Should You Take Medicine (over-the-counter or prescription) “Past” its Printed Expiration Date?
By: Dr. David W. Nierenberg
Expiration dates for medication such as pills, tablets and capsules are set by the manufacturer. They represent the period of time that the active drug (ingredient) remains stable and pharmacologically active, without significant decomposition, when the product is stored as recommended (usually at room temperature, without high temperatures, and without high humidity). The drug manufacturer usually tests the activity of the drug, up to the time printed on the package. Most drugs in tablet form have expiration dates of several years after they are produced.
It’s important to know that how you store a drug determines in part how long the drug remains stable. For example, storing any drug in direct sunlight, at high temperatures (more than 75 F), or in very humid conditions, can lead to decomposition of the active ingredient. As one example, storing a bottle of nitroglycerin tablets (used by patients with angina pectoris) in the glove compartment of your car during the summer, is likely to lead to more rapid loss of activity of the tablets, such that they may no longer be effective when needed!
The U.S. Military has tested a number of their drugs that they stockpile for emergency use to see if they remain active for several years beyond their expiration dates. It seems that most do retain their activity for several years beyond their expiration date if stored as recommended. Despite this general finding, the best way to make sure that your over-the-counter tablets like aspirin or acetaminophen, or your prescription drugs, remain active, is to use the drug before its printed expiration date, or shortly after its expiration date.
Liquid preparations of drugs present a special problem for two reasons. First, some liquid drug preparations (such as ophthalmic solutions) are meant to remain sterile so as not to contaminate the eye during use. These should usually be used within one month of when the seal on bottle is broken for first use. Oral liquid formulations, such as NyQuil™, should be used by their expiration date, which is often shorter than for tablets, because some drugs are less stable over time in a solution that in a dry or powdered form, such as used in a capsule or tablet.
Finally, when you go through your medicine cabinet and discover drugs that are “outdated” by months or years, clean them out and dispose of them properly. Many over-the-counter drugs can be disposed of by mixing the medication with kitty litter; sealing it in a small plastic baggy; and then throwing it away. Disposal of prescription drugs are more complex, and usually should not be simply flushed or thrown out. You can visit the DEA website or the FDA website to find recommended procedures for their disposal. Take-back programs for drugs are often sponsored by local police departments, municipal buildings or pharmacies. Most should not be simply poured down the drain, or dumped into the toilet. Rather, drop your expired drugs off at your local drug collection sites, so that we don’t contaminate our local water with a variety of drugs and medications.
Please note: Saturday, April 29, 2017 from 10 am to 2 pm is National Prescription Drug Take Back Day. Visit the DEA website for a list of drop-off locations throughout New Hampshire and Vermont.
Learn more about the Specialty Pharmacy Prescription Services at Dartmouth-Hitchcock Medical Center here. And to manage your D-H Pharmacy prescriptions, download the free D-H Pharmacy Mobile app here.
David W. Nierenberg, MD, is the chief of the section of Clinical Pharmacology at Dartmouth-Hitchcock.