Are Expired Medications Safe?

Alternatively, I could title this post: "How am I not dead yet?"



If you followed the blog on Friday, you know I was battling some serious sniffles over the weekend. My “What I Did Last Weekend” report includes: sleeping, taking DayQuil, sleeping some more, shooting some nasal spray, eating dinner, popping a few Excedrin (blast that sinus headache!), then calling it a night. Glamorous, no?

The good news is, I’m feeling much (muuuuuch) better this week; I think those extra hours of rest really did the trick. But what probably played zero role in my return to good health was all that medication. Why? Because I realized this morning that all of it had expired: the DayQuil by a year, the Excedrin by two, and the nasal spray—gulp—by nearly five.

I know, I know; this begs a boatload of questions. Like, “When was the last time you cleaned out your medicine cabinet?” Answer: never. And, “How the heck are you still alive??” Answer: I have absolutely no idea.

When I discovered my little expiration-date problem, I was more than a little terrified. Like most people, I best understand expiration dates within the context of food. I don’t think I’ve ever gone more than a few days past the “best if used by date” on anything. (Funny side note: My husband once downed a glassful of orange juice at my parents’ house from a container shoved so far in the back that my mom forgot was in there. When I realized it was four months expired (blessedly, before I took a swig) and told Chris as much, all he said was, “Oh. I was wondering why it was kind of brownish.” Boys.)

Truth be told, before this little episode I’d never really noticed the expiration dates on medications before. But a Google search reveals that the date stamps have been required by the Food and Drug Administration since before I was born, and that they’re on both over-the-counter (OTC) drugs as well as prescription medications. So I did what any good health reporter would do, and I called a doctor. “Doc!,” I practically screamed into the phone. “Should I be worried??”

Mark Gottlieb, a family doctor at Paoli Hospital (who’s mighty patient with panicked health reporters, I might add), explained that those dates are actually guarantees from drug manufacturers that their medication will retain its safety and potency until that date. “That’s where the guarantee ends,” said Gottlieb.

He said studies on whether drugs remain safe and potent beyond expiration dates have found that most do. In fact, one, which looked at medications stockpiled by the military, found that 90 percent of the prescription and OTC drugs tested were still good to use way past their expiration dates, even as many as 15 years later.

“The caveat,” he said, “is that those drugs were stored in ideal conditions”—cool, dark, temperature-controlled places. “Most of us keep medications in the bathroom or a kitchen cabinet, where heat and humidity can cause them to degrade pretty quickly.”  A better place to keep them is the refrigerator.

I thought about my bottles of NyQuil and Tylenol and Bayer and Benadryl, blithely tucked away in my bathroom closet. Guilty as charged.

Gottlieb advised me be careful, especially where prescription drugs are concerned: “Do you want to mess around with cardiac or hormone medication when even the slightest change can have an impact in what it’s going to do and how it might work for you?”

No, actually, I don’t.

As long as they’re stored correctly, he said, hard pills usually last longer because, unlike liquids that can separate, these medications take more time to break down. Plus, you can tell just by looking at it if a pill is questionable: it’s started to crumble, smells, or appears discolored.

“With liquids, like your nasal spray, you have to worry about microorganisms growing in there. There could be bacterial or viral contamination,” said Gottlieb, who tells patients to trash nasal sprays after use during illness. (Whoopsie.)

It’s best to make an annual habit out of cleaning out the medicine cabinet. Take note of expiration dates, weigh the importance of the medication (a cough drop versus a statin, for example), and toss anything you think could be questionable.

But don’t dump old meds down the drain or toilet; as you probably always suspected, trace amounts of hormones and medications do wind up in drinking water. “Your best bet is to take meds out of the bottle, crush them up, put them in the trash, and toss the empty bottle,” said Gottlieb. Some pharmacies and doctors will safely dispose of your expired meds, too, if you ask.

Looks like I’ve got some serious spring cleaning to do.

How about you? When’s the last time you cleaned out your medicine cabinet? Have you ever taken expired meds, or even noticed the expiration dates? Share in the comments!