health
What's hiding in your cabinets?
Facts about expired medicine
By Kaitlyn Syring
ksyring@kansan.com
What would you find if you went through your medicine cabinet today? If it's been awhile since you last cleaned out your cabinets,you might find some artifacts, so to speak.Many people keep prescriptions and over-the-counter medication past their expiration dates.Such expired medications lose effectiveness and, in some cases, can become harmful All types of medicine should be both stored and disposed of in ways that may be very different from what you might think.
Does expired medicine still work? Most medicines lose some of their potency after they expire. Larry Davidow, clinical assistant professor and director of the integrated laboratory in the School of Pharmacy,says the expiration date is generally accepted to mean that after this date there can be less than 90 percent of the stated potency.Therefore,after the expiration date,the manufacturer no longer guarantees its product to contain the labeled strength or to have its beneficial effects.
Davidow says that some current controversy about the use of expired drugs regards whether those most commonly used are still beneficial even after a 10 percent loss of potency.A test conducted by the U.S.Food and Drug Administration in the 1980s concluded that 90 percent of the drugs it tested were safe and effective up to 15 years past their expiration dates. But, Davidow says, all medicines are different. What is considered effective for one drug might not be for another.Because the medicine is no longer guaranteed to work after it expires, Davidow says people should stick to using their medication within the time frame given by the manufacturer.
However, many pharmacies do not put dates on prescription medicines, says Jeff Sigler, pharmacist at Sigler's Pharmacy, 4525 W. Sixth St. He says that Sigler's will usually tell people that the expiration is one year; but the actual expiration depends on when the pharmacy bought the drug and how often that drug is used. If a drug is used frequently, Sigler says, it will be replenished more often and will tend to be more fresh than a drug that is used less often. However, if a prescription is known to have an expiration date of less than one year, Sigler says the pharmacy will mark it on the bottle so the customer is aware. Sigler says most oral prescription medicines will become less effective as time goes on, depending on the kind of medication and where it is stored.
Both Sigler and Davidow say that prescription and nonprescription medications, like Tylenol, should never be stored in bathrooms or kitchens. Many people store their medicines above the kitchen or bathroom sink, but in these places, heat and humidity from the shower and sink are easily trapped inside cabinets and cause the medicine to degrade much faster. Sigler says medicine should be stored in a cool, dark place, like a hall closet. This way, your medicine will be away from heat and humid air, and will be out of the reach of children and pets. Sigler says it's a bad idea to keep medication out on counters or in your car, where it will be exposed to all the elements in the air.
"If you keep a bottle of Aspirin in your glove box in the middle of July, it might be useless within a week," Sigler says.
When it comes to storing medicine, Charlie House, Garnett senior, says there's only one place he turns to. "It's called a medicine cabinet, and it's in my bathroom." House says he has always assumed that was the proper place. He doesn't really know what's in that cabinet right now, he says, but he is guessing some Adil and a prescription pain medicine from when he was in a car accident a few years ago.
"I'm sure some of it is expired," he says, "But I never really pay attention to that."
On the other hand, Meagan Wright, St. Louis junior, is very conscious of expiration dates and storage of her medicine. She says she keeps all her nonprescription and prescription medicine, when she has some, in her bedroom closet. She looks at the expiration dates nearly every month to make sure all her medicine is current.
"I just don't take chances," she says. "It freaks me out to think that past a certain point, those pills might not work or might work in a different way."
I expired medicine harmful?
Some medicine should never be used after it expires, Davidow says. The reasons for this are two-fold, he says. Some—tetracycline, liquid medications and oil capsules—can degrade into harmful byproducts or become contaminated by bacteria.
Some others, more commonly, are so important that it is critical for the consumer to know that the drug will work at all times, like nitrogycerin for heart attacks, insulin for diabetes and birth control tablets.
Is expired medicine harmful?
If a medicine has become contaminated, you might
be able to tell based on the color, smell, texture and shape of the dosage, Davidow says. Some examples Davidow gives of these changes are a strong vinegar-like smell from aspirin, tablets that crumble or look abnormal in color; capsules that are sticking together, liquids that separate or become cloudy and ointments that harden or separate. If you take a dose that you think might have been contaminated, you should consult your doctor or pharmacist. If a prescription or nonprescription medication has not been contaminated, Davidow says, it is unlikely that taking it after expiration will cause you any harm. You primarily need to be concerned about the decreased strength of expired medicine.
Antibiotics, says Sigler, are a different story. Sigler says that, if taken correctly, you will not have pills left from a prescription antibiotic. If you do, that means you did not finish your round of medication, and the infection could still be in your body, he says. It also means that you will not have enough pills left to treat a repeat infection. Such an approach to taking antibiotics could allow your body to build an immunity for certain medications, thus rendering them completely ineffective.
Davidow says that it's good practice to check dates and purge medicine cabinets at least once every six months.
Sigler has several suggestions for disposing of your expired medicines. Do not flush them down
the toilet, he says. Doing so can cause medication to get into the water supply and make people hypersensitive to bacteria or cause bacteria in the water to become resistant to treatment. He says the best way to get rid of medicine is to throw the bottle and the pills away separately to prevent people from gaining access to medication in your trash. When throwing away the pills, you should put them directly into your trash can and mix in some kitty litter or coffee grounds, he says. Such substances will speed up the decomposition process, while also deterring people from taking the pills. If someone were to find the pills, they would have so little potency at that time that it would not matter if the person took them, Sigler says.
So this weekend, it might be time to take a look in your medicine cabinet. Keep a few things in mind while doing it: Any prescriptions that have expired or that you have had for more than one year will most likely be less effective. If you find medicine that looks contaminated—has a strange odor or texture—it's time for that medicine to go. Throw all pills away with a dash of kitty litter, and throw bottles away separately. At the end of your cleaning, make sure all your medicine is stored in a cool, dry place like a hall closet. Do not store medicine in the bathroom or kitchen. These tips will ensure that you get the most out of your medication.
Photo illustration by: Jessie Fetterling for more information: www.talkaboutrx.org
05.08.2008
VOL, 5 ISS, B1
15