Originally published at: http://boingboing.net/2017/07/18/drugs-that-are-30-years-past-t.html
…
4 Likes
I’d be interested to see what types of drugs when stored correctly can last past their expiration date. I have always refused to take expired drugs because… well i’m not a chemist or pharmacist and the last thing i want to do is take something with a past expiration date. With food you can make a judgement call if something is off or not but for pills there’s no way to know.
7 Likes
To anyone considering using expired drugs, keep in mind that while most drugs might be fine past their expiration date, certain drugs break down into toxic substances. Tetracycline is one such example: if you take expired tetracycline, you’re probably going to need a kidney transplant. So if you’re thinking of doing this, at the very least look up the specific drug and what its breakdown products are. Don’t assume that all pharmaceuticals are good forever.
26 Likes
The DoD has an extensive database of the extendability of the shelf life of drugs as they have a massive program of stock piling drugs for various reasons.
They do not really make the details public, but the summary is 88% can typically be extended an average of 66 months past their expiration date and it gets rather variable after that.
11 Likes
Drugs that are 30 years past their expiration date “still as potent as they were when they were manufactured”
I had thought this was going to be about homeopathics…
8 Likes
Tetracycline is one such example: if you take expired tetracycline, you’re probably going to need a kidney transplant.
Are you sure?
From the report, the poison control doctor said this:
Still, he said, to his knowledge there has only been one report of a drug that became toxic after it had expired, and that was due to an inert ingredient in one particular manufacturer’s formulation.
“Beyond that there has never been a well-documented case of any expired medication that became toxic,” Cantrell said.
8 Likes
You might have to take a large dose before you actually kill your kidneys outright, but it’s been known for over half a century that tetracycline breakdown products are toxic. Here’s a 1964 article: http://journals.sagepub.com/doi/abs/10.3181/00379727-115-29082
Tetracycline is pretty much the textbook example for toxic breakdown products of phramaceutical drugs. Also, it might be fine as long as the drugs were stored properly, and the breakdown products might only result from improper storage. But if you find a pill bottle of decades-old tetracycline, do you want to roll the dice on whether it was stored properly that whole time?
9 Likes
The article oversimplifies things quite a bit. The Hacker News discussion does a better job with the subtleties.
Many drugs remain good long after their expiration. Some drugs slowly lose effectiveness, which can be very dangerous in itself with drugs that require a precise dose to work properly. Some drugs are well-documented to degrade into toxic substances–and saying there’s no documented cases of a human being poisoned is pretty disingenuous; all that means is that the expiration dates are working.
And remember that, once the research is done, most drugs are so cheap to make that the cost of creation might as well be zero. No real value is lost if the drugs are destroyed and exchanged for new ones. If manufacturers are refusing to exchange expired drugs, that’s a problem that should be dealt with, but the solution isn’t “remove expiration dates”.
It does sound like expiration dates for some medicines are overly conservative. Do we really want to encourage drug companies to take risks, though? Nobody wants another thalidomide.
7 Likes
/thinks of those videos of the guy trying ancient ration packs and survival kits with the tabs of military-grade uppers.
5 Likes
I am willing to let the most rich among us start using expired medications. Hell … they should be charged for them.
Market them as “cask aged” and watch people demand expired medications.
4 Likes
One problem with throwing out still viable pharmaceuticals because of an arbitrary expiration date is that a lot of the waste will wind up in the waste water stream, and water treatment plants aren’t really set up to either treat or even detect them. That means low levels of a lot of pharmaceuticals (or their decomposition products) are getting into the environment. (Of course this also happens during excretion, but dumping the drugs exacerbates the problem.)
As far as some decomposition of the drugs, the biggest thing to prevent it would be protecting them from heat and moisture (i.e., proper storage). Most reactions work better is there’s a little water around (alka seltzer is an extreme example of this), and heat speeds up the kinetics of any reaction.
8 Likes
Ya, I did a little googling and that study is the only one to suggest that and actually directly contradicted by the DoD SLEP database that never found tet to get toxic.
But, as you said, I am not rolling the dice for no reason on the most likely candidate to be a problem. I rarely take antibiotics and never have any left over anyway of course.
Another drug the DoD found does not last much past its expiry date are malaria drugs.
3 Likes
The Wikipedia article on Fanconi syndrome talks about this: “Causes include ingesting expired tetracyclines (where tetracycline changes to form epitetracycline and anhydrotetracycline which damage proximal tubule)”.
“Heirloom Drugs”?
7 Likes
It used to be the case that pharmacies had the obligation to take back expired drugs. Doctors did advise me to bring back pharmaceuticals to them for proper disposal. However, this was Germany, and mostly last century… 
If you are in the United States, there are plenty of facilities that will properly dispose of expired or otherwise unused medications:
The FDA webpage even tells you which meds are safe to flush.
5 Likes
One problem is with PRN or as needed meds. I used to be a nurse ages ago, and I’d have elderly patients with PRN’s that were past the expiration date. We’re talking pain meds, or ativan, or the like. For them, having to rebuy these meds was a financial hardship. As a rule we said these PRN’s were fine, and go ahead. I remember the doc we worked with advising that.
5 Likes
Well, I for one am totally bummed. I really wanted to find out that expired drugs either became hallucinogenic or, even better, converted you into some sort of superhero or X-man thing.
3 Likes
I’d also expect that the storage conditions make a massive difference. Particularly temperature, and whether the container has been opened or is sealed.
3 Likes
Drugs that are 30 years past their expiration date “still as potent as they were when they were manufactured”
Wow, so close to Friday too.
4 Likes
