Austin Ulrich, PharmD, BCACP
May 24, 2021, 12:17PM (PT)
Key takeaways:
- The manufacturer sets medication expiration dates, and they do not always mean that the medication stops working after that date.
- Some medications can be harmful or cause health risks if taken after their expiration date.
- Storing your medications as instructed on their labels can help them keep their potency until their expiration date.
- There are a few different ways you can dispose of expired prescriptions and over-the-counter items, depending on what they are. The safest way is to bring your medications to a drug take-back location.
When was the last time you looked through your medicine cabinet for expired medications? If it’s been more than a few months, you may find expired medications. So what do you do with these expired medications? While some medications simply won’t work as well after expiring, others can be dangerous to take.
Generally, it’s a good practice to avoid taking any prescription or over-the-counter (OTC) medications after their printed expiration date and always consult with your healthcare provider before taking something that has expired.
In this article, you’ll learn what the expiration date on medications means and how to approach handling expired items.
What are expiration dates, and why are they important to pay attention to?
A medication’s expiration date is defined as “the final day that the manufacturer guarantees the full potency and safety of a medication.” Expiration dates are assigned to prescription medications, OTC medications, vitamins, supplements, and herbal products, but with varying amounts of oversight from organizations like the FDA.
Since 1979, the FDA has regulated the expiration dating of medications to improve medication safety. Manufacturers often set an initial expiration date, which can be updated or extended after long-term testing of the medication has been conducted.
Despite these efforts for safe medication use, some people believe that taking medications after their expiration date can still be effective or help save them money. While there may be some truth about medications still working after their printed expiration date, the FDA clearly states that consumers should not use expired medications because of potential risks.
As a general rule, solid medications like tablets are more stable than liquids after their expiration date has passed. But this does not mean that you should take any medications after their expiration date.
Do written prescriptions expire?
When your healthcare provider sends in a prescription to your pharmacy, you usually have up to one year to fill the prescription before it expires in most states. The exception to this is prescriptions for controlled substances, which may not be valid after 6 months or less, depending on state laws.
If you try to fill a prescription that has expired, your pharmacy will tell you that you will need a new prescription from your provider to fill the medication. They can often request a new prescription from your provider on your behalf, especially for routine medications.
Prescription expiration dates are based on state and federal laws and are different from manufacturer expiration dates, which reflect how long medication is guaranteed to be safe and effective. Sometimes, the medication inside your prescription vial may still be good after the prescription is no longer valid to refill. Ask your pharmacist where on your prescription label the manufacturer expiration date is, so you can be sure it is safe to keep taking it.
What common medications are harmful when expired?
Currently, only the antibiotic tetracycline is known to be harmful when expired. In several reported cases, expired tetracycline has caused Fanconi syndrome, a rare form of kidney damage that can lead to severe dehydration. For this reason, you should never take expired tetracycline.
This problem has not been seen with other medications in the same class as tetracycline, such as doxycycline or minocycline.
Medications you should never use if expired
Some medications, especially those taken to treat critical health issues, should always be taken before the manufacturer’s expiration date because they can break down quickly after expiring. Examples of these medications are nitroglycerin, insulin, EpiPens, antibiotics, and birth control.
There are no studies that show using these medications after their expiration date causes serious harm. The risk is related to how effective the medication is. Taking them after their expiration dates could cause a serious health risk or consequence because the medications are not as effective.
Examples of medications you should always take within the expiration date:
| Medication | What it’s used to treat | What happens after the expiration date |
|---|---|---|
| Nitroglycerin | Chest pain and heart attacks | Very sensitive to heat and moisture. Breaks down quickly and could fail to stop a heart attack. |
| Insulin | Diabetes | Breaks down quickly after the expiration date, making it less effective. Using after its date can cause high blood sugar levels. |
| EpiPen | Life-threatening allergic reactions (closing of the throat and airways) | Breaks down quickly after the expiration date and may not work to stop allergic reactions. |
| Oral liquid antibiotics | Bacterial infections | Can become contaminated with bacteria after their expiration date. Could make you sicker and may fail to treat your existing infection. |
| Eye drops | Various eye conditions and illnesses | Can become contaminated with bacteria and lead to eye infections, suchas the pink eye (conjunctivitis). |
| Birth control | Pregnancy prevention, monthly bleeding regulation, acne, and other hormone-related conditions | Not as effective after the expiration date. Lower effectiveness could lead to unwanted pregnancies, breakthrough bleeding, and spotting. |
What about popular OTC medications like Tylenol?
Commonly used OTC medications that treat aches and pains or allergies are not likely to harm you if used past the expiration date. While it’s best only to use non-expired medications, one study conducted by the U.S. military showed that some medications could retain their potency up to one year after the expiration date has passed. However, the potency of the medications in the study varied from batch to batch, so there’s no way to know if your OTC medications at home are still effective after they’ve expired.
OTC medications such as ibuprofen (Advil, Motrin), pseudoephedrine (Sudafed), acetaminophen (Tylenol), diphenhydramine (Benadryl), and loratadine (Claritin), as well as topical creams or ointments, may not have serious health risks if taken after the expiration date. But they may not work as well — or at all — to alleviate your symptoms.
In some instances, people use OTC medications to treat chronic conditions. For example, aspirin can be used daily to prevent heart problems and may not work properly after its expiration date has passed. Taking expired aspirin could raise your risk of serious health issues, such as a stroke.
It’s best to discard expired products and always consult your healthcare provider to stay up-to-date with your medications.
How to store medications to ensure their effectiveness and longevity
Heat and moisture are the biggest factors that affect the breakdown of medications. Both prescription and OTC medications should be stored in a cool, dry location such as a kitchen cabinet, dresser drawer, closet shelf, or storage box unless otherwise instructed on the labeling. This will help your medications remain safe and effective up until their expiration date.
You should avoid storing your medications in a damp bathroom cabinet because they could break down faster than usual in a high-moisture, high-temperature environment. If a potential storage location is near a hot appliance, like an oven, it may be best to find a new spot farther away from heat sources. Medications stored in common areas of your home (living room, kitchen) should be secured so they are not easily accessible, especially if you have children or pets.
It’s important to note that some medications have different storage requirements. For example, some oral liquid antibiotics and insulins may need to be stored in the refrigerator. Read the labeling on your medication carefully for storage instructions, and contact your pharmacist if you’re unsure.
How to properly dispose of expired medications
If you do have expired medication, there are several ways you can dispose of it. If you still have the label information that came with the medication, you can look for specific instructions the manufacturer may have provided about how to dispose of it safely. However, not all medications have this information included.
According to the FDA, disposing of your medications at a drug take-back location is the safest way to get rid of old medications. Many health systems, police departments, and community pharmacies offer unused medication drop boxes where you can simply place any medications to be disposed of in the bin.
The federal Drug Enforcement Administration (DEA) sponsors National Drug Take-Back Days, where extra drop-off locations are available twice a year to dispose of unwanted medications. These take-back days typically happen at the end of April and October. You can search for a year-round medication disposal location near you on the DEA website.
If you’re not able to discard your medications at a take-back location, there are still ways you can safely get rid of them. To dispose of medications in the trash, the FDA recommends mixing them with an undesirable substance like kitty litter, dirt, or used coffee grounds, sealing the mixture in a bag, and throwing the sealed bag in the trash. Do not crush tablets or open capsules before mixing them with the dirt, kitty litter, or other substance.
The FDA has a list of medications that you should flush down the drain rather than dispose of in the trash. These are often medications that have high abuse potential or can result in death if one dose is accidentally taken. Be sure to check the FDA flush list before disposing of your medications at home.
While some people may be concerned about the environmental impact of flushing medications, the FDA found the impact was insignificant after an investigation. They also believe that accidental exposure of these medications to humans carries a much greater risk than potential harm to the environment from flushing them.
The bottom line
Overall, it’s best only to use medications before their expiration date passes. While some products may still be effective for a year or more after their expiration date, there is no sure way to know if expired medications in your cabinets at home are still working properly. You should always speak with your healthcare provider before taking an expired medication. Storing medications as recommended on the label and disposing of expired items properly is essential for ensuring medication safety in your home.
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