Can expired medicines be taken?

Let's say right away: drugs that have expired are still worth getting rid of. The U.S. Food and Drug Administration (FDA), for example, strongly recommends thisDon’t Be Tempted to Use Expired Medicines. And there are a number of serious reasons for such a recommendation.

So, in some drugs, bacteria can begin to multiply over time. Others become dummies: you drink them, hoping for a cure, and the disease progresses. Still others change the chemical composition and generally turn into poison.

The FDA's arguments sound logical. However, the issue of expired drugs is not as straightforward as it seems. And that's why.

Why expired drugs aren't necessarily bad

First, let's figure out what the expiration date is. This is the periodDrug Expiration Dates - Are Expired Drugs Still Safe to Take?, during which the pharmaceutical company that released a particular drug guarantees its safety and effectiveness. But the definition of the duration of this period is a very dubious thing.

The shelf life is generally defined as follows. After releasing another drug, the manufacturer fixes its characteristics, including the chemical composition and concentration of active ingredients, and then puts the drug on the shelf. A year later, the composition of the drug is analyzed again and a conclusion is made about its effectiveness. The analysis is repeated two years later. Etc.

The problem is this: suppose a medicine has been on the shelf for three years. It cannot be released on sale without a specified expiration date.Expiration Dates - Questions and Answers. However, the pharmaceutical company is trite unprofitable delay the start of sales. Therefore, the manufacturer indicates the already checked period as the expiration date - the same "3 years" - and with a clear conscience sends the drug to pharmacies.

In fact, the drug can remain effective for more than three years. But the creators no longer check this.The Myth of Drug Expiration Dates.

Pharmaceutical companies are the only ones with the money to conduct long-term research on drug efficacy. However, they have absolutely no financial incentive to do so.Does Medicine Really Expire?.

Lee Cantrell, Director of the San Diego Division of the California Poison Control Center

However, departments that have a financial incentive to study the true shelf life of drugs are still there. This is, for example, the US Department of Defense. In 1986, together with the FDA, it launched the so-called Shelf-Life Extension Program (SLEP).Expiration Dating Extension) - to save on the costs associated with the need to update drugs that are stored in emergency storage.

The program regularly pays off. For example, in 2006, SLEP tested 122 different drugs stored under ideal conditions. The shelf life of most of them was eventually extended.Stability Profiles of Drug Products Extended beyond Labeled Expiration Dates for about four years.

Which expired medications can be taken and which cannot

We emphasize again: despite the above data, it is still worth listening to the FDA recommendations and diligently updating the first aid kit as needed. It's not the most economical, but definitely the healthiest option.

Expiration date is the date on which responsibility for the efficacy and safety of a drug passes from the manufacturer to the consumer.Is it ok to take Claritin (loratadine) D that expired March of 2014?.

Barbara Stark Baxter, MD, Columbia University College of Surgery and Therapy, New York

However, in some situations, it is permissible to move the shelf life slightly. For example, you have a headache and you have only expired ibuprofen on hand. Or worse: you or someone nearby has a severe allergic reaction (the same Quincke's edema), and there is even a syringe-auto-injector with adrenaline, but the expiration date... Inject or not? Let's figure it out.

Which expired drugs are unsafe

Clinical studies have not been conducted to confirm the danger of expired drugs. However, the experts of the Drugs.com information database, using common sense, strongly recommendDrug Expiration Dates - Are Expired Drugs Still Safe to Take? Do not use the following drugs after the expiration date.

1. Insulin. It is used to control blood sugar levels in diabetes. The drug can change its chemical composition and at least not help.
2. Oral nitroglycerin. A popular remedy for angina pectoris. After opening, nitroglycerin loses its effectiveness rather quickly.
3. Biological preparations. This category, in particular, includes vaccines, blood products, immunoglobulins, toxoids. Their active ingredients are also rapidly destroyed.
4. Antibiotics from the tetracyclines group. According to some reports, after the expiration date, they can produce a toxic metabolite. It's controversialDrug Expiration Dates - Do They Mean Anything? the question, however, it is better not to seek the truth, risking their own health.
5. Antibiotics in the form of suspensions. After the expiration date, they are very likely to become useless.
6. Eye drops, nasal sprays, and other preservative medications. Over time, preservatives disintegrate, which means that in solution bacteria may begin to multiply.
7. Medicines by injection. You should not take risks with them, even if the contents of the syringe have not changed their appearance. And it is definitely necessary to refuse injections if the solution becomes cloudy, discolored, or a precipitate appears in it.
8. Individually formulated preparations. These drugs are not FDA approved but are sometimes necessaryCompounding and the FDA: Questions and Answers. A pharmacist can combine several ingredients to create a product that is tailored to the needs of the individual patient. In no case should individually combined drugs be taken after the expiry date stated by the attending physician, as their effect becomes unpredictable.
9. Any medicines that look old and tainted. If the tablets crumble or smell unpleasant, the solution has become cloudy, and the ointment or cream has dried out, do not eat or smear them on yourself. This is strictly prohibited.

What medicines with an expired shelf life can be used if necessary

The list of such drugs is potentially quite wide. So, in the studyStability of Active Ingredients in Long ‑ Expired Prescription Medications In 2012, scientists analyzed eight drugs with 15 active ingredients, which expired 28-40 years ago.

We have found that some of these drugs, even 40 years after their date of manufacture, are still fully effective.

Lee Cantrell

Perhaps there are many more such "long-lasting" drugs. But we have collected drugs for which there is already established data.

1. Paracetamol. Even being overdue for many years, the drug retains more than 99% of the active ingredient. The researchers, however, do not guarantee that all expired pills will be equally effective. So if the first pill doesn't work, then don't take the second.
2. Aspirin. Not as magical as paracetamol: 10 years after the expiration date, aspirin loses 99% of its effectiveness. But if only 1–2 years have passed, and there is no other pain reliever at hand, you can try to heal with such a pill. By the way, there is a life hack that allows you to recognize an unambiguously spoiled drug: unusable aspirin breaks down into components and begins to smell unpleasantCan You Take Expired Claritin? acetic acid. Taking such a remedy is definitely useless.
3. Codeine. Strictly prescription drug with antitussive action. Even being deeply overdue, it retains its effectiveness by more than 90%.
4. Antihistamines, in particular loratadine-based. Men’s Health publication provides data16 Drugs to Take or Toss from Your Medicine Cabinet that loratadine successfully survived stress tests: it was heated for 6 hours at a temperature of 70 ° C, and then marinated in direct sunlight for another day. After such tough experiments, 99% of the active substance "survived" in the preparation. This means that loratadine is likely to remain effective long after the expiration date.
5. EpiPens. These are expensive auto-injectors of adrenaline that are used to stop deadly allergic reactions. In one studyEpinephrine Concentrations in EpiPens After the Expiration Date it was found that after 4 years the EpiPens expiration date retained their 84% effectiveness. This is not a record figure or carte blanche that removes the need to buy a new auto-injector to replace an expired one. It's just information: in an emergency, an expired EpiPen is better than nothing.

After mentioning EpiPen, an important thing must be said: it is permissible to experiment with the expiration date of drugs only in cases where your life does not depend on these drugs. If you still value your health, update your first aid kit in a timely manner.