Are expired drugs safe?

Medically reviewed by Femi Aremu, PharmD

Chances are your medicine cabinet contains some medications, including over-the-counter (OTC) drugs, prescriptions, and supplements, that have been out of date for at least a few months.

Drug expiration dates appear on most drug labels, including prescription and over-the-counter drugs, vitamins, and supplements. You might wonder how seriously they will take their expiration dates.

Could you still use them or should they be trashed immediately?

Since 1979, the Food and Drug Administration (FDA) has required drug manufacturers to label their products with expiration dates. The manufacturer guarantees the full efficacy and safety of the drug up to the date printed on the label.

However, the rate at which the efficacy and safety of some pharmaceuticals deteriorate varies based on the drug’s ingredients, uses, and storage methods.

This article will look at the guidelines surrounding the use of expired medications and discuss the types of medications that cannot be taken after their expiration date versus those where exceptions can be made.

My drug has expired: can I still take it?

In general, drug manufacturers and the FDA advise against taking drugs after their expiration date.

However, once a drug has reached its expiration date, it has continued to work or has become dangerous beyond that date. The date indicates that the manufacturer cannot guarantee that it will remain safe and effective.

Examples of this include medications for minor pain or heartburn, including TUMS (calcium carbonate), Tylenol (acetaminophen), or nonsteroidal anti-inflammatory drugs (NSAIDs), such as Advil or Motrin (ibuprofen). These drugs are usually safe and effective for at least a year after expiration.

However, whether you can or should take drugs after their expiration date depends on why you’re taking it and the type of drug.

What drugs are unsafe after their expiration dates?

The most significant risk of most drugs is not toxicity but loss of efficacy after expiration. This means that the drug may stop working or not work even after the expiration date.

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In the case of life-saving drugs, this can be very serious or lead to highly undesirable consequences.

Some examples are:

• Nitrostat (nitroglycerin), used to treat angina (chest pain) and heart attacks are sensitive to heat and humidity. These can cause it to rupture and the drug may fail to stop a heart attack.

• Insulin degrades rapidly after its expiration date, making it less effective. This can lead to hyperglycemia (high blood sugar levels) and other dangerous complications. Make sure you understand how to store insulin properly.

• The EpiPen (epinephrine) is used to stop allergic reactions that can be life-threatening, such as anaphylaxis. It breaks down quickly after expiration and may not be able to prevent allergic reactions. Note, however, that in an emergency, taking expired epinephrine is better than not taking it at all.

• Oral liquid antibiotics can potentially become contaminated with bacteria after they expire. They may fail to cure the infection they were prescribed for and may even cause further infections.

• Eye drops can be contaminated with bacteria and lead to an infection, such as conjunctivitis (pink eye), if used after their expiration date.

• Birth control may become less effective once the expiration date has passed. This could easily lead to unwanted pregnancy and breakthrough bleeding and spotting.

The only drug known to be toxic to humans after its expiration is tetracycline.

Which drugs are likely safe after they expire?

Other than the drugs listed above, most are likely safe after expiration. However, beyond the immediate safety implications, other factors, such as efficacy, should be considered when considering an expired drug.

For example, using a bottle of Zestril (lisinopril) after it has expired may not cause direct harm, but if it fails to control your blood pressure, your risk of cardiovascular (heart) disease may increase.

Even so, most medications remain potent after their expiration dates:

Results from a 2019 study revealed that 90% potency was maintained at least five years after the stated expiration date on more than 100 pharmaceutical products. However, in this study, the drugs tested were in unopened containers that had been stored properly.

Potential consequences of taking expired medications

Taking some drugs after their expiration date can be very dangerous or have undesirable results, especially if they are life-saving drugs that lose their effectiveness after their expiration date.

Examples of these potential consequences include Nitrostat (nitroglycerin) failing to stop a heart attack, insulin failing to lower blood sugar levels, or birth control failing to prevent pregnancy.

How can I store my medicines correctly?

Proper storage of medications can help extend the time they remain safe and effective.

Most medications are best stored in a cool, dry place away from sunlight and strong light. Examples include a nightstand, dresser drawer, or kitchen cabinet.

Keep bottle caps tightly closed and always keep medicines out of the reach of children and pets.

Some refrigerated medications, such as insulin, can also be stored at room temperature for a limited time and should be marked with the date they are removed from the refrigerator.

Always ask your pharmacist any questions regarding the proper storage of your medications.

What should I do with expired medicines?

The best and safest way to dispose of expired or unnecessary medicines is to take them to a medicine collection point. Many hospitals and clinics, police departments, and local pharmacies offer lockers where you can leave expired medications.

National Drug Take-Back Days are also held a couple of times a year, typically in April and October, when different take-back locations accept unwanted drugs. These are sponsored by the Drug Enforcement Administration (DEA).

Instead of throwing medications in the household trash, mash them up and mix them with used coffee grounds, cat litter, sawdust, dirt, or flour.

This can help prevent your medications from being accidentally swallowed by a child or pet.

Do not flush unwanted medications down the toilet or pour them down the drain. This can lead to environmental problems. Even if only some of the drug is removed during water treatment, it can end up in the water supply, increasing the chances of contamination.

The only exceptions to this rule are drugs listed on the FDA-approved flush list.

Summary

It is advisable to use the medicines before the expiration date. This ensures that the medicine will continue to work at its full capacity.

This is especially important for potentially life-saving drugs such as Nitrostat (nitroglycerin), EpiPens (epinephrine), and insulin.

But most medications, especially those in tablet form, are likely safe and effective for at least a year after expiration. Properly storing your medications in dry places will also help prolong the life and safety of your medication.

When in doubt, talk to a healthcare professional if you have concerns about the safety of your medications regarding their consumption and existing potency.

Frequent questions

Can drug expiration dates be extended?

Drug expiration dates can be extended, but the process depends on up-to-date drug manufacturer testing and data following a protocol approved in the New Drug Application (NDA) or Abbreviated New Drug Application (ANDA).

Additionally, there are some circumstances where the FDA may extend expiration dates for some products, such as when supply is low or when the benefit to the public outweighs the small risk of reduced safety or potency.