Expiration Dates

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Today’s theme was drugs past their beyond use dates and what that actually means. There were several people who called or stopped by to ask about it. People tend to call it the expiration date, but that’s not the best choice of words, since most drugs do not actually go bad at that date.

One person that stuck out in my mind was an elderly lady who called to ask if her husband could use the Nasonex they had in their house. I asked when it was dated for and she told me February of 2010. I told her it was best to get a new one if possible. She told me money was tight, so I told her to ask her physician for samples or to see if they had any copay coupons available for their patients. I also told her to ask about generic alternatives, since he had never been on anything but Nasonex. She thanked me and hung up.

So, what is a beyond use date? It’s the date that’s stamped on drugs (prescription and OTC alike) that you should use it by. So what happens on this magical date? Does the medication suddenly turn into a pumpkin, like the carriage in Cinderella? No. Most of the time, all that date represents is the date at which the medication is no longer guaranteed to be more than 90% effective. There are only very few drugs that actually go bad or become toxic after their beyond use dates. So, what does this mean for you? Well, if you have something in your cupboard that is dated for a few months ago, taking it is probably not going to cause any harm. You’re just not going to get the effect from it that you would if it were new.

There are a few exceptions to this. The following should not be taken past their beyond use dates. The list is not all inclusive, so always ask a healthcare professional before using a medication beyond its date on the container.

1.) Tetracycline and all other drugs related to it. These drugs actually become toxic once the date passes, so for them, it truly is an expiration date. Do not take it, even if the date has very recently passed.
2.) Birth control pills and other female hormonal supplements. Typically, women using these are trying to either prevent pregnancy or prevent other reproductive medical problems. Taking these when the date has passed can result in an unwanted pregnancy or the return of gynecological symptoms.
3.) Antibiotics besides tetracyclines. You want your antibiotics to be as effective as possible, so it gives your body that best chance it can to fight off that infection.
4.) Nitroglycerin tablets. These are meant to stop a heart attack in its tracks until you can call an ambulance. Once their brown glass container is opened, they are only effective for 6 months afterwards. Keep these up to date in case you ever need to use them. You want them to work as well as possible, since they can save your life.
5.) Blood thinners, such as Coumadin (warfarin), Pradaxa, aspirin, etc. Some blood thinners have a very narrow window of opportunity to do their jobs correctly. By using these after the date has passed, you’re at a risk for blood clot development and all the things that come with it.
6.) Digoxin and its family members. These control the heart rhythms of people with heart arrhythmias. It seems like it would be common sense for these to be as effective as possible, since your heart is (in many ways) in charge of your life.
7.) Insulin. Once the vial or pen is opened, it only stays effective for 28 days. Using it after that point will not keep blood sugar levels controlled as well.
8.) Test strips and control solution for blood glucose meters. They will not give you accurate readings if they are past their dates.
9.) Anything in a pharmacy provided amber vial. This vial can only guarantee a year of efficacy, which is why they all say to dispose of any unused medication after a year from the date it was filled.

Like I said, this list is not all-inclusive, so always double check with a healthcare professional first. These were just the most important ones that popped into my mind.

I hope your days are all going well!

 

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