Complying with expiry dates on medicines

[brockenspectre]

This probably sounds a peculiar question but I just went to my "medicine cabinet" (actually a mini medicine backpack) as my right knee is still acting up and I have run out of Ibuprofen 400s that the GP prescribed a couple of months ago and sprayed my knee with an Ibuleve spray. My knee is now feeling a lot better but something made me look at the use by date on the bottle - it says Dec 2002!!! Now I am sure that nothing too amazing is going to happen to my knee as a consequence of using this out of date spray - I am just relieved it has worked but ....

my question is... how tight are the expiry dates on medicines and do they vary from product/type to product/type and... what can happen if you ingest/use a medication (over-the-counter or ohterwise) that is time expired??

:confused:

[Paracab]

It very much depends on what is in the medication - some will be 'safe' for a long time, others will deteriorate quickly.

Often, the main problem is that the medication can be less effective which in itself carries a lot of problems, perhaps your pain will not be relieved sufficiently or illness treated effectively.

Temperature is another problem which can affect certains meds, during the heat wave last summer, some drugs were withdrawn from our vehicles as the shelf life may have been cut by up to half.

As for what you can use post expiry, I wouldn't like to say, but personally I would look at what type of medication it is and how far out of expiry it is.

[AerBabe]

It depends also on whether it's 'wet' or 'dry'. Tablets should remain chemically stable for longer, but the carrier used in creams can go a bit odd. I keep them in the fridge, which helps. Would also be more cautious about the liquid caplet thingies as you're injesting them. If it's a pain-relieving gel you're spreading onto an intact area of skin, it's less likely to give you something nasty.

[Northern Chique]

Few years back I used to work for a vet on and off. He would be given some out of date meds suitable for use on animals. The only ones he wouldnt touch was antibiotics, particularly if the storage had been in doubt.

Vaccines are another he didnt trust.

But overall, most sterilising / preparation and packaging processess are sufficent to ensure safety for some period after the use by date. With some drugs particularly liquid form, dehydration of the product increases the concentration of the active drug. Some chemical changes can happen over time as well.

A simple loop diruretic can last for years, where as something like synthetic adrenalin (epinephrine) is degraded by UV light, so average exposure can render the drug useless or worse still, dangerous.

Limits are set as use by dates and are calculated with lots to spare. Although if we give someone an out of dater to which they throw a reaction, we have a lot of explaining to do. So as part of our protocols, we dont use out of date drugs. Even our in date drugs are inspected regularly as working in the tropics, things are a little more susceptible to heat degradation. Things like GTN for use in angina patients, are cycled more regularly than the manufacurer recommends due to the conditions, purely as a safeguard.

Simple ruling is....... if its out of date either take it back to the chemist (and no not for a refund but some chemists offer a disposal service) for disposal or dispose of it yourself. Just bare in mind though.... what you flush down the loo or sink ends up in the environment.

[gingernut]

Brokenspectre, its difficult to get a straight answer off those in the know.

For medico-legal reasons, I would be loathe to use out of date meds on any of my patients.

I once made enquiries to the manufacturer about the safety of some slightly "out of date" vaccines, and they advised me to discard them immediately. ( but they would say that wouldn't they!)

Having said that, if my trusty bottle of paracetamol was slightly out of date, I would be tempted to use them for myself.

The big no-no is eye drops, as they tend to grow protozoal micro-organisms, once opened, which can apparently damage the eye.

By the way, ibuprofen can be bought (cheaply) from your local pharmacist/supermarket.

[cortilla]

occasionaly using centrum (you know the tabs from A to zinc) which expired in october 2003. Show's you much i use em.

[Rabid Dog]

With you on that one Gingernut.
In general, anything expired should not be used, and should be appropriately disposed of ( and this doesn't mean flushed down the sink).
What drugs and why? Some examples:
Tetracycline etc. - old drug can cause serious, irreversible kidney damage;
vaccines lose potency (especially if what is known as 'the cold chain' is broken);
Antibiotic eye drops - readily grow bugs that can cause serious damage to the eye;
GTN spray/tablets (used for angina/chest pain) readily lose potency within 3 months;
Many drugs are light-sensitive, so storage will compromise their actions.
Remeber too that ANY drug should be taken for the appropriate indication, and to tke a few left-over antibiotics etc. when nest you have 'the flu' is a very silly thing to do.
And for those of you in OS operations, beware the cheap 'rip off' drugs available in many parts of the world - they may not be what they claim to be.

[Boss Raptor]

When I rarely take medicines I am not usually bothered by expiry dates

A friend, specialist at GSK has just answered my query to this question and indicates that expiry dates on many simple generic compound drugs are unlikely to affect the actual drug action as long as they have been stored correctly

However more complex compounds which inevitably are by prescription only can and will break down and either loose effectiveness over a relatively short period of time or can in some cases of adverse storage even change actual make up/structure...and so this is a good case to avoid taking out of date meds...however in the case of these drugs they are likely to be a one off course which will be 100% used during the course of treatment

Any drug which is organic based like a vaccine will definately have a limited shelf life and must be stored with care.

[mini]

IMHO most drugs begin to lose their efficacy after the expiry date, assuming they have been stored in ideal conditions etc.

Vaccines are politically sensitive in that protection rates would be affected by the use of vials that are time expired/cold chain violated etc.

BTW most countries have a legally defined method of destruction for pharma products.

[QDMQDMQDM]

I used exclusively out of date medicines while working in the third world for a brief spell. The problem you have is that you don't know if lack of effect is due to using the wrong drug or because the medicine has expired.

QDM