Have you ever been guilty of this? You have a headache, a cold, or a cough. You rush to the medicine cabinet to grab an analgesic or cold medication to relieve your achy head or a runny nose and, lo and behold, the expiration date says it expired three years ago!
What did you do? Did you take it or flush it? If you took it anyway, you’re in good company, surveys show people take expired medications a lot. Taking expired medication is pretty common, but the question is whether it’s smart.
What Does the Expiration Date Mean?
Let’s look at the expired medication issue more closely. The FDA first required medication makers to post an expiration date in 1979. Before that time, medications didn’t have an expiration date. Does that mean an expiration date isn’t THAT important? After all, it took a long time to require an expiration date.
The reason expiration dates came into being is the result of a study by the Food and Drug Administration. The military had accumulated a huge stockpile of medications and didn’t like the idea of throwing them out after a year or two. Not only is tossing them costly, they need to be disposed of properly.
Probably some of you feel like that too. Medications are NOT cheap. So, a team of researchers monitored the potency of the military’s medications over many years. What they found was 90% of the medications they tested, both prescription and non-prescription, still retained their potency 15 years after the expiration date expired.
Fifteen years? That’s pretty awesome, right? While 90% is a hefty percentage, that still leaves 10% that DID lose some of their potency.
Sometimes the medication is even tougher than the illness – Sanya-Richards Ross
The expiration date on most medications is between 12 and 60 months, but, as the above study shows, a drug doesn’t magically lose its potency the day after it expires. It’s a slow process that occurs over years for MOST medications.
In fact, the expiration date on a medication is a GUARANTEE that the medication, stored under proper conditions, will retain at least 90% of its potency before the expiration date. That doesn’t mean the potency will take a nosedive once that date arrives, it will be a gradual process.
Is It Safe to Take Expired Medications?
It’s helpful to know that most medications retain their potency even after they expire – but what about safety? These studies didn’t address the safety issue – only potency or how much of the active ingredients remained.
Remember, medications are usually a mixture of a variety of chemicals with different properties. Over time, chemical reactions can take place that create new compounds. How stable medications are and how resistant they are to reacting with each other depends on the particular medication, the length of time that’s passed as well as exposure to light, humidity, temperature extremes, and air.
If you store medications in an area where they’re exposed to light or heat, they’re more likely to react with each other and potentially form unhealthy compounds. That’s why many medications and supplements come in dark bottles that minimize exposure to light.
As far as stability goes, research shows liquid medicines are less stable and more likely to degrade or react and form other products than medications in solid form. Taking this into account, you should discard liquid medications once they’ve passed their expiration date. This includes supplements like fish oil and flaxseed capsules since the fatty acids in these medications aren’t very stable. Also, be sure to store them in a dark, cool place.
It’s also a good idea to look at liquid medications and capsules before taking them, even if they’re still within their expiration date. If you find one that looks discolored, has a strange smell, or has any kind of solid debris, toss it.
With so many people taking expired medications, you might wonder whether anyone has suffered an ill effect. The Medical Letter, a drug-prescribing publication for health practitioners, did a search in 2009 for injuries due to taking expired medications.
Despite an intensive search, they found one case, occurring 40 years ago, of a person suffering kidney damage from taking expired tetracycline and that was back in 1963 when they formulated tetracycline differently. So obviously, ill effects aren’t common even when you take an expired medication.
Guidelines for Dealing with Dated Medications
Before assuming it’s okay to take those expired medications hiding in the back of your closet (We bet you have some), here are some caveats:
If a medication is critically important for your health – insulin, a heart medication, thyroid medication, blood pressure medication, don’t take it after its expiration date. A medication that’s lost even a small amount of its potency could jeopardize your health.
If you have an epinephrine pen that you keep on hand for life-threatening allergic reactions, make sure it’s not past its date of expiration. Epinephrine is a medication that degrades more quickly. If you should have a serious allergic reaction, you need your epinephrine pen to work quickly and effectively. Nitroglycerin for chest pain is another medication that falls into this category. Make sure they’re fresh!
Here’s a list of medications to NEVER use past their expiration date:
- Seizure medications
- Thyroid medications
- Oral contraceptives (unless you want to get pregnant)
- Eye drops – subject to bacterial contamination as the preservative loses potency
Also, don’t use liquid medications after their expiration date. They are less stable than solid meds.
Whether a medication stays potent depends, to some degree, on how you care for it. Store medications properly. Never keep them in a bathroom or other humid area, and if you store them in the kitchen, make sure it’s far from the stove. Remember, the bottles they come in aren’t heat or humidity resistant. Keep them in a dry, dark cabinet or a dedicated medicine chest
Remember, the bottles they come in aren’t heat or humidity resistant. Keep them in a dry, dark cabinet or a dedicated medicine chest like this one.
Taking Expired Medications: What about Antibiotics?
We don’t recommend using outdated antibiotics, especially if you’re taking one for a serious infection. One antibiotic, in particular, you should never take when it’s expired and that’s tetracycline. When tetracycline breaks down, it forms compounds that can damage your liver. By the way, you shouldn’t have antibiotics hanging around in your closet unless you didn’t finish a prescription, right?
While writing this article, I checked out our medicine cabinet and was surprised to find medications with expiration dates hailing back to the early 2000s. Yikes! So, we’re guilty of not cleaning our medicine cabinet out as often as we should either.
If you do clean out your medicine cabinet to get rid of old medications, follow the FDA guidelines for disposing of them properly. Here’s a link to the site with the guidelines. You don’t want to just toss them into the trash can. Some medications are harmful to the environment. Plus, a child or pet going through the trash could come upon one and be poisoned.
What about Supplements?
Vitamins and nutritional supplements aren’t required to post an expiration date. If they DO post one, they have to have data supporting their stability up until that date. Since some loss of potency can happen before the expiration date, manufacturers sometimes add extra quantities of vitamin or supplement to the product to compensate for any breakdown of the active ingredients.
Most supplements will retain their potency for two years or more after you purchase them, although some are less stable than others. Liquid supplements, like fish oil and flaxseed oil, and probiotics have shorter shelf lives.
Take special care in storing all vitamins and supplements in a cool, dry place. Certain vitamins, like B-vitamins and vitamin C, break down when they come into contact with moisture.
For probiotics, read the label and see if it needs to be refrigerated. Some manufacturers recommend refrigeration. In general, we don’t recommend keeping liquid or probiotic supplements longer than a year.
Take Home Points
- Don’t take any of the medications on the “never” list above if they’ve expired.
- Don’t take expired antibiotics, especially tetracycline, if you’re trying to treat a serious infection.
- Don’t take liquid medications or supplements past their expiration date.
- Don’t keep supplements longer than 2 years after purchase.
- Store supplements and medications in a cool, dark, dry place, preferably not in a bathroom and kitchen due to heat and moisture. Some probiotics may require refrigeration.
- Dispose of medications properly. Use the link above to find out how to dispose of them safely so they won’t harm people, pets, or the environment.
- Clean out your medicine cabinet regularly. Don’t let old meds pile up.
- Eat a healthy diet, exercise, and sleep 7 or more hours nightly so you’re less likely to NEED medications.
The good news? If you have medications like Tylenol or Advil that you’re using to treat minor symptoms like a headache, you should be able to take them without a problem.
Medical Daily. “What Your Pharmacist Can’t Tell You About Drug Expiration Dates: ‘It’s Complicated”
GW Frimpter et al, JAMA 1963; 184:111.
U.S. Food and Drug Administration. “Expiration Dating and Stability Testing for Human Drug Products”
Harvard Health Publications “Drug Expiration Dates — Do They Mean Anything?”