Is It Safe to Take Expired Medicines?
It’s almost cold and flu season now – yes, we can still enjoy it, even during a pandemic. Let’s say you wake up one morning with a sore throat. Trying to convince yourself that it’s not COVID, you head to the medicine cabinet and find that the only vial of cold medicine expired in 2012. (Oops … don’t let this happen !) Take those old drugs or put on your pants (and mask) and get fresh supplies from the pharmacy? In general, expired medications are unlikely to kill you, but there are some things you should be aware of.
As always, you should talk to your doctor if you have a question about a specific medication. And we, of course, will not recommend taking what is written on the packaging that you should not take it. But you may be happy to know that old pills don’t “go bad” in the same way as food. However, they can become less effective over time.
Back in the 1960s, there was one case where people got sick from expired antibiotics. Three patients developed kidney disease and recovered . In addition, expired drugs are not associated with any dangerous conditions.
Instead, these medicines deteriorate in more subtle ways. The active ingredient can slowly break down over time, so a medicine that has passed its expiration date may not be 100 percent effective. The FDA describes the time to expiration as the time when you can expect a drug to retain its identity, strength, quality, and purity .
However, after that date, the drug can still be good. If a manufacturer wants to guarantee that a drug will last for two years, they only need to check if it will last two years, and that’s it. They are not required to check what happens to the medicine after that date. This is where things get a little fuzzy.
Many (but not all) medicines are still valid beyond their expiration date.
However, if you are curious about the medicines in your stock, you are in good company: the government holds medicines for emergencies and is unwilling to replace them unless they really go bad. As such, the FDA has a shelf life extension program under which the Department of Defense or the Centers for Disease Control and Prevention can request additional testing.
A report published in the Journal of Clinical Pharmacology in 2006 found that 88 percent of batches of drugs tested were good for at least one year after their expiration date, with an average extension of five years. Some lasted much longer. One batch of the antibiotic ciprofloxacin , the drug of choice for treating anthrax , was still good nearly 12 years ago. Several batches of potassium iodide granules included in the treatment of people exposed to radiation were still good after 18 years.
But here’s the problem. You cannot be sure that your bottle of your favorite drugs will still be good. The report’s authors concluded that “many drugs can be renewed beyond their original shelf life, but this additional period of stability is highly variable.” If storage conditions are not ideal, the drug probably won’t last that long. And some drugs may be more stable than others.
Unfortunately, there is no StillTasty for medicines, so it is impossible to know if this pill bottle in the back of the medicine cabinet is one of the ultra-stable ones or if it has already begun to lose its effectiveness.
Don’t take risks with life-saving drugs
If your Tylenol or cold medicine is slightly less effective than when brand new, it’s not the end of the world; you just get sick or start sniffing a little more. But if you’re relying on something like the Epi-Pen to save your life, you’ll need a full-fledged drug pen .
The epinephrine in Epi-Pens is actually a drug thatbecomes significantly less effective after the expiration date . While you sit here thinking about it, you should replace the expired one you already have. But if you have a sudden allergic reaction, it is better to use the Epi-Pen than nothing.
eMedExpert suggests that you replace medications that lose their potency very quickly or work with a very specific potency. Here are some examples:
- Anticonvulsants such as phenytoin, carbamazepine, lamotrigine, and oxcarbazepine.
- Dilantin, phenobarbital
- Nitroglycerine
- Warfarin
- Procan SR
- Theophylline
- Digoxin
- Thyroid medications such as levothyroxine sodium
- Paraldehyde
- Oral contraceptives
- Adrenaline (e.g. Epi-Pen)
- Insulin
- Tears
This makes sense because you need birth control or insulin for an important reason. A less effective dose of this kind will damage the core.
Don’t stock up on drugs for no good reason
In some cases, it makes sense to stockpile drugs. You have your allergy medicine because from time to time you come across a cat or tree full of pollen. But with regard to other drugs, especially prescription drugs, you may be asking yourself why you have leftovers.
For example, if you have antibiotics left, you probably did not take them as prescribed . Next time you get a prescription for an antibiotic, try setting reminders using an app like Dosecast, or just a recurring calendar reminder so you don’t forget to take your pills.
It’s the same with opioid pain relievers. Trying to keep them actually increases the likelihood that you will become addicted to them. And certainly don’t put off leftover food for a rainy day. Using a strong pain reliever for anything minor, like a headache, puts you at risk of addiction .
Nevertheless, it is wise to have on hand an additional medication in serious medical kit for survival or just for convenience, when you are away from the pharmacy. You will need to use your own judgment to decide if you are comfortable taking the risk and taking expired drugs.
So, let’s summarize the results of this first aid kit. Expired allergy medications simply mean you have to go to the pharmacy … after all. Expired drugs should be replaced as soon as possible. And then bring unnecessary medications to the pharmacy or look around your area for a medication day — no need to keep it with you.
This story was originally published in April 2016 and has been updated on November 2, 2020 to provide more complete and up-to-date information, as well as an updated context.