Don't Throw Those Meds Away!: The Shelf-Life Extension Program

Disclaimer:  This is not medical advice.  The following post is for education and information only.  You should always consult your physician before taking any medication, whether over the counter or prescription.  It is unlawful to take any prescription medication that has been prescribed for another individual.  Only a licensed physician has the authority to re-allocate prescription drugs for use by another individual.

Have you ever wondered about those "use by" dates printed on the bottles of your prescriptions and over-the-counter medications?  Have you ever suspected that if, say, aspirin in a bottle labeled "use by October 2021" was safe to take on October 31, 2021, that it might also be safe to take on November 1, 2021?

Wonder no more.  About thirty-ish years ago, the US government began to wonder the same thing and financed some studies.   Basically, the government recognized it was wasting money if it threw away perfectly good medicines. (I'm totally in shock about this and still trying to wrap my head around it.  Since when has our government ever been concerned about wasting money?) Drug  manufacturers felt about the same.  The results of the studies have been published in a few medical journals, but there doesn't seem to have been much effort to disseminate this information to the general public.  They might not buy as many OTC medicines if they knew.

https://www.fda.gov/EmergencyPreparedness/Counterterrorism/MedicalCountermeasures/MCMLegalRegulatoryandPolicyFramework/ucm411446.htm

https://www.ghdonline.org/uploads/drugs-Stability_Profiles-vencimiento.pdf

https://www.mayoclinicproceedings.org/article/S0025-6196(15)00667-9/pdf

http://www.formatex.info/microbiology4/vol3/1721-1725.pdf

I highly recommend reading the articles yourself.  But in case you don't have time for that right now, the gist of the articles is that it's better to use new stuff, but if there is a bioterrorist attack, or a public health emergency like a massive earthquake, or an epidemic, then it's ok to use older stock. 

??

So, if it's going to save the government money (but not you, because they're going to take all they can get from you, regardless), or there's a crisis that the government can't handle with what supplies it currently has, then it's safe to use older stock.

Translate that however you wish.  Both doctors I took classes from said they had no problem with using older medications--providing that they had been stored properly.  Furthermore, there was no hazard per se to using expired medications, only that they gradually decrease in efficacy.   (But if you have a serious infection and your antibiotic is less effective, that could be hazardous.)  Both doctors stated this was true even for tetracycline family antibiotics (including minocycline and doxycycline, the latter being a drug of choice in treating anthrax).  While tetracycline family antibiotics used to become toxic soon after their use-by date, both physicians said that they have been re-formulated so that this is no longer the case.  According to The Medical Letter, a professional newsletter, "The only report of human toxicity that may have been caused by chemical or physical degradation of a pharmaceutical product is renal tubular damage that was associated with the use of degraded tetracycline...  Current tetracycline preparations have been reformulated with different fillers to minimize degradation and are unlikely to have this effect"  (The Medical Letter, Vol. 44, Issue 1142, 28 October 2002).


There is a major exception, and that is for liquid medications.  Those simply do not have the shelf-life of tablets and capsules.  But again, they don't generally become toxic; they just become less effective.  Epi-pens do decrease in efficacy, but even five years past the use-by date they still have 60% efficacy of dosage, and that may be enough to save a life.  One of my doctor-teachers said he heard of a patient that needed seventeen shots of epinephrine before he was stabilized--until the allergen was completely eliminated from his system. Save those out-of-date epi-pens.  And for those of you with insulin-dependent diabetics in your family, my husband has found that his insulin, one of the boutique insulins (can't remember which off the top of my head) decreases in efficacy about 18 months after its use-by date.  We've read that the cheaper insulins have a longer shelf-life, up to three years. 

Now you know.