What Happens When You Take Expired Medicine?
What’s the first thing you look at before picking out a gallon of milk at the store? The expiration date, right? You want to make sure you have enough time to finish the milk before it starts to go bad.
Like the milk in your refrigerator, the prescriptions and over-the-counter remedies in your medicine cabinet carry an expiration date. Like the date on the milk carton, the date on your pill bottle is there to keep you safe.
Avoiding expired medications is an important safety consideration for anyone taking any medication. In this article, we’ll look at what can happen when a patient takes expired medications.
Expired Medications May Be Less Effective
Many medications begin to degrade slowly as soon as they’re manufactured. Once the seal is broken on the manufacturer’s packaging – whether at the patient’s home or in a pharmacy – that degradation process accelerates as the pills become exposed to the oxygen and moisture in the air. By the time the expiration date on many medication packages arrives, their contents have lost as much as 5-10% of their potency.
Some medications allow for flexibility in dosing, and a slight decrease in medication effectiveness might not be noticeable. In others, however, the dosing is exact, and even a 5-10% decrease in effectiveness can be the difference between effectively managing a chronic condition and suffering a dangerous relapse.
Expired Medications Lead to Unintentional Overdoses
As a medication passes its expiration date and its effectiveness decreases, the patient will begin to see a reduction in its therapeutic benefits. This loss of potency can lead to prescribers increasing the prescribed dosage – which can lead to dangerous overdoses when the patient gets fresh medication that is at full strength.
Certain Expired Medications Can be Actively Dangerous
Most expired medications aren’t dangerous in and of themselves. They’re less effective than non-expired medications and can be hazardous in that they’re not treating the conditions they’re being taken for, but most won’t actively cause harm.
A few medications, however, can be especially dangerous if taken past their expiration date:
Antibiotics
Antibiotics, particularly tetracyclines, can be harmful if taken past their expiration date. Antibiotics tend to degrade faster than other medications, losing potency quickly. Using expired antibiotics creates a perfect breeding environment for antibiotic-resistant strains of bacterial pathogens.
Insulin
Insulin degrades rapidly, and the precise dosing required to maintain healthy blood sugar levels doesn’t allow for much leeway in terms of effectiveness. Further increasing the danger is the fact that expired insulin can cause:
- Blood glucose levels that are higher than normal
- Symptoms associated with high blood glucose, such as thirst, tiredness, and blurry vision
- Emergency conditions, including diabetic ketoacidosis (DKA)
Nitroglycerine
Nitroglycerine is a volatile chemical compound that evaporates from tablets if they’re not stored and used according to strict instructions. Even with proper storage and precautions, unused nitroglycerine can become unstable and ineffective after just a few months. In its role as a rescue medication for patients with heart disease, the potency of a dose of nitroglycerine is critical.
Eye Drops
The preservatives in eye drops are only guaranteed through the drops’ expiration date. After the date has passed, there’s no guarantee that the drops haven’t become contaminated with any number of pathogens that can cause painful, eyesight-threatening conditions.
Drug Expiration Dates Can Change
The expiration date on drug packaging guarantees its effectiveness to the stated date so long as the packaging remains unopened. Once the package has been opened, certain medications degrade so quickly that a new expiration date needs to be set. Pharmacists will typically note the actual expiration date on the prescription label.
For example, consider an antibiotic with an expiration date of January 2025 and a caution that the medication will only be good for 90 days after the package has been opened. If the pharmacy opens the bottle on January 1, 2024, to fill a prescription, that prescription and every prescription filled from that same bottle will expire on March 31, 2024, not on the printed date of January 2025.
Liquid and Compounded Medications Expire Quickly
Many liquid medications, particularly oral suspensions, expire quickly. Generally speaking, if a drug requires refrigeration, then it’s of particular importance to note its expiration date.
Compounded medications also tend to be very time-sensitive. The active and inactive ingredients in a compounded prescription can be dangerous past the medication’s expiration date, and the compound’s expiration date will be on or before the nearest date on any of the compound’s components.
In an Emergency, It May be Okay to Take Expired Medication
With the exceptions above – antibiotics, nitroglycerine, insulin, compounded medications, and eye drops – if a medication is only a few days or a couple of months out of date, it’s probably safe to take a dose if you absolutely must take it in order to keep managing a chronic condition or address a severe or dangerous symptom.
Prevent the Use of Expired Medication With a Consulting Pharmacy
If you operate a skilled nursing or other residential healthcare facility or provide residential healthcare services, managing your entire formulary and ensuring every medication supply is in-date and safe to use is a significant undertaking. When you partner with a consulting pharmacy, such as Angus Lake Healthcare, the pharmacy’s team will manage your facility’s pharmacy needs and ensure that expired medications are disposed of correctly and do not make their way into your patients’ doses.
Angus Lake Healthcare is your local pharmacy consultant, serving facilities and their residents across Central Georgia.
With medication inspection and review services, Angus Lake can help ensure that your patients only receive in-date medications. Schedule a consultation today to learn more: 478-233-1828.
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