Monday, August 6, 2012

Check Your Expiration - Prescription Meds

With the cost of prescription medicines rising, many people might be tempted to hold on to a medication just in case they need to take them again.  Maintenance medications, those we take on a daily basis for chronic medical issues, are filled on a regular basis.  But what about medicine we take for seasonal allergy relief or for temporary pain?  Should we hold onto unfinished portions?  Is it safe to take them again, even if they are a little past their expiration dates?

expired medine
Expiration dates on medicine also called discard after date.
Expiration Dates
The US Food and Drug Administration (FDA) started requiring expiration dates on medicine sold by prescription and over the counter.  Expiration dates can be found on the prescription label, the bottle, or box of the medication.  The FDA contends that medication expiration dates help in determining a medication's effectiveness and safety after expiration.  Expired medication can lose its effectiveness and in some cases can even pose a threat to one's health.  Tetracyclin for example is an antibiotic that can cause serious kidney damage if taken after expiration date.  

Most expiration dates range from one to five years.  However, in some states, pharmacies are required to give a prescription a one year expiration date once they have re-bottled and dispensed it.  Berkeley University advises that under ideal conditions, many medications remain stable long after their expiration dates.  However, most people do not keep their medications in these conditions.  Once the bottle is opened, a medication begins to break down. Exposure to sunlight, extreme temperatures or moisture affect the stability of medications.

Are All Expiration Dates Equal?
Berkeley University lists the following medicines that break down quickly and should not be used past the expiration date.
  • Liquid antibiotics
  • Liquids requiring refrigeration
  • Insulins
  • Nitroglycerine
  • Epi-pens
The following are medications that may be safe to use, although could be less effective, after expiration.
  • Cold remedies
  • Topical ointments and creams
  • Pain relievers
  • Sleeping aids
Medication packaging also contains information regarding safe storage and expiration dates.  As with anything we eat or put on our skin, if it is discolored, has a strong odor or has changed in appearance, for example become powdery, it should be discarded.

effects of expired medicine
Expiration dates on over the counter drugs.
 The FDA advises that expired medication can pose a health risk if taken after the expiration date, especially if not stored properly.  It is important to read and follow the instructions for proper storage of both prescription and over the counter medications.  They should  be stored in a controlled climate and properly sealed in their containers.

Medicine Storage Do's & Don'ts
  • Do store in a cool, dry, dark place away from heat and moisture.
  • Do refrigerate when indicated.
  • Do not store in a bathroom medicine cabinet.
  • Do not store in your car.
Medications can start to break down and lose their potency (also called efficacy) once they are exposed to air and different temperatures.  Does this automatically mean that the expired medicine poses a health risk?  Not necessarily.  Berkeley University explains that there is no evidence to suggest that expired medication is harmful to your health.  It could depend on the medication.  Many experts feel that it is not worth risking.  The FDA advises not to take the risk.  The chemical composition of a medication can start to break down due to improper storage and this could be dangerous.

Even if  there does not seem to be a threat due to an expiration date, consider these reasons for properly discarding unused medications.  Robert H. Shmerling, M.D. of Beth Israel Deaconess Medical Center advises:

Medication Dangers
  • Abuse - Prescription pain killers are often abused, especially by teenagers.
  • Accidental dose or overdose - Children and the elderly can take medications by accident.  Taking a medication that is not prescribed can be dangerous even in a small dosage. 
  • Pets - Like children and elderly parents can get into medications, too.
  • Poisoning - Medication poisoning is a leading cause of death from poisoning.
As a full time caregiver, I will also add that it is very easy to grab the wrong prescription or even over the counter bottle on a busy morning.  Last summer while my mother was taking Coumadin, a blood thinner, she had several different dosages available.  Patients who take Coumadin often experience dosage changes, especially when they first start taking the blood thinner.  It can change every two weeks, or even more frequently.  I had to keep the different bottles well marked and separated in order to avoid giving her the wrong dosage.  Too much and she could bleed to death.  Too little and she could develop a deadly blood clot.

For some medications, we might have to keep some on hand.  For most we do not have to.  Don't make your job harder. Discard expired medication and avoid medication dangers as much as possible.

As rising costs continue to influence how long we hold onto prescription and over the counter medications, expiration dates will factor into our decision to keep or discard those old bottles.  If you are cost conscious, as most of us are, remember that the FamilyWize prescription discount drug card is free and can be used at over 61,000 participating pharmacies.  Save up to 75% off the cost of prescription drugs.

If you do have expired medication, come September is the DEA National Take Back Initiative.  This initiative allows you to return expired medicines so that they are properly disposed of.  We will be posting a blog in September as a reminder and give you more information about where you can go.  In the meantime, check with your pharmacy or FDA.gov for proper disposal directions of over-the-counter and prescription medications.

Caroline Carr
Contributing Writer

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