North Jefferson News, Gardendale, AL

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February 23, 2010

Taking expired medications can have serious consequences

HEALTH WATCH — What do you do when you have a splitting headache? 

You usually go to the medicine cabinet and start looking for the aspirin or acetaminophen, right?

What happens if you take the time to look at the side or the bottom of the bottle, and see that the product expired two years ago? Do you take it or not? Would taking it be a damaging or fatal mistake, or can you expect relief from the headache? 

This is a dilemma that most of us who take the time to read the label face at one time or another. Well, here is some information that will hopefully help you make an informed decision.

In 1979, the U.S. Food and Drug Administration (FDA) began requiring an expiration date on prescription and over-the-counter medications to serve as a very conservative guide to their longevity. The law requires manufacturers to stamp the expiration date on each product. 

The expiration date is a guarantee from the manufacturer that a medication will remain chemically stable — and thus, fully potent and safe — prior to that date.

However, this calculation is based on the stability of the product in its original unopened container. Once a container is opened and the contents are exposed to air and moisture, that date is no longer valid. It’s important to realize that the expiration date does stand for something, but most likely not what you thought it did.

You can easily smell or see when a gallon of milk and loaf of bread are no longer consumable. The expiration dates on them help.

Tablets or capsules in most cases don’t mold or start smelling bad. However, there are some exceptions. When aspirin is stored in the bathroom medicine cabinet, the prolonged exposure to moisture in the air makes the active ingredient in aspirin convert to acetic acid, which is why old aspirin smells like vinegar. 

As with food, the storage environment is the most critical issue in maintaining drug stability and longevity. Moisture is one of the damaging environmental agents to an expiration date.  Therefore, storing drugs in the humid environment of the bathroom is not the best place to extend expiration dates.

A much better place to consider storing medications is in the kitchen cabinet, as long as it’s not over the sink or in an extremely hot or moist environment. Of course, if you choose to store medications there, keep them out of the reach of children and pets.

The expiration date is really a marketing statement rather than a scientific statement. However, there are some exceptions: Drugs like nitroglycerin, used for chest pain; insulin, used in the treatment of diabetes; and some liquid antibiotics are sensitive to the expiration dates. 

These medications, while they might not hurt you, might not be as effective in treatment and should be discarded.

Many drugs lose their potency with age. This becomes a major issue when the patient is using a maintenance drug such as an inhaler or a cholesterol-lowing prescription. The medication loses its effectiveness and can place the user in an unhealthy situation. Would you want to take expired medication for severe cardiac arrhythmia?

Furthermore, medications in the liquid dosage form can actually increase in strength past the printed expiration date because some components of the liquid can evaporate, leaving more of the active ingredient. Outdated eye and ear drops may no longer be sterile and could possibly lead to an infection or irritation.

Some expired medications can become downright dangerous. Tetracyclines, which are “broad-spectrum” antibiotics, are used to treat a wide variety of infections. Doctors may prescribe these drugs to treat eye infections, pneumonia, gonorrhea and other bacterial infections.

The medicine is also used to treat acne, and may be in your medicine cabinet. Tetracyclines become dangerous past their expiration dates and can cause serious damage to the kidneys.

Another issue to be considered when taking old medications is that if your physician gave you something two years ago, he or she based that drug selection on the current medications you were taking at that time. Over time, your drugs may have changed and you could be on something now that interacts with that previous medication. The expiration date is not your only concern in taking old medications.

The next time you face the drug expiration date dilemma, consider what you have read. If the expiration date was a few years ago, and it’s important that the medication be 100 percent effective, then you might want to consider getting a new bottle.

If you have any questions about whether to take it or not, remember your physician and pharmacist are only a phone call away. They can be an excellent resource then it comes to information about your drugs.

Steve Mullenix (R.Ph) co-owns The Pharmacy in Mount Olive with his wife, Sherry Mullenix (J.D., R.N.). They can be reached at 631-1201.

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