Medicines can help you feel better and keep you healthy, but when they are past their expiration dates, some medicines can become toxic. Here's why and how you should get rid of old medicines.

This article discusses:

1. How expired medicines become dangerous;

2. Why expired medicines can be risky to leave around the house; and

3. How expired medicines should be properly disposed of.

 

How Expired Medicines Become Dangerous

Medicines that are beyond the expiration date which is shown on their packages, become dangerous to take for two reasons:

• Some medicines can become chemically unstable and toxic to take.

• Some can become unpredictably less potent.

 

Chemically unstable

As some medicines age, their chemical composition can become altered.  And as they change chemically, they can become dangerous to take. Some examples of medicines which can become especially harmful to take after their expiration dates include:

Tetracyclines:  Tetracyclines are antibiotics used to treat a wide variety of bacterial infections.  This common medication becomes dangerous to take past their expiration dates, and can cause serious damage to the kidneys.

Outdated eye and ear drops:  These may no longer be sterile and could possibly lead to an infection or irritation.

Medications in the liquid dosage form:  These can actually increase in strength past the printed expiration date because some components of the liquid can separate or evaporate, allowing unexpectedly more of the active ingredient to be in a dosage.
 

Unpredictably less potent

Some expired medicines become dangerous because they have become unpredictably less potent.  It may seem odd that less potent can be dangerous, but the problem is that it is unpredictably less potent.  As mentioned above, as medicines age their chemical composition can become altered, and for some medicines, this means that they lose their potency.  But the amount of potency loss can be unpredictable, even in the same bottle.  For example, the medicines toward the top of the bottle may be exposed to air more than ones down below.  The result can be that you try to compensate for the lack of potency of the medicine, and then get too much effect from the rest of it.  Some examples include:

Cholesterol-Lowering Prescriptions:  These medications lose their effectiveness and can place the user in an unhealthy situation because they may think they are getting the proper dosage, but in fact may not.

Asthma Inhaler:  Similarly with inhalers which are taken prophylactically for asthma management.

Vitamins:  Taking higher dosages of certain types of vitamins to make up for their lack of potency past expiration date can lead to toxicity.  In particular, because the body stores fat-soluble vitamins in fat tissues and organs and take longer to leave your system, it is possible for certain kinds of vitamins to build up when taking high doses over time.  Examples of such fat-soluble vitamins include vitamins A, K, D or E.

Advil or Tylenol:  The active ingredient in these particular medicines become less potent and thus less capable of reducing pain or inflammation, and may lead the user to take too many of the pills, which may still be at full strength.

Aspirin:  Prolonged exposure to moisture in the air makes the active ingredient in aspirin convert to acetic acid, which is why old aspirin smells like vinegar.

Injectable Insulin:  Injectible insulin can become dangerous to use after its expiration date because it can unpredictably lose its potency, and therefore unexpectedly not be delivering the benefits that are required. If you are a diabetic and you take insulin that is no longer fully effective, you risk entering into Diabetic Ketoacidosis (DKA), for example, which can be a life-threatening situation.
 

Why Expired Medicines Can Be Risky to Leave Around Your House?

In 2007, there were 255,732 cases of improper medicine use reported to Poison Control Centers in the United States.  Approximately 9% of these cases (23,783) involved accidental exposure to another person’s medicine.  And approximately 5,000 of these accidental exposure cases involved children 6 years and younger, which can easily mistake medicines for candy.

Leaving expired medicines around the house increase the chance that they can get confused for full-strength, safe-to-take medicines, and should, therefore, be disposed of properly (helpful accessory: medicine disposal systems). And the more medicines that you have around your home, the more likely that they can be accidentally taken by the wrong person, especially children (both your own and visitor’s).
 

How Expired Medicines Should Be Properly Disposed

Depending on the specific medicine involved, there are four methods for properly disposing of expired (or un-needed) medicines.  You should check with your pharmacists to see which method applies to your specific medicines:

1. Some medicines can be flushed.

2. Others can go into the trash using an FDA-recommended special procedure.

3. There are “take-back” programs for some medications; and

4. Some expired medicines should be handled as hazardous waste.

Here is a list from the FDA is an example of expired or un-needed medicines you can flush down the sink or toilet to dispose of them: click here.

For medicines which are indicated to be acceptable to be put in the trash, you need to follow the following FDA-recommended special procedure:

1. Take your prescription drugs out of their original containers.

2. Mix drugs with an undesirable substance, such as cat litter or used coffee grounds.

3. Put the mixture into a disposable container with a lid, such as an empty margarine tub, or into a sealable bag.

4. Conceal or remove any personal information, including Rx number, on the empty containers by covering it with a black permanent marker or duct tape, or by scratching it off.

5. Place the sealed container and the empty drug containers into the trash.

For some medicines, there may be federal “take-back” programs where agencies where you can take or send your expired medicines.  And for some medicines, they will even have hazardous waste handling requirements.

As mentioned above, you should check with your pharmacist for how you should specifically handle each of your specific medicines.  And to keep your family safe, at least once a year, you should review your medicines and properly dispose of all of the expired ones.