New Year, New Medicine Cabinet

Ringing in the New Year is an exciting event. “Out with the old, and in with the new,” people say. It’s a time to throw off bad habits and take on better, healthier ones that will precipitate true change. You can take this same adage and apply it to many aspects of your health such as your medicine cabinet. The New Year may be a perfect time to go through all those old medications and throw out the expired vitamins, aspirin, prescription and over-the-counter medications.

While it is easy to tell when food has gone bad in your refrigerator, it is not as easy to determine whether you medication and vitamins are due for replacement. Drug expiration dates exist on most medication labels, including prescription, over-the-counter (OTC) and dietary (herbal) supplements. But can medications be taken past their expiration date?

What does expiration date mean?
The expiration date on a medication is the final day that the manufacturer guarantees the full potency and safety of a medication. Since 1979, U.S. pharmaceutical manufacturers are required to post expiration dates on prescription products prior to marketing. For legal and liability reasons, drug companies will not make recommendations about the potency of drugs past the original expiration date. Taking medication past the expiration date may not do you any harm, but it may not be as effective after the date has passed. For some medications, you may see the expiration date as a “best used by” date.

Pills and solid forms of medication
In 2001, the American Medical Association (AMA) concluded that the actual shelf life of some medications extends past the expiration date. A study called the Shelf Life Extension Program (SLEP) found that 88 percent of 122 drug products were still potent past their expiration date for an average of 66 months. That is five and a half years! Solid dosage forms, such as tablets and capsules, appear to be most stable past their expiration date (compared to liquid medication).

Some medications, such as antibiotics, however, should be consumed within the specified number of days on the label. You may be tempted to keep those extra few antibiotic pills or additional milliliters in the bottle, but you shouldn’t, and this is why: if the antibiotic has lost its potency, you are putting yourself at risk. The bacteria that caused the infection will continue to spread, and it could likely develop an antibiotic-resistant strain. Using expired medication could have very dire consequences when it comes to serious infections.

Liquid drugs
Drugs in liquid form such as Epi-Pen auto-injectors should not be used after the expiration date because epinephrine can lose its potency. Anaphylaxis can be a life-and-death situation, so discard Epi-Pens that have passed their expiration date. Ophthalmic eye drops for conditions such as pink eye should be discarded after the expiration date because eye drops often contain preservatives. These preservatives break down over time and may allow bacterial growth that could result in eye damage.
Insulin, oral nitroglycerin, and other liquid vaccines should be discarded after the expiration date. If the liquid has become cloudy, powdery, crusty, or has a strong smell (even if the expiration date has not passed), throw it out. You can always take your medication to your local pharmacist if you are unsure of its potency.

Proton Pump Inhibitors
Proton pump inhibitors (PPIs) are the most commonly prescribed class of medication for the treatment of heartburn and acid-related disorders. PPIs reduce the amount of acid in your stomach by blocking its acid-producing glands. Reduced acid production gives damaged esophageal tissue time to heal, and cures most cases of esophagitis.

If you are taking PPIs, make sure you are using them as directed on the Drug Facts label. PPIs should only be used as directed for 14 days for the treatment of frequent heartburn. Studies show that long-term usage of PPIs can have some very dangerous side effects. Beyond the common side effects of prolonged PPI use, such as headaches, nausea, diarrhea, abdominal pain, and bloating, you can experience vitamin deficiency, poor absorption of nutrients, hypocalcemia, pneumonia, and increased risk of dementia. If you take PPIs, you should only take a 14-day treatment before visiting your doctor. If you have been taking PPIs, toss out those over-the-counter pills and make an appointment with your doctor.

Make a fresh start this New Year by tossing out old medication and replenishing your medicine cabinet. If you have some medications that are expensive to replace but you are unsure of its potency, talk to your doctor or pharmacist so you can make an informed decision. For all other medications, use your best judgement. If in doubt, don’t take any risks. Your health and well-being is worth a new bottle of medication, vitamins or supplements.