It happens to everybody—you have a headache or feel sick, and you head to the medicine cabinet to get something to help. But once you get there and pull out that prescription drug or over-the-counter medication, you see the expiration date has flown by. So what do you do? Take it or throw it away? It’s a judgment call that, depending on the medication, could have serious consequences.
What does a drug’s expiration date mean?
Every medication, whether prescription or over-the-counter, has an expiration date. And similar to the expiration dates on food, if you ingest it after that date, the results can be a little dicey. Scientifically speaking, says Reed Supe, Pharm.D., a pharmacist in Alaska, “a drug’s expiration date is when the active ingredient has lost 10% of its potency.” Those dates can be a bit conservative, though, because they’re meant to ensure that the drug product is fully effective and safe to use for its entire shelf life. After that date, the chemical components of the drug may change in unexpected ways, rendering the drug unusable.
Lisa Vogel, Pharm.D., a pharmacist who works at a hospital in Illinois, notes that hospitals will never give expired medication, even if it’s an hour past the date and time listed on the drug.
“When we compound something, it has a ‘beyond use’ date, and that is a date and a time specific to the particular drug,” she says. “Those are strict guidelines.”
At home, though, the situation gets a bit more fuzzy. Carl Rauch, RPh, a pharmacist in Wisconsin, says to never take anything that’s expired—”potency and safety cannot be determined after the date,” he says, and with allergy medicine in particular, the side effects could get worse even as the full potency declines.
How long can you take medicine after the expiration date?
Drs. Vogel and Supe agree it’s good not to take any over-the-counter drug that’s expired, though both say to use your best judgment if you have a stockpile of meds. A week or a month, or even up to a year, after the expiration date probably won’t hurt you, the medicine will just be less effective. Just because the expiration date has passed, doesn’t mean the medication is immediately useless—but that’s different for every medication.
“The molecule breakdown is not linear and not the same from molecule to molecule,” Dr. Supe says. “Therefore, there is no blanket statement as to when something is ‘too expired.’”
That being said, a research team may have found information to debate expiration dates. On a study of 14 unopened medications that were all between 28 and 40 years expired, researchers found 86% of them retained at least 90% of the active drug. Still, though, because these results can’t be guaranteed with medication that’s already been opened or stored in less-than-optimal conditions, the U.S. Food and Drug Administration (FDA) doesn’t support taking expired drugs.
Is it safe to take expired medicine?
Whether it’s safe to take something that’s expired really depends on what it is. Every medicine ages differently. Allergy medication, pain relievers (like ibuprofen or acetaminophen), and cold medicine likely won’t hurt you. But avoid taking expired antibiotics, supplements, and eye drops.
Truthfully, you shouldn’t have any antibiotics expiring on you anyway. The prescriptions should always be taken in full only for the indication for which they were prescribed—if you don’t, Dr. Vogel says, you could get worse or risk your infection developing resistance against the antibiotic. Plus, the fundamental composition of antibiotics changes over time, which can cause issues on its own. “Some antibiotics become hazardous past the expiration date and cause more harm,” Rauch says. “Others lose their potency and have little or no effect with increased side-effects.”
Or, if it’s a life-saving treatment—like nitroglycerin—it might still work if you don’t have any other options, but is it worth the risk? Probably not.
What happens if you take expired medicine?
With most over-the-counter (OTC) medication, taking expired drugs will either help you or have no effect—the medicine could no longer be potent. Side effects may be a bit more pronounced, but you probably won’t get sicker than you already are, especially if you’ve stored your medication properly, in its original containers. A lot of things can degrade medicine more quickly than normal: light exposure, temperature, and humidity.
Contrary to popular belief, the medicine cabinet is not the right place to keep your pills. The bathroom is far too hot and steamy for proper storage of medication. You’ll want to find a cool, dark, dry place, out of the reach of children. Some medications require refrigeration and special handling, Dr. Supe says, so be sure to follow the package directions carefully. If you plan on putting pills in a pill box, find one that’s shaded, not clear, to keep them out of direct light.
You should also consider the source of the medication. “Purchasing medication online or from a foreign country is not a safe practice,” Dr. Supe says. “There is no regulating body ensuring the medication is what it says it is and is safe for consumption. There have been many instances where people have purchased medication online from another country due to cost and it has contained rat poison and no traces of the active ingredients it claims to have.” In other words, medication from outside the United States may be unsafe even before it’s expired.
What medications are unsafe after the expiration date?
Some medications are simply ineffective after their expiration. Others, like these, are harmful.
- Tetracycline and doxycycline: These antibiotics become hazardous with time, Rauch says. Tetracycline in particular is known to cause kidney damage after the use-by date.
- Supplements: These aren’t regulated as well as FDA-approved medication, Dr. Supe says, so be more safe than sorry and avoid taking them if they’re expired.
- Eye drops: Expired eye drops lose their pH balance and can end up burning your eyes, Dr. Supe says.
- Injectable/IV drugs: This is mostly a concern in hospitals, but Dr. Vogel says patients will never receive expired medicine in a medical facility.
What should you do with expired medicine?
In the past, guidelines on getting rid of expired medicine haven’t always had the best advice.
“I remember when the recommendation was to flush expired medication,” Dr. Vogel says. Of course, we know now that’s a bad idea—it can get into the water supply. The best thing to do, Dr. Vogel says, is to put the medication in a form where people can’t ingest it, on purpose or accidentally. If it’s a capsule, open it up and dump the contents into the trash. If it’s a tablet, mix it with dirt or something else undesirable and trash it. With liquid antibiotics, pour it into cat litter or coffee grounds so it’s absorbed, then toss it.
If you don’t want to dump the expired medicine in your own trash, you can utilize a take back program. “Many city halls, police departments, and fire departments take unwanted medications,” Rauch says. “There is usually no charge to do this. Just remove any private information before bringing it there.”
Supe also notes that cities around the country host biannual drug take back days, which is an option if the hospitals or police stations near you don’t have disposal sites. The U.S. Drug Enforcement Administration (DEA) runs an annual National Prescription Drug Take Back Day, too.
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“Getting rid of expired medication is a valuable thing to do,” Vogel says. “I don’t think keeping things around because you might need it is necessarily a good idea. You don’t want to get into the mindset that it’s OK to take expired medication. The dates are there for a reason.”
Ultimately, it’s important to remember that those drug expiration dates—no matter how flexible they may or may not be—serve a purpose and you should adhere to them.