Taking Expired Medications: What's the Harm?
Annette (Gbemudu) Ogbru, PharmD, MBA
Dr. Gbemudu received her B.S. in Biochemistry from Nova Southeastern University, her PharmD degree from University of Maryland, and MBA degree from University of Baltimore. She completed a one year post-doctoral fellowship with Rutgers University and Bristol Myers Squibb.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Consumers are sometimes quick to disregard expiration dates of their prescriptions and over-the-counter medications. These habits may be due to the rising cost of medications; negligence; lack of insurance; or unawareness of the harm in doing so.
The term "expired" is defined as something that has come to its end. Popular expressions such as an expired drivers license, passport, or even food, signify that replacements are in order or there may be consequences. The same concept applies to the use of expired medications.
To shed more light onto the relevance of expiration dates, it is important to understand how drug companies determine longevity and expiration of their products. All drugs have unique formulations consisting of active and inactive ingredients geared to treat specific diseases. Once a drug is developed, manufacturers determine the length of time a drug will last without deteriorating; this is known as the drug's shelf-life. If a medication is used within its shelf-life, maximal efficacy and safety of the drug is expected.
Efficacy is an important factor to consider because it reflects the ability of the drug to produce the desired effect; hence, the higher the efficacy, the better the results. Expired medication may not adequately treat minor conditions (for example, minor headache, cold), or serious conditions (for example, diabetes or heart disease) because of reduced efficacy. As a consequence, inadequate relief from sickness could eventually lead to longer sick days, increased absences from work/school, and lost productivity at work/school.
The safety of expired medications should also be considered. Medications may change their chemical and physical properties, as is evident when tablets disintegrate and liquids separate into layers, or even change color within the dispensed bottle.
As can be seen, the big issues with expired medications are two-fold: drugs become weak and may potentially be unsafe. It is advisable to discard all expired medications. Why take the risk? Always check expiration dates posted on boxes and vials and if products are expired, check with your local pharmacy or physician's office to see if they have medication disposal receptacles. It is not recommended to flush unused or expired medications down the toilet as they have the possibility of contaminating the water system.
Tova Alladice, M.D.
American Board of Physical Medicine & Rehabilitation
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