their expiration date?
  3. How do you dispose of unwanted medication?

Most sites mention only two medications that can become dangerous as they age, tetracycline, and diclofenac. Neither finding is for certain, but its best not to take these medication‘s if outdated.

Everything degrades with time, and medications are no exception. Those that are compressed into tablets and kept in the dark and dry tend retain potency longer than those in liquid form. Certain medications, such as nitroglycerin and epinephrine are quite prone to oxidation; epiPen, In ready-to-inject needles, in particular should be fresh; Biologics in general should be current. Drugs that are exposed to water, warm or humid conditions, or that are crumbly or have an odor should obviously be discarded. Liquid medication’s of all types, such as eyedrops, should be carefully stored and within their expiration date. One of my eye medications, latanoprost, requires refrigeration, a sure sign of instability.

That being said, the US Army found that 90% of 100 medication‘s were still effective 5 to 20 years after their expiration date. Another study found that some retain their efficacy even after 10 to 40 years.

Another factor to consider is the danger of the disease that is being treated. If you have such things as heart disease, or a severe infection, You should exert greater care.

If you plan to get rid of medication, look around for an organization willing to accept them; Developing countries are looking for such medication.

Avoid flushing medication down the toilet, since it may enter the environment and  be harmful to the ecosystem. Ideally it should be packaged in a container that is difficult to get into, so that children and other individuals may not have access; almost all medications are dangerous if taken in large amounts.

A lot of information is available on the Internet, with a variable amount of suggested precautions, depending upon the site.

I am a physician, and have taken many outdated medications In a pinch, but if I plan taking them for an extended time I usually get a new prescription.

—Dr. C.

Medicine, Men's Health, Opinion, Rx, Women's Health

PRESCRIPTION DRUGS: “ON MEDICATIONS IN GENERAL”

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Several ideas apply to ALL MEDICINES. Terminology should be clarified. Medicine, Pharmaceutical, and Drug, in my mind are equivalent.

The term “drug” is pejorative, and I try to use it so. The term “Pharmaceutical” is too long, leaving me with “medication”.

There are some Practical points. You should look at your prescription when you first get it, to make sure it is the right one. Yes, pharmacists rarely make some mistakes. They are human.

You should ask the Pharmacist if she knows WHERE the drug was manufactured. Foreign countries, especially China and India, are less reliable, and the USA is safer. The original Brand Name drugs are more often domestically produced, but even these are being “offshored”.

Next, check the prescription date and expiration date.You should get a ” SHELF LIFE” (the difference between the two) of about 2 years, otherwise, you might ask the pharmacist the next time to give you the “best dating” in his stock.

Store your medications in a cool, dark, dry place in order to prolong their life. Light, heat and moisture degrade most compounds. Remember the O.J. Simpson case? Part of the reason he was acquitted is that a critical DNA sample was stored in a plastic bag, which retained moisture, rather than a paper bag, which is recommended because paper is porous, and allows moisture to escape.

You should follow the suggested TIME to take the medication, because there is almost always an optimal time to take a given medication.

CHRONOPHARMACOLOGY is an emerging field, which is finding that more than 50% of medications are TIME SENSITIVE in their effect in the body. This is an unimportant, academic consideration for most Patients, given the high THERAPEUTIC WINDOW (dosage latitude) of most medications, the mild illness of most patients, and the disinclination of most Doctors to add one more detail onto their already heavy load.

In discussing the medicines in my cabinet and a few other important ones, I will be addressing TIMING.

What about OUTDATED MEDICATIONS? As discussed by the following article from Harvard, the dating is not critical except for liquids, and a few others, like Tetracycline.

This is fortunate, given the expense of medications today. What if I drop a pill on the floor, at home. I usually pick it up and take it. if i just dropped it, unless it is very inexpensive.

What if a pill sticks in your throat, like happens to me a lot? I drink water first, to moisten my throat to make it slipperier.

Next, I take a good sip of water, try to swish it back and go back with my head to accelerate the pill backward, and think confidence. Certain sizes of pills are my nemesis and i have to break them in two.

Please follow Dr. Cs Medicine Cabinet in future postings of DWWR.

–Dr.C.

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