"If the drug is an over-the-counter product for minor aches and pains, you may not get 100 percent of the benefits if the expiration date has passed, but it's not dangerous," explains Rabia Atayee, an associate clinical professor of pharmacy at the University of California, San Diego.
However, for people taking medications for chronic or life-threatening illnesses — such as heart conditions, seizures, COPD or severe allergies — a drug that's not completely effective can be downright dangerous, she says.
Here are some answers to common questions that may help you stay out of harm's way when it comes to ingesting and discarding expired medications.
1. "I have some five-year-old antibiotics I want to take on my vacation in case I get sick. Are they still good?"
They won't make you sick, but they may not be strong enough to fight off infection, which can be harmful. Over time, antibiotics stored at home can lose up to 50 percent or more of their strength, meaning they may not be able to halt a potentially life-threatening bug that's invading your system.
Plus, if you're taking leftover antibiotics from a past illness, you won't have a complete dose to knock out all the bacteria. As Amy Tiemeier, associate professor of pharmacy practice at St. Louis College of Pharmacy, points out, not taking a full dose allows the most drug-resistant bacteria to remain in your body. You then risk getting the same infection again and needing a stronger drug to knock it out, which could mean more side effects and pricier antibiotics.
2. "Are there any medications that I should never, ever use beyond their expiration dates?"
Yes, absolutely. Oral nitroglycerin (NTG), a medication used for angina (chest pain), may lose its potency quickly once the bottle is opened and should never be taken after the expiration date. Similarly, insulin, used to control blood sugar in those with diabetes, may stop working after its expiration date. Other drugs you need to be sure are full strength include anticonvulsants, warfarin, digoxin, thyroid preparations and oral contraceptives (see full list here).
Another must-toss once the expiration date has passed: inhalers. "They will lose potency after their expiration date," Tiemeier says. "If you're having an acute respiratory attack and your inhaler doesn't work, it could be a dangerous situation." Ditto for EpiPens; the epinephrine in auto-injectors loses its potency. As with inhalers, EpiPens are used in life-threatening situations like anaphylaxis, so using an expired one is a major health threat.
Lastly, using ophthalmic (eye) drops past their expiration date could be dangerous because of the high risk for bacterial growth. You could risk losing your vision from contaminated drops, Tiemeier says.
Get MORE answers to common questions that may help you stay out of harm's way when it comes to ingesting and discarding expired medications -
- Is a drug's expiration date the same thing as the 'use-by' date I see on my prescription vials?
- I keep all my medications on the kitchen counter so I remember to take them, rather than in my medicine chest. Are they safe there?
- How can I safely dispose of expired medications?
- How often should I clean out my medications?
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