As we went through Grandpa’s belongings after his passing one of the things we came upon were some carefully labeled but expired medicines. And I don’t mean a couple of months expired; generally they had expired a decade or so ago. Grandpa was always a frugal guy – cutting the mold off the cheese and eating the rest or grabbing and consuming the two-week-old casserole with a questionable odor before we could get it to the disposal. So what about these expired meds? Had his frugality in keeping these old prescriptions for later use posed any threat to him? My bet is that almost all of us keep and take a few meds past their expiration date. So just how risky is that?
In 1979 a law was passed requiring drug manufacturers to put an expiration date on their meds. Up to this date the manufacturer guarantees the potency and safety of the medication. So far so good, but how quickly do medicines lose their safety and efficacy after these expiration dates have passed? Some years back, the Food and Drug Administration carried out a study to answer that question at the request of the military. The military had a large and expensive stockpile of drugs which they hated to just discard and replace every few years. The study was carried out on over 100 drugs, including both prescription and over-the-counter meds. They found that more than 90% were both safe and effective even 15 years after their expiration date.
Ok, so for many medicines passing the expiration date doesn’t really mean the medication is no longer effective or is unsafe to use. But are there exceptions to this? One important exception is the EpiPen. They have been in the news recently because of how crazy expensive they can be so there is a temptation to not refill them after the expiration date has passed. Unfortunately a study done several years back found that the pens do in fact lose potency soon after passing their expiration date. That means you really do need to keep your EpiPens up to date. By the way, if somehow you find yourself treating a severe allergic reaction with an EpiPen and notice it’s expired, give it anyways (as long as it isn’t discolored and you can’t see particles in the fluid) since some potency is better than nothing. But do this as you dial 911 or get immediate emergency care. Other important exceptions would be nitroglycerin, insulin, liquid antibiotics, and aspirin. Tetracycline may also be an exception although there is still debate about it.
So you’ll have to decide whether to take Grandpa’s approach and save almost everything or the other extreme of tossing everything the moment it hits its expiration date or some place in between. For most meds, a little laxity with that stamped on expiration date is pretty reasonable. Hey, Grandpa lived a healthy 90 years with his approach.
Andrew Smith, MD is board-certified in Family Medicine and manages the Trinity Medical Associates office at 1503 East Lamar Alexander Parkway, Maryville. Contact him at 982-0835. He is accepting new patients with commercial insurance in a typical fee-for-service model and those without insurance or with Medicare in a Direct Primary Care model.