Patients of all sorts, not just preppers, are concerned about the expiration dates that are provided with over the counter and prescription medications. I mean, we all probably have that ancient aspirin bottle that just sits in our medicine cabinet gathering dust while we wonder if they would still even work. Are they even safe to take? For many, however, they take medications every day, life-saving medications far more complex than that ancient aspirin. In a disaster scenario, will our life-saving medication be safe to take even after they are already out of date?
The expiration date itself is sort of a misnomer to begin with. It isn’t really the last day that something can be used, it is just the final day that an item can be purchased, and thus guaranteed by the manufacturer to be fully potent and safe. U.S. pharmaceutical manufacturers are required by law to place expiration dates on prescription and over the counter products prior to marketing.
The expiration date of a drug is determined by running stability testing under good manufacturing practices as set by the Food and Drug Administration. Drug products marketed in the US typically have an expiration that extends from 12 to 60 months from the time of manufacturing. Once the original container is opened, the original expiration date is no longer valid, however stability studies have shown that the actual shelf life may be much longer than initially determined by the expiration date.
This was also confirmed by the American Medical Association (AMA) who in 2001 concluded that the actual shelf lives of some products are, in fact, longer than the labeled expiration date. The AMA stated the best evidence resides in the Shelf Life Extension Program (SLEP) which was managed by the FDA for the Department of Defense. Over 3000 lots, representing 122 different drug products, were assessed in the SLEP program. Based on stability data, expiration dates on 88 percent of the medications were extended beyond their original expiration date for an average of 66 months, that’s almost five and a half years. Of these only 18 percent were terminated due to failure. Examples of common drug products that were tested and showed no signs of failures included: amoxicillin (antibiotic), ciprofloxacin (antibiotic), diphenhydramine (allergy relief), and morphine sulfate (pain relief / opioid). The extensions they placed on the shelf life of these drugs ranged from 12 to 184 months.
These are promising results for these medications, and an even more, recent study examines the effectiveness of past expiration drugs as well. Researchers at the California Poison Control System, UC San Francisco and UC Irvine tested the effectiveness of eight drugs that had just been sitting around, unopened, in some nearby pharmacies having supposedly gone bad. These drugs were not just a few years past their expiration date, these medications were a full 28 to 40 years past their prime.
The eight drugs contained a total of 15 active ingredients. The researchers couldn’t find a standard test for one of them (homatropine), so they focused their analysis on the other 14. Out of the 14 active ingredients, 12 were still at a high enough concentration – 90% of the amount stated on the label – to qualify as having “acceptable potency.”
- Acetaminophen (Pain Relief / Tylenol)
- Codeine (Pain Relief / Opioid)
- Hydrocodone (Pain Relief / Opioid)
- Phenacetin (Analgesic)
- Caffeine (Stimulant)
- Chlorpheniramine (Antihistamine / Allergy Relief)
- Pentobarbital (Barbiturate)
- Butalbital (Barbiturate)
- Secobarbital (Barbiturate / Sleep Aid)
- Phenobarbital (Barbiturate /Controls Seizures /Anti-anxiety)
- Meprobamate (Tranquilizer /Anti-Anxiety)
- Methaqualone (Sedative / Muscle Relaxer)
The other two ingredients in the study that missed that 90% effectiveness cutoff point were aspirin and the stimulant amphetamine, though they still proved effective, just to a lesser degree.
Not only do expired medications appear to remain generally effective, there are no specific reports linking expired medication to any sort of dangerous toxicity level. So it appears they are safe to take too.
Solid dosage forms, such as tablets and capsules, appear to be the most stable medications past their expiration dates. Drugs that exist in solution and ones that require refrigeration, such as Codeine cough syrup, may not be as effective once it becomes out of date. While expired medications are safe to take, the loss of potency can still be a major health concern for certain types of medications.
A good example is an EpiPen auto-injector. Epipens are used in life-threatening situations like anaphylaxis shock, therefore loss of potency can be a major health threat. Other medicine of concern include: insulin (diabetes), oral nitroglycerin (Chest Pain), and any vaccinations. These medications prove to lose their potency, which makes them far less effective after they become outdated. In a true medical health emergency, that loss of potency could be the different between life and death for people who rely on these medication to stay alive. If you, or someone in your family will need these types of medications to stay alive, be sure to stay mindful of those expirations dates. Sometimes it may work and be better than nothing, but the danger of medication losing its effectiveness to a life-threatening level is a real concern.
Insulin, and some other medications, also run the risk of simply going bad. Insulin is a protein dissolved in water. Like any other protein, it can spoil. Again, the medication wouldn’t make you sick, it just might not work as well. Medications like insulin are kept in the refrigerator, and while they won’t last as long past expiration as other medicines, keeping them stored in a cold place will encourage a longer life past their time.
When it comes to stockpiling medication, proper storage may help to extend their potency and effectiveness. Medications remain most stable when stored in a dry, cool space sheltered from light. Keep the prescription bottle caps tightly closed and anything with a manufacturers seal should remain that way if at all possible.
Even though it doesn’t appear that the majority of your medication will become unusable over time, it is probably still wise to keep adding to your supply with new medications regularly. Remember, that even if you know that your Tylenol is still good 10 years after the expiration date, it still might not provide as high a value in a bartering situation as a more potent version.
Preparing for an emergency can definitely be complicated by health concerns. By knowing your medications and how they are effected over time can not only help you prepare, but it could possibly even be the difference between life and death.