Expired medicines may be less effective, and some can be unsafe. Ask a pharmacist before taking them, and do not use expired antibiotics or nitroglycerin.
Are they dangerous
Most are not harmful, but some lose potency. The FDA found that many drugs stay potent well after the date, based on a Shelf Life Extension Program study.
Exceptions
- Nitroglycerin, insulin and liquid antibiotics.
- Epinephrine auto-injectors.
- Tetracycline (can harm the kidneys).
Storage
Heat and humidity cause damage faster.
What to do
Ask a pharmacist, and dispose of old drugs at take back sites.
Expiration date meaning
The expiration date is the last day the manufacturer guarantees full potency and safety. A landmark US military study, the Shelf Life Extension Program (SLEP) of the 1980s, tested 122 drugs and found that about 90% were still safe and effective for 15 years or more past the date, when stored properly. That doesn’t apply to all drugs or home storage conditions.
Usually reduced potency, not toxicity
Most expired pills lose some potency over time, rather than become toxic. Still, there is no guarantee.
Medicines you should never use after expiry
- Nitroglycerin tablets.
- Insulin.
- Liquid antibiotics.
- Epinephrine auto-injectors (EpiPen).
- Eye drops, since contamination can cause infections.
- Tetracycline antibiotics, which have been reported in the past to cause kidney damage when degraded (older reports).
- Seizure medications and blood thinners such as warfarin, where dosing is critical.
Storage
Heat, humidity and light speed up degradation. Avoid keeping medicines in the bathroom or car. Keep in the original container in a cool dry place.
Disposal
Use drug take back programs, usually at pharmacies or police stations. The DEA National Prescription Drug Take Back Day happens twice a year. If no take back program is available, the FDA gives instructions for mixing with used coffee grounds or cat litter in a sealed bag. Some drugs, like opioids, should be flushed per the FDA’s flush list.
Ask a pharmacist
A pharmacist can tell if your medicine is okay to use past the date.
Emergencies
If you must choose between no treatment and an expired medicine in a serious situation, call a doctor or poison control (1-800-222-1222 in the US).
What studies found
The FDA and Department of Defense Shelf Life Extension Program tested stockpiled drugs, and a 2006 analysis in the Journal of Pharmaceutical Sciences found that about 88 percent of the products tested remained potent well beyond their labeled expiry dates, often by years. An expiration date is the last day the manufacturer guarantees full potency and safety under proper storage. Expired pills are usually less potent rather than toxic. Heat, humidity and light speed degradation, so a bathroom cabinet is not ideal storage.
Drugs to avoid and disposal
Do not rely on expired medicines for serious conditions, such as insulin, nitroglycerin, epinephrine auto-injectors, anticonvulsants, blood thinners, liquid antibiotics and eye drops, where reduced potency or contamination can be dangerous. Ask a pharmacist if unsure. The FDA advises using drug take back programs for disposal, and the DEA holds National Prescription Drug Take Back Days in April and October. If no take back is available, mix medicines with used coffee grounds or cat litter in a sealed bag and throw them in the trash, and flush only those on the FDA flush list.
Based on data from the FDA and the Journal of Pharmaceutical Sciences
