You had a yummy dinner outside, come back home and in the middle of the night youstart vomiting and your tummy hurts; you open your medicine chest only to realise that the medication you wanted to take has expired a few weeksago.

What do you do? Normally you would throw it away because of the common belief that the drug has turned toxic or will not be effective. It is frustrating because medicines are expensive, you don’t want to throw them away nor do you want to get any sicker with the side-effects of an expired pill.

The airneeds to be cleared regarding this issue.

What Does An Expiration Date Mean?

In our country the medicines are regulated by the Drugs and Cosmetics Act 1940 and rules 1945, amended from time to time. The regulation stipulates that every drug must have a date of expiry of potency, which indicates the date up to which the manufacturer guarantees the full potency and safety of the drug.

At the time of the medication expiry date, the drug must be at least 90% of the original potency under proper storage conditions, according to the US standards.

The expiration date certainly does not indicate a point when a medication spontaneously or suddenly loses potency or becomes toxic.

One study conducted by the US Food and Drug Administration, on the request of the US military concluded,“over 90 per cent of more than 100 drugs, both prescription and over-the-counter, were perfectly good to use even 15 years after the expiration date,” retaining most of their original potency.

Of course, exceptions prove the rule. There are drugs whose stability and potency decrease relatively faster e.g. nitroglycerine, insulin, liquid antibiotics etc.

Potency & Efficacy

The potency of drugs begins to reduce from the moment it is manufactured, this is called ‘drug decay’. So your medicine doesn’t become unusable at a particular hour.

Safety & Toxicity

Contrary to common perception and belief, there is hardly any scientific evidence that the expired drugs are toxic and, therefore, harmful.

The only report, in 1963, of human toxicity that may have been caused by chemical or physical degradation of a pharmaceutical product is renal tubular (kidney) damage that was associated with use of degraded tetracycline. Since then, tetracycline products have been changed to eliminate the problem. Not withstanding the fact that there are not many studies reported in this field, the lack of other reports of toxicity from expired medication is reassuring.

Life-Saving Drugs Must Be Avoided Post Expiration

Certain drugs, like an anti-epileptic drug Dilantin and a very commonly used anti-anginal drug Nitroglycerine, should not be used past their expiration date. Oral contraceptives, eye drops and Insulin also fall in the same category.Certain live vaccines also should not be used after the expiry date.

Bottom line: if your life depends upon your medication, make sure they are compliant with the expiry date.

What to consider in deciding whether to use an expired medication:

• Appearance of the drugs. Use it only if it appears as the original medicine would. Brittle tablets, discoloured injections, soft or leaky capsules should not be used. Never take medicine that seems suspicious in any way.
  
• Storage conditions. Medications do not retain their effectiveness if they are not stored at recommended temperatures and in dry conditions.
  
• Dosage formulation: liquids and suspensions are less stable than tablets and capsules.
  
• Time elapsed after the expiry date.

Be Practical

Doctors and pharmacists are bound by law and will never advise you to use expired pills on the record. The wisdom suggests that if it is a life saving drug, and you must have full original strength, it is better to be safe than sorry.

That said, there is very little science in the “best before use” label, so for a headache, acidity, cold or constipation, pop in the expired pill without apprehension. You are unlikely to get hurt except in the rarest of rare cases, yet be assured, the drug certainly won’t turn into poison.

Also Read: Is Dietary Cholesterol Really the Villain It’s Made Out To Be?

(Dr Ashwini Setya is a Gastroenterologist and Programme Director in Delhi’s Max Super Speciality Hospital. His endeavor is to help people lead a healthy life without medication. He can be reached at ashwini.setya@gmail.com)