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Is taking expired pills OK?

Is taking expired pills OK?
• First, the expiration date, required by law in the United States, beginning in 1979, specifies only the date the manufacturer guarantees the full potency and safety of the drug -- it does not mean how long the drug is actually "good" or safe to use.

• Second, medical authorities uniformly say it is safe to take drugs past their expiration date -- no matter how "expired" the drugs purportedly are. Except for possibly the rarest of exceptions, you won't get hurt and you certainly won't get killed.

• Third, studies show that expired drugs may lose some of their potency over time, from as little as 5% or less to 50% or more (though usually much less than the latter). Even 10 years after the "expiration date," most drugs have a good deal of their original potency. So wisdom dictates that if your life does depend on an expired drug, and you must have 100% or so of its original strength, you should probably toss it and get a refill, in accordance with the cliché, "better safe than sorry." If your life does not depend on an expired drug -- such as that for headache, hay fever, or menstrual cramps -- take it and see what happens.

One of the largest studies ever conducted that supports the above points about "expired drug" labeling was done by the US military 15 years ago, according to a feature story in the Wall Street Journal (March 29, 2000), reported by Laurie P. Cohen. The military was sitting on a $1 billion stockpile of drugs and facing the daunting process of destroying and replacing its supply every 2 to 3 years, so it began a testing program to see if it could extend the life of its inventory. The testing, conducted by the US Food and Drug Administration (FDA), ultimately covered more than 100 drugs, prescription and over-the-counter. The results showed that about 90% of them were safe and effective as far as 15 years past their original expiration date.

In light of these results, a former director of the testing program, Francis Flaherty, said he concluded that expiration dates put on by manufacturers typically have no bearing on whether a drug is usable for longer. Mr. Flaherty noted that a drug maker is required to prove only that a drug is still good on whatever expiration date the company chooses to set. The expiration date doesn't mean, or even suggest, that the drug will stop being effective after that, nor that it will become harmful. "Manufacturers put expiration dates on for marketing, rather than scientific, reasons," said Mr. Flaherty, a pharmacist at the FDA until his retirement in 1999. "It's not profitable for them to have products on a shelf for 10 years. They want turnover."

For patients who rely on medications to stay alive, like heart medications, expired drugs can be dangerous because they may not be getting the full effectiveness of the drug.

The Medical Letter, a respected source of independent information about drugs, stated in a 2002 article that certain medicines, stored in high humidity and other bad conditions, stayed good to use for 1 1/2 to nine years after their expiration dates.”For instance, Symmetrel (amantadine) and Flumadine (rimantidine), anti-viral drugs used to prevent and treat influenza, withstood 160-degree temperatures and were good after the equivalent of 25 years of ordinary storage,” the reports states. "Many drugs stored under reasonable conditions retain 90 percent of their potency for at least five years after the expiration date on the label, and sometimes much longer."

Guidelines
If the medication has been opened, or stored in a high temperature or high humidity environment (like your bathroom medicine cabinet), it is wise to dispose of it. Tetracycline type antibiotics and some seizure medications can cause serious toxicity if taken beyond the expiration date. Liquid drugs are less stable than tablet/powder/capsule medications. Some medications are especially affected by age. For example, taking oral contraceptives that have expired may produce an unexpected pregnancy. Some drugs obviously disintegrate, such as acetilysalycilic acid, that develops an acidic smell when it is old. If you have a question about the safety of a particular drug, take the medication to show to your physician and get his advice.

The bottom line
Although expired medications are unlikely to be harmful, it is important to analyze the risks versus the benefits of using them.

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