Are Expired Medications Safe?

Chances are that your medicine cabinet contains some medications, including over-the-counter (OTC) drugs, prescriptions, and supplements, that are at least a few months expired.

You may wonder: Could you still use them, or must they be trashed immediately?

Since 1979, the Food and Drug Administration (FDA) has required drug manufacturers to label their products with expiration dates.

Therefore, manufacturers must guarantee the full potency and safety of the medication until the date printed on the label.

Nonetheless, the speed of deterioration regarding the efficacy and safety of certain drugs differs based on the medication's active ingredients, indication(s), preparation requirements, and storage methods, amongst other factors.

This article will review the guidelines surrounding the use of expired drugs and discuss the types of medicines that cannot be taken past expiration versus those in which exceptions may be made.

My Medication Is Expired: Can I Still Take It?

Generally, drug manufacturers and the FDA do not recommend taking medications after expiration.

Once a drug has reached its expiration date, the manufacturer cannot guarantee it will remain safe and effective.

However, in some cases, some drugs can function beyond their expiration date and perform close to or as adequately as when they were first purchased.

Such examples include medications for minor pain or heartburn, such as TUMS (calcium carbonate), Tylenol (acetaminophen), or nonsteroidal anti-inflammatory drugs (NSAIDs), including Advil (ibuprofen). These drugs are usually safe and effective for at least a year after expiration.

Nonetheless, while you should generally avoid taking expired medications, in some cases, you may be able to take select drugs depending on your medical history and current condition.

Always speak with a healthcare provider regarding any concerns you have over the safety of your medication; they can help determine the risk behind expired drugs and let you know whether the expired drug you're considering is worth the risk.

Expired Medications to Avoid

Most medications' primary risk is not toxicity but the loss of potency after expiration. This means that the drug may stop working or not work as well after the expiration date.

In the case of lifesaving medications, this can be very serious or lead to highly undesirable consequences.

Examples include:

• Nitrostat (nitroglycerin), used to treat angina (chest pain) and heart attacks are susceptible to heat and moisture. These can cause it to break down, and the drug may fail to stop a heart attack.
• Insulin breaks down quickly after the expiration date, making it less effective. This can lead to hyperglycemia (high blood sugar levels) and other dangerous complications. Make sure you understand how to store insulin properly.
• EpiPen (epinephrine) is used to stop allergic reactions that may be life-threatening, such as anaphylaxis. It breaks down quickly after expiring and may be unable to prevent allergic reactions. Note, however, that in an emergency, taking expired epinephrine is better than taking none at all.
• Oral liquid antibiotics can potentially become contaminated with bacteria after they expire. They could fail to treat the infection for which they were prescribed and could also cause further infection.
• Eye drops may become contaminated with bacteria and lead to an infection, such as conjunctivitis (pink eye), if used after expiration.
• Birth control could become less effective once its expiration date passes. This could easily lead to unwanted pregnancies and breakthrough bleeding and spotting.

For context, the only medication known to be toxic to humans past its expiration is tetracycline (an antibiotic often used for the treatment of severe acne).

Taking select medications after expiration can be dangerous and bring about undesirable outcomes, especially if they are lifesaving medications that lose potency past expiration.

Potentially Safe Medications

Despite the above-mentioned medications, most FDA-approved drugs do not pose a serious health-risk if taken after expiration.

However, beyond the immediate safety-related implications, other factors, such as efficacy, should be considered when considering an expired drug.

For example, using a bottle of Zestril (lisinopril) after it has expired may not cause direct harm, but if it fails to control your blood pressure, your risk of cardiovascular (heart) disease may increase.

Even so, most medications do remain potent following their expiration date:

The results of a 2019 study revealed that 90% potency was maintained at least five years after the expiration date listed on over 100 drug products. However, in this study, the tested drugs were in unopened containers that had been stored properly.

Storage Guidelines

Storing medications properly can help extend how long they remain safe and effective.

Most medications are best stored in a cool, dry place, away from sunlight and harsh light. Examples include a bedside table, dresser drawer, or kitchen cabinet.

Keep bottle caps tightly closed and always keep medications out of reach of children and pets.

Some refrigerated medications, such as insulin, may also be kept at room temperature for a limited time and should be marked with the date you remove them from the fridge.

Always ask your pharmacist any questions regarding the proper storage of your medications.

What Should I Do With Expired Medication?

The best and safest way to dispose of expired or unneeded medication is to bring it to a drug take-back location. Many hospitals and clinics, police departments, and community pharmacies offer drop boxes where you can drop off expired medications.

National Drug Take-Back Days also occur a couple of times a year, typically in April and October, when different drop-off locations accept unwanted medications. These are sponsored by the Drug Enforcement Administration (DEA).

Instead of throwing medication in the household trash, crush and mix it with used coffee grounds, kitty litter, sawdust, dirt, or flour.

This may help keep your medications from being accidentally ingested by a child or pet.

Don't flush unwanted medicines down the toilet or pour them down the drain. This can lead to environmental problems.

Even if only some of the drug is removed during water treatment, it can end up in the water supply, raising the chances of contamination.

The only exceptions to this rule are the medications listed on the FDA's approved flush list.

Summary

It is best practice to use medications before their expiration dates. Doing this guarantees the medicine will still work at its total capacity.

This is especially important for potentially lifesaving medications such as Nitrostat (nitroglycerin), EpiPens (epinephrine), and insulin.

But most medications, especially those that come as tablets, are likely safe and effective for at least a year after expiration.

Storing medications properly in dry places will also help extend the medication's life and safety.

When in doubt, speak with a healthcare provider if you have concerns about your prescription regarding its impending expiration date or remaining potency.