Dating of prepackaged medications expiration
Friday, October 06, 2017 by Vansh
At some point during your practice you will likely get this question from a patient, “Can I take prepackaged pharmaceuticals after they have expired?”
While you may be quick to give a yes or no answer, take a minute. You don’t want to encourage your patients that yes, it is okay to take medicines after the expiration date marked on the package. What if they have a liquid medicine that is slowly turning into something filled with bacteria?
Or, what if they have a heart condition and take expired doses of anti-coagulants? If the prepackaged pharmaceuticals are losing their power then the heart is less protected.
The answer doctors should give is that you follow the guidelines of the recommendation by the Food and Drug Administration. You encourage them to throw out expired medicines.
There are others things you can do, however, to help your patients find an answer to their question.
Empower them with knowledge. This is the perfect opportunity to teach your patients everything there is to know about an expiration date.
First, define the expiration date.
What Does an Expiration Date Mean?
Many people think the expiration date on a product represents the very last day you can use that product. The small stamp incites fear in some, making them feel they will be harmed in some way if they use the product after the date given.
For some prepackaged pharmaceuticals, this is true. But for most, the expiration date is a suggestion or recommendation, not a requirement.
The expiration date means that is the last day the manufacturer of the product guarantees the quality of that product. Makers have tested their products in varying temperatures and storage locations.
The expiration date is the date they found their product to show signs of degrading. Therefore, they don’t want consumers to use their product past this date because the potency may not be as strong as it was before the date.
Why is Potency of Prepackaged Pharmaceuticals Important?
Potency tells you the strength of a product. Prior to an expiration date, the potency of a medication should be at one hundred percent. After the expiration date, potency can start to decrease.
Between ninety and one hundred percent potency is still considered effective when it comes to medications.
The military requested a study be done by the Food and Drug Administration that tested expired products. They found the majority of the medicines studied had over ninety percent potency up to fifteen years after they were supposed to expire.
The medicines they tested were not even stored in the right location or at the right temperatures. This study confirmed that there are some medications, in solid form, that can maintain their potency and effectiveness for many years.
Not all medications can do this, however.
Can Expired Medicines Be Toxic?
There is a list of medicines to never take after expiration. Insulin and liquid antibiotics are two of the most popular medicines that can’t be used after the expiration date.
Nitroglycerin, phenobarbital, theophylline, and epinephrine lose their potency quickly. Avoiding these drugs after their expiration date can help your patients avoid getting any bacterial infections.
Anticonvulsants, warfarin, digoxin, birth control pills and thyroid medicines have a narrow therapeutic index. They lose their effectiveness quickly and because they are associated with consequences that can be severe if not taken correctly, it is recommended your patients follow the expiration guidelines for these medicines.
Antibiotics are added to this list, not because they are harmful, but because they won’t work as well past the expiration date. So, if you have an infection and your patients take an expired antibiotic, it may not kill their infection.
In fact, it may cause them even more damage by building up an immunity for antibiotics. Liquid medicines are also to be avoided after their expiration date.
What About Liquid Medications?
Liquid medicines can go bad quickly after their expiration date.
Liquid medicines usually come in the forms of solutions and solvents. These forms can easily get too cold or freeze, or they can overheat if stored in an area where the temperature is too hot.
Fortunately, it is often easier to tell if a liquid medication is bad or not. Some liquids will turn an unusual color, some will smell foul, and some will start to gel or harden. Others may foam or become overly runny.
If the liquid medicine your patient is using appears different in any way than it was when bought, throw it out. Rules and regulations were put into practice to protect consumers from absorbing drugs that can harm you after a certain time.
The Law that Changed Expiration
In 1979 a law was created by the Food and Drug Administration. It required all manufacturers to put an expiration date on their products. Every type of prepackaged pharmaceuticals, whether over-the-counter or prescription, must follow this rule.
Because so many manufacturers did not know the actual expiration date, they had to perform tests and study the medicines they were producing. The time in which their product began to show signs of losing its effectiveness in any way became their expiration date.
This law has created some controversy. Some claim it was created to pad the pockets of the government and the pharmaceutical companies. Others complain it is a waste of money to throw out drugs that may be still effective.
Reports have shown it can cost around $200,000 per hospital per year to toss out old prepackaged pharmaceuticals.
Despite the complaints, the 1979 law allows doctors and patients to know when a medicine is at its most effective and least effective. This can help with decisions about taking expired medicines. Ultimately, it is a choice to be made by the individual.
How to Instruct Your Patients
It would not be appropriate to advise your patients to go ahead and take any prepackaged pharmaceuticals, whether they have expired or not. Doctors have to follow the laws that direct you to tell patients to throw out all expired medications and cannot practice in office dispensing with expired medication regardless of its potency.
While following these guidelines, you can also provide them with detailed information regarding the expiration date, what it means and why it was created.
Tell your patients which medicines are dangerous after the expired date and which have not shown to harm people.
You have limited time with your patients. You aren’t accessible each time they have a question about medicines. Therefore, educating your patients is the best way to help them.
Give them knowledge regarding expiration dates, specific to their medicinal regimen, that can help them make their own decision about what they ingest.