Drug Expiration Dates

[1WattLightbulb]

Here's an article on when drugs actually expire.

http://www.medicaldaily.com/what-your-pharmacist-cant-tell-you-about-drug-expiration-dates-its-complicated-342978

“Many drugs stored under reasonable conditions in their original unopened containers retain 90 percent of their potency for at least 5 years after the expiration date on the label, and sometimes much longer,” The Medical Letter report concludes, with one important caveat: “Epinephrine in EpiPen is an important exception” as these products gradually lose potency once the expiration date passes.
...
"Generally, the authors warn, liquid drugs are not as stable as solid dosages, and should a liquid become cloudy, discolored, or show signs of precipitation, it should not be used."
...
“Given the potential cost-savings, we suggest the current practices of drug expiration dating be reconsidered,” Cantrell and his co-authors wrote in the conclusion.

For those of you in the medical field, what other drugs would you say expire sooner rather than later?

[Kitsune]

I work in pharmaceuticals, though I am not a pharmacist. Note that this is not legal or medical advice; proceed at your own risk. :)

They're right - liquids lose their potency much more quickly than pills. Cough syrup seems to be the one that everyone stores in the back of the cupboard, but it typically loses most of it's effectiveness within a few months of the expiration date. Liquid benadryl is also something that most people keep around the house (it's incredibly helpful for quick reaction on allergic reactions, and if you're far away from a hospital it can give you time to get there...) but it does expire and need replacing relatively often.

Not a medication, but: check the expiration date on your sunscreen. You can get wicked bad sunburns with stuff that's only 2-3 months expired.

Beyond that, I personally push it on drugs where 90% efficacy is perfectly fine with me (pills: advil, tylenol, aleve, migraine medication, allergy meds, etc - I've used all of these several years expired, and they worked as I needed them to). For stuff where I actually depend on the efficacy, though, I'm not willing to push it (birth control pills, EpiPens, and the like). Some things are worth ensuring 100% efficacy. :)

[Blonde Lawyer]

I'm not in the medical field but I can say that insulin does expire.  Not as fast as the FDA says but it still loses its effectiveness.  I can get about three months out of a bottle for my cat and then I need to throw it out.  I know it stops working because his blood sugar goes up (evidenced by the type of urine he leaves in the litter box.)  FDA says throw it out after 28 days so I'm getting a lot more than that but it certainly isn't good until it's gone.

[NoraLenderbee]

I have some aspirin in the bathroom that expired in 1993.

[Dee18]

There was a gun article about that in the Wall Street Journal, suggesting eggicacy of some drugs was extremely long.

http://www.wsj.com/articles/SB954201508530067326

[screwit]

There are several things which are of importance when considering the shelf life of drugs and level of efficacy is just one of them. As @Kitsune noted, tablets are more stable than liquids however you should keep several things in mind.

1. Pharma companies want to claim the longest shelf life that they safely can, as this improves their logistics. So they're not doing it just to force you to buy aspirin more often, they're doing because of safety regulations which are there for a reason.

2. Shelf life is set based on several things and efficacy is just one of them. An active substance becomes less active by the chemical structure being modified (breaking down, oxidisation etc) - this creates by-products which may become harmful in larger amounts, or for which the safety just hasn't been well documented.

3. Stability studies are carried out according to set guidelines which require testing at various temperatures and humidity. Storing your drugs in the warm, humid conditions of your bathroom is almost the worst case scenario and your drugs WILL breakdown faster in that environment.

4. By the above token, if you live in a warm humid environment then your drugs will also be more affected by that - so New Orleans is, for example, a worse environment than Chicago. Room temperature is not alway room temperature (officially it is 25°C/65% humidity).

[forummm]

There was a gun article about that in the Wall Street Journal, suggesting eggicacy of some drugs was extremely long.

I think you meant to post that here:
http://forum.mrmoneymustache.com/ask-a-mustachian/eggflation/

[Gone Fishing]

One has to also judge the risk involved with a medication not working as intended.  A bad epipen could result in death.  A bad ibuprophen that doesn't help a headache, no biggie.

[forummm]

One has to also judge the risk involved with a medication not working as intended.  A bad epipen could result in death.  A bad ibuprophen that doesn't help a headache, no biggie.

Some medications can become toxic as they degrade. You can probably find out which ones do that online.

[Gone Fishing]

One has to also judge the risk involved with a medication not working as intended.  A bad epipen could result in death.  A bad ibuprophen that doesn't help a headache, no biggie.

Some medications can become toxic as they degrade. You can probably find out which ones do that online.

Looks like the list is pretty short:
Tetracycline

A few others were mentioned with some possibility of toxic effects but references were limited.

[forummm]

One has to also judge the risk involved with a medication not working as intended.  A bad epipen could result in death.  A bad ibuprophen that doesn't help a headache, no biggie.

Some medications can become toxic as they degrade. You can probably find out which ones do that online.

Looks like the list is pretty short:
Tetracycline

A few others were mentioned with some possibility of toxic effects but references were limited.

There are probably many others that were never tested. It's not something the FDA requires for very long time frames, so there isn't an incentive to test for it.

Personally, I think the risk is pretty minimal. Just mentioning it.

[accolay]

It all depends on the medication, how much it's used and how much it costs. Unless you have a chronic/possibly emergency medical condition what medications are you keeping as extras around your house that you could possibly need all the time anyway? Maybe Tylenol, ibuprofen. Maybe Benadryl/allergy meds? Couple more if you have kids? What do you really need and how much do you take it?

Instead, perhaps don't buy the giant 3000 pill bottles of whatever at Costco (because it was cheap) if you only use it every once in a while. Buy small amounts as needed in the generic versions. What a waste (time, money, liver) if a drug loses any percentage of its efficacy. If I need to take something, I'd rather take something up to date that will work.

Of course after the apocalypse this all goes out the window. Preppers, the floor is yours.

[Bajadoc]

There are drugs and there are drugs. I was a doctor for 25 years. I used plenty of "expired" drugs on people. I took home expired samples for myself and my family. I also used them to help indigent and homeless people who would have nothing else. I would not recommend this be done in life dependent situations (drugs needed to sustain life). I was always observant and cannot remember a time when the drugs did not work. There are a million variables and you should not try this at home.