Ground Truth on Expiration Dates

[BchBum11511]

What is the truth about expiration dates on over the counter medicine? I've heard got to get rid of it the day it expires, the date is just something the manufacturer is forced to put on so it doesn't matter, and everything in between. I tend to error on the side of expired medicine is better than no medicine although it might not be as potent. I try to keep my medicine up-to-date, but curious nonetheless. Thoughts?

 

[Boostpowered]

Never had a problem with anything but pain killers some actually can get stronger with age. I would imagine it all depends on what it is and what ingredients are in it.

To add a question to your question. Would putting meds in freezer prolong the life like freezing meat?

 

[Road]

In care-taking a family elder for years, I had the same question about dates. I was told by the docs that a lot of it would still be good, though it depends largely on type of med. Those tiny nitro pills, for example, were said to decline rapidly in effectiveness.

The docs also said, off the record, that some exp dates are there so you refill more often (the pharmaceutical industry is one of the few that always weathers any economic downturn or recession) and for liability reasons.

I would research each drug you're wondering about and ask your doctors. Don't just assume it's good.

.

 

[BchBum11511]

In care-taking a family elder for years, I had the same question about dates. I was told by the docs that a lot of it would still be good, though it depends largely on type of med. Those tiny nitro pills, for example, were said to decline rapidly in effectiveness.

The docs also said, off the record, that some exp dates are there so you refill more often (the pharmaceutical industry is one of the few that always weathers any economic downturn or recession) and for liability reasons.

I would research each drug you're wondering about and ask your doctors. Don't just assume it's good.

.

You bring up a point of clarification. I’m mostly curious about OTC meds. The answer may be the same, but we don’t have any prescribed meds we take long term.

Edited the original post.

 

[Rich_the4x4podcast]

Prescription meds it's best to replace before they expire. The efficacy of the medication is not guaranteed to work as prescribed. If it's not working as prescribed, then there's no benefit to taking it and may actually cause harm. The strength of the medication is only one thing to consider. If you are taking an extended-release or long-acting medication, that could be affected as well. The medication could be released more rapidly than intended or slower (both are equally as bad). OTC meds, again, it's the efficacy of the meds that comes into question. I do feel little safer taking a Tylenol that is several months past its expiration date. Here is a nice little summary of some studies related to medications and expiration dates. Do Drug Expiration Dates Really Matter? - Poise and Potions

 

[BchBum11511]

Prescription meds it's best to replace before they expire. The efficacy of the medication is not guaranteed to work as prescribed. If it's not working as prescribed, then there's no benefit to taking it and may actually cause harm. The strength of the medication is only one thing to consider. If you are taking an extended-release or long-acting medication, that could be affected as well. The medication could be released more rapidly than intended or slower (both are equally as bad). OTC meds, again, it's the efficacy of the meds that comes into question. I do feel little safer taking a Tylenol that is several months past its expiration date. Here is a nice little summary of some studies related to medications and expiration dates. Do Drug Expiration Dates Really Matter? - Poise and Potions

Thanks for the data. Some good info in there!

 

[udbknight]

Just to add another perspective, I realize that you are talking about over the counter, but this article might be of interest anyway. Defense.gov News Article: Program Extends Drug Shelf-Life. It's kind of a calculated gamble, but so is driving a car...

 

[slomatt]

I've heard that many medications are still effective well after their expiration date if they are stored in a cool dry location. That said, if they are in a first aid kit stored in a vehicle then the fluctuations of heat and humidity are probably not an ideal situation for keeping medicines "fresh".

 

[LndXrsr]

Most OTC medications will be fine well past their expiration date. Maybe slightly less potent, but safe to take. Can't really put a hard number on how far past the expiration, but 1-2 years after, most drugs are still plenty effective for what you need them for (headache, itching, allergies, etc).

One exception to this is ASPIRIN. Per a pharmacist friend, over time, aspirin can degrade and create some toxic byproducts that can harm the kidneys. I've read some contradictory things about this on the internet, but I figure, why take the chance? I keep just a small amount around in case anyone has chest pain and I'm worried about a heart attack...I treat all my actual pain with Tylenol or ibuprofen.

The other commonly debated and important med in the world of overlanding/wilderness medicine is the Epi-Pen. As long as the liquid in the pen doesn't have crystals, which wouldn't be able to be dispensed out the needle, it's fine to use. The pen itself says don't use if discolored, but this is a natural process of the solution and studies have tested Epi-Pens up to 10 years expired and all had at least 80% of the epinephrine activity remaining. Some epi is better than no epi in an emergency...

 

[Cort]

Another point to consider is if you are to give someone else expired drugs and things don’t go as planned you can be at risk. Best to replace when expired, not all state protect good Samaritan’s and if you have training you are expected to give care within the range of your training.

 

[Elzevir]

I know this is a necro, but I feel the last post needs clarification for folks. I agree with @Cort with your potential liability and replacing things as best practice. That being said, we operate in an Ideal-to-real principle world and sometimes having expired things is better than nothing at all.

There is some discrepancy in the last sentence.

All 50 states (& DC) have a good Samaritan Law, but each is worded differently and should be researched if you are operating in that state. In most states, there is no expectation/requirement for you to act based on your training or license level. Any duty to act, in the majority of instances, is while acting in a professional or volunteer capacity where all or part of that role has been advertised as providing medical assistance. Some volunteer basis are covered under Good Samaritan Laws. There are a few Bad Samaritan (Duty-to-Act) states, so advocating research of your operating area is the best advice to offer.


Here is a document from Council of Residency Directors in Emergency Medicine, which of course deals with liability of Physicians. Most of this is the same for lower forms of training.

Microsoft Word - good.samaritan.laws.summary.handout.docx (cordem.org)

 

[Buckaroomedic]

Howdy - long time lurker, first time posting,

A lot of good info in this thread.

A couple things that should be avoided; aspirin (ASA) will degrade into toxic components after expiration date. I don't recommend ASA for anything really anymore. Tylenol (APAP) or Motrin (IB) can do the same as ASA but with less side effects and even less allergies than to ASA. About the only thing i would use ASA for is baby aspirin for chest pain, and even that is controversial these days. Follow your protocols

Nitroglycerin (NTG) will lose if efficacy after its exp date and if not kept in opaque containers. If you need NTG, you probably already know this. NTG should only be administered if you know what you're doing and have the appropriate medical training and gear in case the patient's BP bottoms out.

I read a study a few years ago (that I can't seem to find anymore) about the efficacy and strength of expired Epi-pens. The study offered new, in date, epi-pens on a one-for-one exchange to anyone no matter what condition. They received quite a large sample as I recall. The pens had been kept in various conditions; some were kept in refrigerators while some rattled around in back packs or glove boxes for years. Some of the pens had just expired and some had been expired for years. When the epinephrine was withdrawn and tested; all samples were still in compliance with FDA potency regulations. A similar study, published around the same time, did the same test with some medicines that were taken from various health clinics around Africa. This test also found the same results as the epi-pen study.

When I was in the Army, our Brigade Surgeon would routinely extend expiration dates from six to 12 months. My physician medical control would do the same thing at my last job.

Just some more info to ponder. If it was me, I would rather treat a person with expired meds and potentially save their life than not treat. I'll deal with legal repercussions later.

Get some medical training and certifications and stay in your lane when it come to treating people. Do not treat beyond your scope of practice and you should be good to go.

Y'all take care