Tell the truth. When’s the last time you dug around for some medicine you just knew was lying around somewhere, only to discover that the bottle you were looking for technically expired last year…yet convinced yourself that taking expired medications really isn’t that bad?
I mean, it’s not going to really hurt you, right? Or…is it?
What do you do when you can just baaaaaarely make out the expiration date, but you can see just enough black ink to know that the bottle is at least 3 years old? To take or not to take?
Chances are you already know the “right” thing to do.
If it makes you feel any better, you’re not alone. Even Your Friendly Public Health Pharmacist has fallen into the expired medications trap before.
So don’t beat yourself up about it. I’m going to lay out the arguments for and the arguments against taking expired drugs so you can make your own informed decision.
Then I’ll provide you with a list of 14 drugs you should never take when expired.
But first, a little clarification because the expiration date doesn’t mean what you might think it does.
What does the expiration date on medications really mean?
First, a quick summary of exactly what the expiration date means and why it exists:
In the late 70s, pharma companies became required to include an expiration date on each drug container. The expiration date is the last date that the drugmaker can guarantee the full potency and safety of the drug.
By “full potency,” you would assume that means 100% potent, right? Nope! “Full potency” really means that the drug must still have at least 90% of the strength that it did when it was first made.
The expiration date does NOT tell us exactly when a drug loses potency and therefore no longer works. It also doesn’t tell us when a drug becomes unsafe. Usually, the drugmaker will set the expiration date somewhere between 2 and 5 years from when it was made.
Alright, so what are some of the arguments for and against taking expired meds?
What are the arguments for and against taking expired medications?
I’m a realistic person. You don’t have to convince me that convenience plays a huge factor in whether someone takes an expired medication or not.
If you have some old pills stashed away, you don’t have to get up and buy more medicine.
Sure, if it’s an over-the-counter (OTC) product, you may able to get to a new bottle easily, but maybe you just don’t want to or can’t at the moment.
If it’s a prescription drug, you may not be able to get a prescription called in or make it to a pharmacy to pick it up.
If convenience is the only factor you’re considering, you may lean towards taking the expired medication.
Convenience: To Take
Remember that potency is how well the drug works. The drugmaker promises “full potency” up to the expiration date. After that, all bets are off.
That means it’s possible that the drug may not work as well if it is past its expiration date.
If you’re thinking about taking expired medications, it’s safe to assume you really need it and therefore really need it to work.
Here’s a thought: what if the drug doesn’t work as well anymore (in other words, it has lost its potency)?
Potency: Not to Take
In reality, even though the drug may have lost its potency, it could work just fine.
A study by the US Food and Drug Administration (FDA) showed that many medicines are potent enough years beyond their expiration dates, when stored properly.
FDA runs something called the Shelf Life Extension Program where they test drugs stockpiled for the US military. If test results show the drugs are still potent and stable…you guessed it! That expiration date gets extended.
The downside is this: FDA hasn’t run these tests on the cough medicine at the bottom of your junk drawer. So unfortunately, there’s no way to know.
Potency, again: To Take (???)
Stability tells how predictably the drug will behave in the body. (Trust me, you want the drug to be predictable.)
If a drug isn’t stable anymore, it’s not safe anymore either.
Drugs are even more likely to be UNstable if they’ve been stored in less-than-ideal conditions like a hot car or a humid bathroom.
(Yes, the bathroom is actually a terrible place to store your medicines. Read this post to find out why.)
When drugs are unstable, they can cause serious side effects or allergic reactions. Because of this, certain drugs should never be taken after their expiration dates.
Safety: Not to Take
We’re 2-for-2 in terms of taking versus not taking old drugs, but understand that taking expired medications is usually risky business.
Personally, I would err on the side of caution and avoid taking medications that have expired.
There are two cases where I definitely would NOT take or give expired drugs:
1) I would never give expired medications to children. Drugs can have more powerful effects in children than in adults.
2) I would avoid taking any medications in the chart below if they have expired.
**Disclaimer: 1) Make sure you discuss this with your doctor. 2) Some drugs in this list are used to save lives, such as epinephrine (the active ingredient in EpiPen), insulin, and nitroglycerin. A recent study shows that EpiPens may still have their full potency up to 4 years after the expiration date. However, we don’t know about other forms of epinephrine that have expired or expired insulin and nitroglycerin. In life-threatening situations, you’d have to make that judgement call, but realize that there is a risk the expired drugs will not work.
So folks, once you consider convenience, potency, and stability, the choice is ultimately up to you.
Would you ever (or have you ever) taken expired medicine?