Is it okay to take expired medicines?

Using medicines after expiry has often evoked a genuine controversy. Patients creating noisy chaos in a hospital pharmacy after being dispensed expired medicines (which often happens unintentionally) to the incident making a BIG national news headline, most of us as professionals, have seen it all.

But, is it fatal or debilitating to intake outdated medicines?

Well, not really.

The date of expiry stamped on your medication packaging assures the full functioning of the medicine as it is supposed to do, till the mentioned date. While the working capability might get compromised post the date. However, with several studies done, the medicines are likely to retain their functionality even after 5-10 years of expiry or even longer, IF, the medicine is stored in ideal conditions. More than an expiry date, storage condition is what determines the actual activity of medicinal components.

These are just a few of the facts that pharmacists and other front-line healthcare workers should be aware of about the safety of expired medications.

·       * Studies show solid dosage forms (tablets and capsules) are more stable. Liquid preparations are likely to go through chemical reactions after a certain time and chances for microbial growth remain due to the presence of sugar and water.

·       * The real concern arises with the use of expired antibiotics as the slightest reduction in antimicrobial action can slow the recovery of a patient contributing to long-term antibiotic resistance.

·     *   Nitroglycerine, aspirin, and insulin have exhibited physical decay over time, and using them after allocated time does not seem to be clinically wise. Adrenaline and mefloquine have also shown reduced potential post expiry.

·      *  Medicines with a narrow therapeutic index (phenytoin, digoxin, theophylline, warfarin, etc.) with a decrease in pharmacological activity can cause serious clinical consequences. They are not advised to use it beyond their expiry. Monoclonal medicine should also be included in this group.

·      *  Avoid the use of expired tetracyclines. Outdated tetracyclines undergo chemical alteration affecting kidney function, termed Fanconi syndrome.

Having known all these, what would be my response if someone asks me if he/she can take an expired medicine? Well, I would enquire, what are they taking it for? If it is for a skin allergy or a headache, taking it in the unavailability of fresh medication is advisable. If it is for an elevated blood pressure, I would advise not to. If there is no medicine at all, the use of expired medicine can still be considered. However, upon easy access, I would recommend medicines that are valid as per the expiry date. Better safe than sorry.