Last of two parts
THE best way to avoid taking a potentially dangerous expired medication is to simply not have expired meds around. You can do this if you:
– Don’t buy in bulk. Avoid the temptation to buy bulk-sized packages of medications because it feels like a better deal. “Most people don’t need to keep a giant bottle of pain reliever or antacids on hand,” Dr. Hodes notes. “Wasted medication is common and adds to our carbon footprint.”
– Keep prescriptions fresh. If you take prescriptions, don’t get extra refills. “Many people end up with different medications or a change of dose over time,” Dr. Hodes points out. “Loading up on your prescription refills could leave you with medications you can’t use.”
– Spring clean. “Go through your medicines at least once a year and take expired medicines out,” Dr. Hodes suggests. “If you do get rid of any medications, make a note to get a fresh supply from your pharmacy or health care provider.”
What to do with expired meds
The best way to get rid of unwanted medicine is to take them to a take-back program in your community. Ask your pharmacist or local law enforcement about a location near you.
If a takeback isn’t an option, you can:
– Throw it in the garbage. Most medications can safely go in your normal garbage. Mix them with dirt, cat litter or undesirable material so others won’t find them and try to use them. Promptly take the garbage out to keep it away from children or pets.
– Flush them. Some medications have specific instructions to flush leftovers down the toilet. These medicines are dangerous if people or animals find them in the garbage. Don’t flush all of your medications, though — just the ones on the FDA’s flush list.
– Handle prefilled syringes with needles properly. Don’t throw needles — new or used — in the trash. They must always be carefully disposed of — usually in a sharps container or through your local pharmacy or take-back program.
– Take expiration dates seriously. You probably wouldn’t chance it with expired meat or moldy cheese, so don’t use expired medications either. “If people don’t overstock and clean out their medicine cabinets like they do their refrigerators, they can avoid expired medicines,” says Dr. Hodes. “Just like with food, try not to over-order. And when in doubt, throw it out.”
While many medications remain safe and potent for months or even years past their expiration date, especially if stored properly, it is generally not recommended to take them. The date guarantees full potency and safety; afterward, drugs may lose efficacy or degrade, risking ineffective treatment or, rarely, toxic reactions.
Key safety considerations
– Risk factors: Expired drugs can be less effective, leading to failure to treat conditions like infections.
– Never use: Do not use expired antibiotics, blood thinners, nitroglycerin, insulin, or EpiPens, as their effectiveness is crucial and their decline can be dangerous.
– Form matters: Tablets and capsules are generally more stable, while liquids, suspensions, and eye/ear drops (which lose sterility) degrade faster.
– Visible clues: Discard medication if it looks discolored, powdery, or smells different.
– Storage: Medications stored in warm, humid places (like bathrooms) are more likely to degrade before the expiration date.
The testing conducted by the US FDA ultimately covered more than 100 prescription and OTC drugs. The result showed that about 90 percent were safe and effective as long as 15 years past their original expiration date. Loel Dawis, expiration date chief, said that with a handful of exceptions, notably nitroglycerin, insulin and liquid antibiotics, most drugs are probably as durable as the agency tested.
A study done by Simons on outdated EpiPen and EpiPen Jr auto-injectors: past their prime, noted that drugs differ in terms of their forms, dosage and stability. Usually, drugs in liquid form (e.g., solutions and suspensions) are not as stable as those in solid form (e.g., tablets and capsules). It has been reported that the bioavailability of EpiPen (epinephrine auto-injectors) was reduced when administered between 1 and 90 months after the labeled expiration date compared with those that were not yet expired.
The US Center for Drug Evaluation and Research officially recommends that drugs past their expiration date be disposed of. It has been argued that this practice is wasteful, since consumers and medical facilities are encouraged to purchase fresh medication to replace their expired products, also resulting in additional profits for pharmaceutical firms.
Bottom line: When in doubt, it is safest to discard the medication or consult a pharmacist.