Thursday, April 06, 2006

Info from Harold

Harold Dundee sent the following information.

The AARP Bulletin v.47, no. 4 (just arrived) carries an article about a
Florida pharmacist who says most prescription drugs are completely safe to use long after the stated expiration date. He says manufacturers set dates short so that they can make more sales. He has gotten the Florida
Legislature to tell the Florida Board of Pharmacy that it could no longer
require phamacists to use discard-after dates on prescription labels as it
had done since 1993.

The US Food and Drug Administration has determined that many drugs remain effective, often for many years after the stated expiration date. FDA does, however, warn against drugs stored in steamy bathrooms or hot cars. [I am aware of the recommendation that drugs be stored at temperatures below 76 degrees F. Accordingly, when I travel I keep my medications in a small styrofoan box with a bottle of ice in it so that the drugs will stay cool--HD]

I learned from my second wife who was a pharmacist that with aspirin, you can tell when it has aged beyond reliability. Sniff the bottle of aspirin. If it smells of acetic acid (vinegar smell) then it has lost much of it
efficacity.

Later Harold added this:

The recommendation is to keep drugs under 86 degrees F., not 76 as I
stated. Of course the cooler, usually the better.

One response that I had said, "When I have an expired medication I call
the pharmacist and he/she tells me if it can be used or not. I had some
things that were 10 years old and still good, just had to use a double dose because they weakened with time.

3 comments:

DrugMonkey, Master of Pharmacy said...

Here's what the Pharmacists Letter had to say about expiration dates a few years ago:


"FDA tests show that most drugs remain safe and effective long after their expiration date, if kept in their original container.

This has a huge economic impact.

For example, it costs the military about $100 million a year to replace outdated medicines...to keep their stockpile in date.

The FDA started testing military drug supplies 15 years ago. Over 90% of the drugs tested have been found to be safe and effective for many years past their expiration date.

Even outdated tetracycline is probably not a concern.

Many years ago there was a report of Fanconi's syndrome linked to outdated tetracycline. Since then, every pharmacist and physician has learned to be cautious about kidney problems from outdated tetracycline. But current tetracycline formulations do not seem to cause this problem.

Manufacturers typically use 2- to 3-year expiration dates.

It's convenient. They don't need to perform longer stability tests...and the short dating assures the purchase of new drugs.

Manufacturers also say it's safer...people won't hang on to old bottles that don't have current labeling and precautions.

But remember there's a big difference between a manufacturer's original package, and an Rx vial that is dispensed to a patient.

USP recommends no more than a one-year expiration date for drugs that are not in their original, unopened package.

Keep in mind the drugs that need even shorter expiration dates because they degrade easily...nitroglycerin...insulin...mefloquine...some liquid antibiotics...and others.

Also, keep in mind the narrow therapeutic index drugs where exact potency is important...warfarin, digoxin, carbamazepine, etc.

Tell patients that many tablets and capsules that are stored properly remain potent for several years past their expiration date.

But advise them that even if an older drug is still potent, it may not be appropriate for them to take...due to changes in their condition."

Anonymous said...

Hmmm. I keep all medications and vitamins in the fridge, unless the bottle advises otherwise. I guess it really is the best place.

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