So, you returned from work with a splitting headache. You reach for your first aid box and thankfully there was a pair of tablets left in sachet of paracetamol. You briskly pressed the tablets out of the sachet, but just before you threw them at your headache through your mouth, you looked at the expiry date on the sachet… the drug expired only yesterday! Do you go ahead and take the drug? If you decide to take the paracetamol, will it be a fatal mistake or will you simply continue to suffer from the headache?
This is a dilemma many people face in some way or another.
Technically, the expiration date on a drug does stand for something, but probably not what you think it does. By law, drug manufacturers are required to stamp an expiration date on their products. This is the date at which the manufacturer can still guarantee the full potency and safety of the drug. The expiration dates of drugs are very conservative to ensure you get everything you paid for. So, the expiration date doesn't really indicate a point at which the medication is no longer effective or has become unsafe to use.
Much of what is known about drug expiration dates comes from a study conducted by the Food and Drug Administration (American equivalent of NAFDAC) at the request of the US military. With a large and expensive stockpile of drugs, the military faced tossing out and replacing its drugs every few years. What they found from the study is 90% of more than 100 drugs, both prescription and over-the-counter, were perfectly good to use even 15 years after the expiration date. A similar study by the American Medical Association (AMA) concluded in 2001 showed that the actual shelf life of some products is longer than the labelled expiration date.
Medical authorities state expired drugs are safe to take, even those that expired years ago. It's true the effectiveness of a drug may decrease over time, but much of the original potency still remains even a decade after the expiration date. This, of course, is not without exceptions, thus:
1. Some drugs like nitroglycerin, insulin, and liquid antibiotics (the list is by no way comprehensive) lose their potency easily, and so would be useless at least beyond their expiry dates. Vaccines, biologicals or blood products could also be subject to quick degradation once the expiration date is reached. If a patient finds a medication is powdery or crumbling, has a strong smell, or has dried up (as in the case of or ointments or creams), these drugs should be discarded.
2. Tetracycline was found to cause renal tubular necrosis after its expiry date. However, the formulation of tetracycline that had that effect has since been withdrawn from market.
3. Once the original container is opened, either by the patient or the health care provider who will dispense the drug, that original expiration date on the container can no longer be relied upon.
4. If a medication is essential for a chronic and potentially life-threatening disease, for example, a heart condition, seizure, or life-threatening allergy, it is probably wise to get a new prescription once expired.
5. Solid dosage forms, such as tablets and capsules, appear to be most stable past their expiration date. Drugs that exist in solution or as a reconstituted suspension, and that require refrigeration (such as amoxicillin suspension), may not have the required potency if used when out-dated. Loss of potency can be a major health concern, especially when treating an infection with an antibiotic.
6. It is difficult for any one consumer or health care provider to know which product could have an extended shelf life. The ability for a drug to have an extended shelf life would be dependent upon the actual drug ingredients, presence of preservatives, temperature fluctuations, light, humidity, and other storage conditions. Additionally, the drug lots tested in researches quoted earlier were kept in their original packaging.
The next time you face the drug expiration date dilemma, consider what you've learned here. If the expiration date passed a few years ago and it's important that your drug is absolutely 100% effective, you might want to consider buying a new one. If a medication is needed, and the patient is not able to replace the expired medication, there is no evidence that it is unsafe to take the medication in most cases. And if you have any questions about the safety or effectiveness of any drug, ask your doctor/pharmacist.
Share your experience, if any, with expired drugs with us in the comment section below.
To Your Health!