Is it safe to use expired medication?

Using Expired Medications: Safety Considerations

Using expired medications is generally not recommended as they may have reduced efficacy, potential for degradation, and possible safety concerns.

Understanding Medication Expiration

• Expiration dates on medications are established by manufacturers to guarantee the full potency and safety of the product until that date 1.
• After expiration, medications may begin to degrade, potentially reducing their effectiveness or developing harmful byproducts 2.
• The American Society of Clinical Oncology (ASCO) recommends proper disposal of expired medications rather than continued use 1.

Risks of Using Expired Medications

• Expired medications may have reduced efficacy, which could lead to treatment failure and worsening of medical conditions 1.
• Some medications, particularly those requiring precise dosing (like cardiovascular drugs), may pose significant risks when used beyond expiration 1.
• Inappropriate use of expired medications contributes to polypharmacy issues, which are associated with increased risk of adverse drug reactions, drug-drug interactions, and poor health outcomes 1.

Specific Medication Considerations

• Liquid medications, injectable drugs, and biologics are particularly susceptible to degradation and contamination after expiration 2.
• Medications requiring refrigeration or those with specific storage requirements are more likely to degrade quickly once expired 3.
• Antibiotics used beyond expiration may have reduced potency, potentially contributing to treatment failure and antimicrobial resistance 1.

Special Circumstances

• In resource-limited settings or emergency situations, healthcare providers may face ethical dilemmas regarding the use of expired medications when alternatives are unavailable 2.
• Some studies have shown that certain medications (like epinephrine) may maintain chemical concentration and sterility beyond their expiration dates, but this cannot be generalized to all medications 4.
• The Shelf Life Extension Program (SLEP) conducted by the FDA for the military has found that some medications remain stable beyond their labeled expiration dates, but this program applies to specific medications under controlled storage conditions 5, 6.

Proper Medication Disposal

• Healthcare facilities should have standard operating procedures for proper disposal of expired medications 1.
• Patient education should include information about proper disposal of unwanted or expired medications 1.
• Improper disposal of expired medications can lead to environmental contamination and potential harm to humans and animals 3.

Recommendations for Healthcare Providers

• Regularly review medication inventories to identify and remove expired medications 1.
• Educate patients about the importance of checking expiration dates and proper medication storage 1.
• Consider implementing medication management systems to minimize waste and ensure timely use of medications before expiration 1.
• When prescribing, consider the patient's ability to use the medication within its shelf life, particularly for elderly patients or those with polypharmacy 1.

Recommendations for Patients

• Check expiration dates regularly on all medications, including over-the-counter products 3.
• Store medications according to instructions (e.g., refrigeration when required) to maintain potency 3.
• Do not keep medications beyond their expiration date, especially those for serious conditions requiring precise dosing 1.
• Consult with healthcare providers or pharmacists about proper disposal methods for expired medications 1, 3.