The truth about ex­pired meds

Tak­ing ex­pired med­i­ca­tions can lead to un­wanted con­se­quences.

The Star Malaysia - Star2 - - LIVING -

THERE’S cer­tainly con­tro­versy about ex­pi­ra­tion dates on food, but as up­set­ting to your stom­ach as it can be to eat items that are no longer fresh, tak­ing ex­pired med­i­ca­tions can be more com­pli­cated and, in cer­tain cases, have far greater con­se­quences.

“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 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% 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 in the United States 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.

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.

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.

3. ‘ Is a drug’s ex­pi­ra­tion date the same thing as the use- by date I see on my pre­scrip­tion vials?’

No. The ex­pi­ra­tion date is the one legally re­quired to be on the orig­i­nal large con­tainer the phar­ma­cist re­ceives for dis­pens­ing drugs. The “dis­card af­ter” or “do not use af­ter” date on bot­tles or pack­ages given to pa­tients is of­ten for a shorter time – gen­er­ally a year af­ter dis­pens­ing – be­cause of safety rea­sons once the drug is no longer be­ing stored at the phar­macy.

Some states in the US even re­quire phar­ma­cists to add this date. Drugs such as ni­tro­glyc­erin and in­sulin have even briefer “use by” win­dows: ni­tro­glyc­erin’s is typ­i­cally six months; in­sulin’s is 28 days from the first use, says Atayee.

4. ‘ 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?’

It de­pends. Heat and hu­mid­ity can af­fect a drug’s po­tency, and a small kitchen gets hot quickly when the stove or oven is be­ing used.

Iron­i­cally, the medicine cab­i­net in your bath­room isn’t ideal for stor­ing drugs ei­ther, par­tic­u­larly if the space lacks proper ven­ti­la­tion and gets hot and hu­mid. “Meds need to be kept in a dry, cool place,” says Atayee, who sug­gests us­ing a stor­age box with a lid.

Also im­por­tant: Don’t store med­i­ca­tion in your car’s glove com­part­ment. It may seem con­ve­nient, but the tem­per­a­ture ex­tremes can af­fect the drug’s strength.

5. ‘ How of­ten should I clean out my med­i­ca­tions?’

If you want meds that you know will be po­tent, aim for ev­ery six months. Time this purge to co­in­cide with other safety habits you do at home at the half- year mark, such as check­ing the bat­ter­ies in your fire alarm. “Think of it as a whole- house safety check,” Atayee says. – HealthNewsDigest. com

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