Should you take expired medicine?

Since 1979, the U.S. Food and Drug Administration (FDA) has required pharmaceutical companies to put expiration dates on prescription and over-the-counter drugs. However, that does not mean your medicine will go bad in the same way as an expired carton of milk. The date you see printed on the bottle is the date the drug manufacturer guarantees the drug is safe and effective. However, how long the drug is actually safe and effective is still a matter of debate.

In addition to some medications with short expiration dates, such as insulin and liquid antibiotics, many medications can last much longer than the date printed on their packaging. However, not everyone knows this. Poison control centers occasionally receive calls from people who have accidentally taken expired medications.

According to Lee Cantrell, director of the San Diego Division of the California Poison Control System, there is no documented evidence of expired drugs causing any problems in humans.

“The effectiveness of the drug may decline over time, but there is very little research on this,” he said.

A few years ago, Cantrell had a rare opportunity to test some old medications, including antihistamines, painkillers, and weight-loss pills, found in the back of a pharmacy. “We found that these medications, some of which were at least 40 years out of date, were still fully potent,” Cantrell says.

The study was published inJAMA Internal Medicinein 2012. In 2017, Cantrell published another study that found that EpiPens, expensive auto-injectors used to treat life-threatening allergic reactions, were still 84% effective more than four years after their expiration date. So, in an emergency, an expired EpiPen could be used as a temporary solution. The US also has a stockpile of drugs that could be needed in an emergency such as a terrorist attack or a disease outbreak.

In 1986, the FDA and the Department of Defense started the Shelf Life Extension Program (SLEP) to save money on replacing expired drugs in the stockpile. A 2006 SLEP study tested 122 different drugs stored under ideal conditions. The results showed that the expiration dates of most drugs in the stockpile could be extended by an average of four years. In 2016, the program saved $2.1 billion.

However, the FDA still warns consumers not to use expired drugs because some expired drugs carry the risk of developing bacteria that lead to more serious illnesses and antibiotic resistance.