Can I take expired medicines?
Let's say right away: drugs that have expired are still worth getting rid of. The US Food and Drug Administration (FDA), for example, strongly recommends Don't Be Tempted to Use Expired Medicines. And there are a number of serious reasons for such a recommendation.
So, in some drugs, bacteria can begin to multiply over time. Others become dummies: you drink them, hoping for a cure, and the disease progresses. Still others change the chemical composition and generally turn into poison.
The FDA's arguments sound logical. However, the issue of expired drugs is not as straightforward as it seems. And that's why.
Why expired drugs aren't necessarily bad
First, let's figure out what the expiration date is. This is the period Drug Expiration Dates, Are Expired Drugs Still Safe to Take? , during which the pharmaceutical company that released a particular drug guarantees its safety and effectiveness. But the definition of the duration of this period is a very dubious thing.
The shelf life is generally defined as follows. Having released another drug, the manufacturer fixes its characteristics, including the chemical composition and concentration of active ingredients, and then puts the drug on the shelf. A year later, the composition of the drug is analyzed again and a conclusion is made about its effectiveness. The analysis is repeated two years later. Etc.
The problem is this: suppose the medicine has been on the shelf for three years. It cannot be released for sale without a specified expiration date. Expiration Dates, Questions and Answers. However, it is corny for a pharmaceutical company to delay the start of sales. Therefore, the manufacturer indicates the already checked period as the expiration date, those same 3 years, and with a clear conscience sends the drug to pharmacies.
In fact, the drug can remain effective for more than three years. But the creators no longer check this The Myth of Drug Expiration Dates.
Pharmaceutical companies are the only ones with the money to conduct long-term research on drug efficacy. However, they have absolutely no financial incentive to do this. Does Medicine Really Expire? ...Lee Cantrell Director of the San Diego Department of the California Poison Control Center
However, departments that have a financial incentive to study the true shelf life of drugs are still there. This is, for example, the US Department of Defense. In 1986, it launched the Shelf-Life Extension Program (SLEP Expiration Dating Extension) with the FDA to save on the cost of renewing drugs stored in emergency stores.
The program bears fruit on a regular basis. For example, in 2006, SLEP tested 122 different drugs stored under ideal conditions. Most of them eventually extended their Stability Profiles of Drug Products Extended beyond Labeled Expiration Dates by about four years.
Which expired medications can and cannot be taken
We emphasize once again: despite the above data, it is still worth listening to the FDA recommendations and diligently updating the first aid kit as needed. This is not the most economical, but definitely the healthiest option.
Expiry date is the date on which responsibility for the efficacy and safety of a drug passes from manufacturer to consumer. Is it ok to take Claritin (loratadine) D that expired March of 2014? ...Barbara Stark Baxter MD, Columbia University College of Surgery and Therapy, New York
But what if, for example, you have a headache, and you have only paracetamol expired for a couple of months? Or worse: you or someone nearby have a severe allergic reaction (the same Quincke's edema), and there is even a syringe-auto-injector with adrenaline, but the expiration date ... Inject or not? Let's figure it out.
Which expired drugs are unsafe
Clinical studies have not been conducted to confirm the dangers of expired drugs. However, the experts in the Drugs.com information database use common sense to strongly recommend Drug Expiration Dates, Are Expired Drugs Still Safe to Take? DO NOT USE the following drugs after the expiration date.
- Insulin . It is used to control blood sugar levels in diabetes. The drug can change its chemical composition and at least not help.
- Oral nitroglycerin . A popular remedy for angina pectoris. After opening, nitroglycerin loses its effectiveness rather quickly.
- Biological preparations . This category, in particular, includes vaccines, blood products, immunoglobulins, toxoids. Their active ingredients are also rapidly degraded.
- Antibiotics from the tetracyclines group . According to some reports, after the expiration date, they can produce a toxic metabolite. Is It Controversial Drug Expiration Dates, Do They Mean Anything? the question, however, it is better not to seek the truth, risking their own health.
- Antibiotics in the form of suspensions . After the expiration date, they are very likely to become useless.
- Eye drops, nasal sprays and other medications with preservatives . Over time, preservatives disintegrate, which means that bacteria can begin to multiply in the solution.
- Medicines in the form of injections . You should not take risks with them, even if the contents of the syringe have not changed their appearance. And it is definitely necessary to refuse injections if the solution becomes cloudy, discolored, or a precipitate appears in it.
- Individually formulated preparations . These drugs are not FDA approved, but Compounding and the FDA: Questions and Answers are sometimes needed. A pharmacist can combine several ingredients to create a product that is tailored to the needs of the individual patient. In no case should individually combined drugs be taken after the expiry date declared by the attending physician, as their effect becomes unpredictable.
- Any medicine that looks old and tainted . If the tablets crumble or smell unpleasant, the solution has become cloudy, and the ointment or cream has dried out, do not eat or smear them on yourself. This is strictly prohibited.
Which expired drugs can be used if necessary
The list of such drugs is potentially quite wide. Thus, in the 2012 study Stability of Active Ingredients in Long ‑ Expired Prescription Medications, scientists analyzed eight drugs with 15 active ingredients, the shelf life of which expired 28–40 years ago.
We have found that some of these drugs, even 40 years after their date of manufacture, are still fully effective.Lee Cantrell
Perhaps there are many more such long-lasting drugs. But we will list only those active substances and preparations for which there is scientifically established data.
- Paracetamol . Even being overdue for many years, the active ingredient retains its effectiveness by 99%. The researchers, however, cannot guarantee that all expired pills will be equally effective. So if the first pill doesn't work, don't take the second.
- Aspirin . Not as magical as paracetamol: 10 years after the expiration date, aspirin loses 99% of its effectiveness. But if only 1-2 years have passed, and there is no other pain reliever at hand (but very necessary!), You can try to heal with such a pill. By the way, there is a life hack that allows you to recognize an unambiguously spoiled drug: useless aspirin breaks down into its components and begins to smell unpleasant. Can You Take Expired Claritin? acetic acid. Taking such a remedy is definitely useless.
- Codeine . Strictly prescription substance with antitussive action. Even being deeply overdue, it retains its effectiveness by more than 90%.
- Antihistamines, in particular loratadine-based . Men's Health reports 16 Drugs to Take or Toss from Your Medicine Cabinet that loratadine successfully survived stress tests: it was heated for 6 hours at 70 ° C and marinated in direct sunlight for 24 hours. After such harsh experiments, 99% of the active substance survived. This means that loratadine is likely to remain effective long after the expiration date.
- EpiPens . These are expensive epinephrine autoinjectors that are used to treat deadly allergic reactions. One study of Epinephrine Concentrations in EpiPens After the Expiration Date found that 4 years after the expiration date, EpiPens were 84% effective. This is not a record figure or carte blanche that removes the need to buy a new auto-injector to replace an expired one. It's just information: in an emergency, an expired EpiPen is better than nothing.
After mentioning EpiPen, an important thing must be said: it is permissible to experiment with the expiration date of drugs only in those cases when your life does not depend on these drugs. If you still value your health, update your first aid kit in a timely manner.