Thursday, January 10, 2013

Drug expiration dates

My apologies for not posting as often as I'd like -- we've been slammed! Nonetheless, I wanted to get a quick post up concerning an important issue.

As a follow up to my New Year's Day activities of sorting through our medical supplies, several readers raised the question of drug expiration dates and the wisdom of storing over-the-counter drugs if their efficacy will only be neutralized over time.

By the grace of God none of us in my family are on prescription medications, so we don't have to worry about stockpiling those. And as far as over-the-counter stuff, it appears that many drugs have a vastly longer shelf life than we're led to believe.


Don found some online research which addresses this issue. Please see these articles:

Study Highlights Debate Over Drug Expiration Dates

Program Extends Drug Shelf-Life

I'm afraid I won't be able to answer any specific questions about drugs since I have no medical training. However these data suggest that many, if not most, over-the-counter drugs are efficacious for far longer than we've been led to believe.

Make of this what you will.

16 comments:

  1. Thank you, Patrice and Don.

    While in some cases expiration dates are called for and useful, I think by and large the expiration date racket is one of the biggest rip-offs of the age.

    It primarily benefits big business at the expense of the consumer and the environment.


    A. McSp

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  2. Be warned that some drugs DO lose potency quickly!
    I have twice had triple antibiotic ointments lose efficacy fairly soon after the expiration date. One was a local grocery store brand, the other was Wal-Mart brand. I stored both in a dark medicine cabinet of a dry house that maintained temperature with use of heating and air conditioning.
    After 2 days of topical use, they had no affect on an infected cut. I got a new tube of store brand ointment both times and the infection was noticeably reduced in less than a day.

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  3. They'll last a lot longer if you don't keep them where nearly everyone does... in the bathroom. Heat and humidity will cause them to deteriorate faster. Keep them someplace cool and dry.

    Julie G

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  4. I appreciate that you and your husband are always willing to dig for information. One clue, if the odor of the medication changes-think about it. an Example is aspirin-too old and it smells like Vinegar.

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  5. Actually, this is a Federal requirement per 21 CFR Parts 210 and 211. You are required to demonstrate the stability of the product, typically by demonstrating the stability of the Active Pharmaceutical Ingredient (API).

    Typically, these studies are conducted both at the final storage temperatures (for example room temp at 18-25 C or refrigerated at 2-8 C) as well as at accelerated conditions to demonstrate that the product maintains efficacy (typically 90% of the value of the API at time of initial formulation, although it can go as low as 80% depending on the product) and measure the degradation pathways (how products degrade, what potential byproducts are, etc.)

    What is the "okay" level of an API in a given product to have it function as intended? That completely varies from product to product.

    I don't know that I'd categorize expiration dates as a "racket". Do companies leave themselves a cushion between what the real "failure" date is and what they claim? Possibly. Should a company open itself up to a lawsuit because the expiration date is extended to the point that the product is unsafe, unefficacious, and impure? Probably not - besides, it is illegal per the regulations.

    (I'm not a scientist or a medical doctor, but I do have 15+ years experience in the industry)

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  6. Astma inhalers lose efectivness after the experation date.Found that out in the emergency during ab an asthma attack.

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  7. I can imagine an ointment might be more likely to be less effective over time. My antihistimine, however, is three years out of date--and is still doing fine.

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  8. I'm very curious about the "Band Aid" containers on the corner of the table, lower left of the picture. Did those come full of....Band Aids? Or were they some sort of first aid kit?

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    1. Those are Band-aids, bought at Costco. They come in a three-pack, each with its own plastic container. I used to be el-cheapo generic band-aids, but they didn't stick very well. These are better.

      - Patrice

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  9. Just as Toirdhealbheach Beucail says the date is a case of the company protecting itself from a potential lawsuit. They need to *prove* the drug is still viable after 6 months, to *prove* it's still viable after 2 years they would need to wait another 18 months which would delay the introduction of the product by .... 18 months. So they don't prove it. It is still effective? Maybe, possibly, probably but the company doesn't claim it and so doesn't have to prove it or accept liability from someone using an out-of-date product.
    Consider them similar to "best before" dates on food.

    If you use if after the date and something 'bad' happens you have no come back.

    Of course there is some margin on this date. The product won't all be fine on day 183 and all go bad on day 184. At 12 months maybe 5% of the product has gone bad or it's only 70% as effective as it should be. There is no sharp cut off date it's a slow decline in the effectiveness (or in some cases safety) of the product.

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    1. You are quite correct in the fact that things do not magically go bad in one day. Product stability is typically a linear drop over time.

      As also has been noted above, the type of drug, its composition and its storage condition all play a role. A tablet, stored in the original packaging in optimal conditions (room temperature, no extremes, sheltered from light) is probably going weather better than an open tablet out on a car dashboard in the sun.

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  10. Some drugs do lose strength and the new asthma inhalers will definately lose their propellant soon after the expiration. The general rule of what we (I was an RN for 20 years) are taught (or at least I was many, many years ago) when dealing with very rural home care when a pharmacy is not readily available is that if the tablet looks and smells fine then it is generally safe to use. Tablets will begin to deteriorate or change colors. Capsules with humidity will melt together and inhalers may lose their propellant. I personally have used meds that were 5 or 6 years out of date and they were fine. Also think about this: In a SHTF situation which is why we stockpile things in the first place, a tylenol that works with 80% efficacy is better than no tylenol at all! Rotate your stock and keep them as fresh as you can if the SHTF and Wal-Mart is no more then well we will survive with what we have.

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  11. I remember this article beign useful: http://www.doomandbloom.net/2012/10/new-evidence-on-expiration-dates-2.html

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  12. I'm sure there's a measure of lawsuit-protection with those expiration dates.

    I'm also not surprised some break down and are less effective. I guess I would be worried about whether they'd break down into something unsafe. During a severe toothache I wondered about the prescription pain pills I had left over from several years earlier ... and passed on them.

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  13. I have a store brand (H.E.B.) triple antibiotic that expired in April 2001 and a tube of Health Mart brand, expired May 1998, and they both still work just fine. These are both Bacitracin-Neomycin-Polymyxin B.

    Sometimes, if a TAO doesn't work on a particular small wound, it may be because the infection has developed a resistance to the particular antibiotics used, but that doesn't mean they won't work on other wounds. Most medications will lose their efficacy over time, some longer times than others. The only meds I would not use past their expirations (and there are probably others that I don't know about) contain Tetracycline. This does turn to a poison in a relatively short time.

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  14. Expiration dates are merely the dates at which the company is guaranteeing at least 90% effectiveness. After that, there is the potential of losing potency. After reviewing many articles and studies, most OTC medicines, in pill form are fine long after the expiration, they may just start to lose potency. Same for most ointments. As stated in previous replies, if the smell of a medicine has changed or if it has started to degrade, dispose and replace.
    It does say, for creams to check and make sure there hasn't been changes in color, texture or smell. If there have been, properly dispose of and replace.
    For prescription meds, pills generally follow the same as for OTC, but if there is concern to just contact your doctor and they can let you know if it'd be safe. They say most prescription ointments or creams shouldn't be used without speaking with your doctor first.

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