The shelf-life rules

You’ve got a splitting headache but the ibuprofen in the medicine cabinet is a year out of date. Do you take it, or don’t you? Michele O’connor investigates

Sticking to best-before dates on food labels is second nature, but when it comes to medication, we are far more sloppy. A third of us admit to clinging on to leftover pills, and a further third confess to using medication past its expiry date. But can doing this cause us any harm?

“Expiry dates are put in place after rigorous trials and controlled experiments to ensure the safety and effectiveness of drugs,” explains Mike Wakeman, vitmedics.com clinical pharmacist. “In short, they guarantee the potency of the medicine.”

Possible consequences of using expired medicines are that the active drug becomes chemically unstable; the effectiveness of the drug may change; the breakdown of the drug may be toxic and harmful to the patient; or there is raised risk of contamination from bacteria and other microbes.

Not all drugs deteriorate at the same rate. Liquid preparations usually have a shorter shelf life than tablets so, just like with food and drink, once the seal is broken, the process of “going off ” accelerates.

So even if a product is many years off its expiry date, you may only have a limited time to finish it once you use it for the first time.

Can I take out-of-date medicines?

Officially, pharmacists and medics agree that, to be on the safe side, you should never take drugs past their expiry date.

“Unlike having a sip from a bottle of out-of-date milk, taking expired over-the-counter medicines could harm your health,” warns Mike.

However, Dr Tony Steele, medical director at Doctor Fox Online

Pharmacy, says where there is no realistic alternative, studies suggest most medicines are likely to be safe and effective, even after their expiry dates.

Dr Steele refers to several studies where out-of-date medicines were tested, including the US Shelf Life Extension Programme, which found two thirds of 122 drugs tested were still potent, even though they were beyond their expiration. But he stresses UK guidelines haven’t changed and he does not advocate taking old medicines.

Old medication you should not chance

There are some medicines that should only ever be used within their expiry dates:

Liquid preparations of an antibiotic made up by a pharmacist Eye drops/ointments

The antibiotic tetracycline

(it can have a dangerous effect on the kidneys)

Glyceryl trinitrate (GTN) – used for angina

Insulin – for diabetes

Epi-pen – for severe allergy and anaphylaxis.

Can’t read the date?

There are three signs your medicine is too old:

1. Alterations in appearance – colour changes and separation of liquids in the bottle.

2. Changes in texture – tablets and pills becoming softer, crumbling or sticking together.

3. Changes in smell.

Safe storage and disposal

Medication should be kept in the original container and stored in a cool (below 25C) dry place unless refrigeration is required (between 2C and 8C), advises Mike.

“Hand out-of-date medicines to a pharmacy for safe disposal.

“Putting medicine in the bin runs the risk of it being found by children or pets, while flushing it down the toilet or sink is not the safest nor the most environmentally-friendly solution.”

If you regularly have to dispose of unused/expired medication, then you should review your medication ordering.

“Unused medicines obtained on prescription cost the NHS around £300million a year.

Expiry dates are put in place after trials, they guarantee potency

Why you should never take someone else’s medication

Mike outlines the key points to keep in mind:

You might not properly understand the uses – and effects – of the medicine.

Medicines can have similar sounding names but be completely different drugs.

The drug might not be suitable for someone with your particular medical condition and could interact with other medication you are taking.

Taking the medicine without a proper diagnosis from a doctor could mask symptoms of an underlying condition, which could be getting worse.

It could be the wrong dose for your size or weight.

You might be allergic to their medication.

You could have either liver or kidney dysfunction and not be able to metabolise the medication.

You might need to take other medications along with it to prevent side effects.

If you have a serious reaction, no one will necessarily know you’ve taken someone else’s medicine.