by Tania Houspian, PharmD 2011 | email@example.com
You open your refrigerator door and take out a milk carton (non-fat of course) to top off your morning cereal. As you tilt the carton, expecting a stream of delicious white liquid, you instead get disgusting clumps of a cottage cheese-like substance. It’s safe to say that the milk has passed its expiration date. You, being the sensible human being that you are, throw away the expired milk and settle for a granola bar for breakfast instead and plan to buy a new carton of milk on your way home from work.
Let’s look at another scenario. You open your medicine cabinet and take out a bottle of Motrin wanting to take a couple of tablets to alleviate the muscle pain from a rough game of basketball last night (those 16 years olds didn’t look so tough at first). You scan the bottle looking for how many you should take and notice that it expired June 2009. You open the bottle and see that the pills look fine. There is no molding… they don’t smell funny…so you figure it’s fine to take. Besides, you have a stellar conspiracy theory that expiration dates are an evil ploy by pharmaceutical companies to get you to buy medication more often. You pop two tablets and go on with your day.
If you find yourself nodding emphatically saying, “That’s so true. I totally do that!” then you’re not alone. One of the most common questions pharmacists are asked is “Can I take this medication even though it expired last year?” On the other hand, you don’t ever go back to the grocery store and ask the clerk, “Can I drink this milk even though its been expired for a year?” This paradigm makes sense, though. When there’s proof of spoilage (i.e. stinky cottage cheese instead of milk) we’re way more likely to believe the expiration date. We don’t blame you, old milk tastes horrible but old Motrin still has that delicious sugary coating.
So, what’s the final verdict? Are expiration dates just a way to get you to buy more medications or did your Motrin become ineffective as of June 2009?
The Evil Ploy Side: The main argument presented by the “Expiration Dates are for Pansies” faction of society is a study performed by the military and presented to the FDA in 2002. In the study, the military evaluated all of their expired stockpiles of medication and discovered that some were still considered stable and efficacious for up to 54 months after their noted expiration date.
Now you can take those results and run with them or you can look at the details of the military’s findings. The military noted that the “degree of stability” depended greatly on the medication, manufacturer, and lot number. They were not issuing a blanket statement saying all medications are good for 54 months after the printed expiration date. They merely found that some drugs remain good after the date on the bottle. This fact, though, may be enough for some to call into question the validity of the expiration date on that Motrin bottle.
Here is the take home message: You are not the military. Earth-shattering, we know. What we mean by that is that you don’t store and care for your drugs the way the military does (just a guess). The military stores their stockpiled medications in cool, dry, dark, and temperature controlled warehouse-type locations. Where do most people store their medication? A few common “store houses”: medicine cabinet in the bathroom, spare cabinet in the kitchen and, last but not least, purses. Think about all the temperature and humidity changes those locations go through. Repeated exposure to temperature variations and light affects the stability of medications. Even though the pharmaceutical company knows the medication will be good for 10 years, they may decide to give it a 5 year expiration date to account for variations in how people store their medications. The date printed on your bottle of Motrin takes into account all the abuse you dare inflict on your personal medication supply.
Now you say: “So what! I took some expired Motrin (Tylenol, Nyquil, etc.) and nothing bad happened to me!” Okay, but there’s also a chance that nothing good happened either. When a medication passes its expiration date it means that the company that manufactured it no longer guarantees it will work for you. You may not get any relief from your muscle pain, sore throat, runny nose, or whatever symptom you were trying to treat. Not the kind of medicine we endorse. The treatment of the aforementioned mild conditions may not be life altering but the issue of efficacy is important with medications that are used to treat life-threatening conditions. Medications like nitroglycerin, insulin or antibiotics should never be taken past their expiration date. If these medications don’t work properly, the stakes are much higher (read hospitalization or, even worse, death).
Anytime you ask a health professional if it’s okay to take a medication past its expiration date the response you’re most likely going to get is, “No.” It’s just not worth the possibility of not receiving adequate treatment. For the skeptics in the room, there is one time that you’ll hear of medications being used past their expiration date: severe shortages. At those times, desperate times call for desperate measures and the medical community works with the limited resources available. Next time you look at the back of your medication bottle and see its expired, ask yourself: Is this really a desperate time or can I easily get more medication that’s guaranteed to work? I think we all know the answer.
Questions? E-mail the Author: firstname.lastname@example.org