Is it safe to take expired medications?

“Should I take expired medications?” Although this question may sound simple, the answer is a bit complicated.

It all begins with safety. The mandated expiration date traces back to a law passed in 1979 requiring drug manufacturers to provide a specific date on their medications to guarantee potency and safety of the product up to that date.

Deciding how strictly to follow the expiration date is the more difficult task at hand. The Missouri Poison Center handles many calls about drug storage, safety, and dosing. Frequently our poison specialists are asked, “Do medications need to be thrown away past the expiration date or are they still safe to use?” OR “Is there any risk taking my medicine past the expiration date?”What the Experts Say…The effectiveness of medication may lower over time, but there are few studies on the issue to provide an exact answer.

The bottom line is that “Drug expiration dates reflect the time period during which the product is known to remain stable, which means it retains its strength, quality, and purity when it is stored according to its labeled storage conditions.”

Proper storage is an important part of keeping a medication safe and effective. This information can be found on the Drug Facts Panel under “Other Information” which includes a range of ideal temperatures for medication storage. It is also important to keep the medication dry, avoid direct sunlight, and refrigerate if necessary. Following these storage guidelines will help to keep the medication’s proper potency and quality.

Sometimes patients are faced with making the decision to take an expired medication or skip taking the medicine altogether. Many factors need to be taken into consideration before taking an expired medication. If it is for the treatment of something minor, such as medication for a headache or allergies, most people choose to take a dose and then replace the expired medication when they are able. If it is a prescription medication that is being taken for a serious condition such as one for heart disease or seizures, it is best to call the doctor to update the prescription and get it filled immediately.Don’t be tempted…Here are some medications that should not be taken after the expiration date.

• Liquid medications that require refrigeration such as liquid antibiotics. They can lose potency when outdated and will not be able to treat infections as effectively.
• Insulin (an injectable medication used to treat diabetes) degrades quickly after the expiration date. Expired insulin may be less effective at lowering blood sugar.
• Oral nitroglycerin, a medication used to treat chest pain, starts to lose its potency once the bottle is opened.
• Any solid medication that has a strong smell or appears powdery and crumbly.
• Any medicated ointment that is dried up should be discarded.
• The antibiotic, tetracycline, can breakdown into a chemical that has the potential to damage the kidneys.
• Medications that come in a food form, such as vitamins that come in a gummy formulation or calcium that comes in a chew formulation. It is the other ingredients in the formulated product that may spoil and cause unwanted side effects.

How to get rid of the old…For proper disposal of expired medications, take advantage of a medication disposal program. They are often offered by pharmacies or police departments.

If there is not a program available in your area, follow these steps:

• Take your drugs out of their original containers.
• Liquids should be poured over paper towels, kitty litter, or used coffee grounds. Place tightly wrapped mixture into a disposable container with a lid, such as an empty margarine tub, or into a sealable bag.
• Solids (pills, capsules, tablets) may be mixed with undesirable substances such as used coffee grounds or kitty litter so that they are less likely to be eaten. Place the tightly wrapped mixture into a disposable container with a lid, as above.
• Conceal or remove any personal information, including prescription number, by covering it with permanent marker or duct tape, or by scratching it off.
• The sealed container with the drug mixture, and the empty drug containers, can now be placed in the trash.

DO NOT: Flush expired or unwanted drugs down the toilet or drain unless the label or accompanying patient information specifically instructs you to do so.

DO: Return unwanted or expired prescription and over-the-counter drugs to a drug take-back program or follow the above steps for household disposal.