We’ve all been there: You’ve got a headache, but the pain reliever in your cupboard is expired. Or you reach for your prescription medication and realize the expiration date has come and gone. What do you do?
Family physician Simon Hodes, MD ChB, delivers the details on dated medication to help you know what’s safe to take — and how to safely dispose of expired medication.
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What is a medication expiration date?
The U.S. Food and Drug Administration (FDA) and the National Health Service (NHS) in England require medication companies to include an expiration date on their products. An expiration date means the company guarantees its safety and efficacy (its ability to work properly) until that date.
“Drug manufacturers put an expiration date on each medication they sell,” Dr. Hodes says. “The date is important because medications don’t last forever, and they may be ineffective or could even harm your health if they’re spoiled.”
Risks of expired medicines
Are medications dangerous right after they expire? No, but it’s difficult to know whether the med in question is still good — and what kinds of risks you might be taking.
Expired medications can:
- Become weaker, so they can’t treat the medical issue properly.
- Contain harmful germs because the preservatives in them have broken down.
- Contribute to other health problems, like antibiotic resistance, if they no longer have the correct strength.
“The expiration date is there for your protection,” Dr. Hodes reinforces. “Given enough time, the ingredients in any medication will break down and lose their quality.”
Can I take an expired medication?
What if you need the medicine now and can’t get to the pharmacy? Can you take the medication just this once?
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Usually, you should avoid taking expired medication if possible. But there are a few factors to consider.
Is it for a serious health condition?
Taking some expired ibuprofen for a headache is probably OK. But using expired insulin for diabetes or nitroglycerin for angina is a different story.
“Contact your provider right away if your medication is expired and you have a serious health condition like diabetes or heart disease,” Dr. Hodes advises. “Insulin and nitroglycerin are two medications in particular that degrade quickly once they reach their expiration date. Having the wrong dose of these types of medications could lead to a medical emergency.”
But in select cases, expired meds are better than nothing.
For example, using an expired EpiPen (epinephrine, or adrenaline in the U.K.) for anaphylaxis is better than no medication at all. In this case, call 911 or an emergency number and use the expired medication. Tell your care providers that you took expired epinephrine and provide the expiration date, if possible.
Is it a liquid or a solid?
Liquid medications tend to grow bacteria more easily than solid pills. Eye drops, ear drops and some antibiotics are some examples of liquid medicines that aren’t safe to use past their expiration date.
“Liquids easily become contaminated,” Dr. Hodes shares. “Anything you put in your eyes or ears should be sterile, so avoid expired eye and ear drops. Medications you swallow, such as liquid antacids or antibiotics, also have a higher risk of breaking down quickly.”
That doesn’t mean expired solid pills are always safe, but they have a lower risk of going bad soon after their expiration date.
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“Many liquid medications have clear instructions to be stored in the fridge after opening and/or disposed of within a short period of time once opened. Don’t take any meds that don’t look or smell like they normally do, regardless of what type of medicine it is. And always check the storage and disposal details,” Dr. Hodes stresses.
How expired is it?
Medicine that expired last week is different from one that expired months ago. The longer it’s been expired, the more likely it isn’t any good.
Where has it been stored?
Most people store their medications in their bathroom. And that’s probably the last place they should be.
“Heat and humidity accelerate spoilage,” Dr. Hodes explains. “Keep medications in a cool, dry cupboard out of direct sunlight. Don’t put medications in the refrigerator unless the label says to do so.”
So, a pain reliever that’s been in a cool, dry cupboard and is a month expired? Probably OK. A prescription that’s been in a steamy bathroom and expired six months ago? Avoid it and replace it with new medication ASAP.
Avoid the expired med dilemma
The best way to avoid taking a potentially dangerous expired medication is to simply not have expired meds around. You can do this if you:
- Don’t buy in bulk. Avoid the temptation to buy bulk-sized packages of medications because it feels like a better deal. “Most people don’t need to keep a giant bottle of pain reliever or antacids on hand,” Dr. Hodes notes. “Wasted medication is common and adds to our carbon footprint.”
- Keep prescriptions fresh. If you take prescriptions, don’t get extra refills. “Many people end up with different medications or a change of dose over time,” Dr. Hodes points out. “Loading up on your prescription refills could leave you with medications you can’t use.”
- Spring clean. “Go through your medicines at least once a year and take expired medicines out,” Dr. Hodes suggests. “If you do get rid of any medications, make a note to get a fresh supply from your pharmacy or healthcare provider.”
What to do with expired meds
The best way to get rid of unwanted medicine is to take them to a take-back program in your community. Ask your pharmacist or local law enforcement about a location near you.
If a take-back isn’t an option, you can:
- Throw it in the garbage. Most medications can safely go in your normal garbage. Mix them with dirt, cat litter or undesirable material so others won’t find them and try to use them. Promptly take the garbage out to keep it away from children or pets.
- Flush them. Some medications have specific instructions to flush leftovers down the toilet. These medicines are dangerous if people or animals find them in the garbage. Don’t flush all of your medications, though — just the ones on the FDA’s flush list.
- Handle prefilled syringes with needles properly. Don’t throw needles — new or used — in the trash. They must always be carefully disposed of — usually in a sharps container or through your local pharmacy or take-back program.
Take expiration dates seriously
You probably wouldn’t chance it with expired meat or moldy cheese, so don’t use expired medications either. “If people don’t overstock and clean out their medicine cabinets like they do their refrigerators, they can avoid expired medicines,” says Dr. Hodes. “Just like with food, try not to over-order. And when in doubt, throw it out.”
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