How to make the most of expired medications

As practice managers, dealing with expired medications is a common query, and it’s crucial to provide informed advice. Let’s dive into Dr. Paauw’s insights on the matter and unravel the truth behind using expired meds

CREDIT: This is an edited version of an article that originally appeared on MDedge

Dr. Paauw stresses that an expiration date isn’t a sudden death for medication efficacy or an open door to toxicity. It’s a legal requirement set by manufacturers, ensuring over 90% original potency. Take the example of Epinephrine (EpiPen), a costly drug often replaced post-expiration. Surprisingly, studies show that its potency remains stable even 30 months beyond the expiration date.

Expired doesn’t mean ineffective

Weir et al. examined epinephrine syringes 30 months past expiry, revealing unchanged epinephrine content. Rachid et al. found 84%-101% epinephrine in EpiPens 3-36 months post-expiration, with > 90% dose retention in those less than 24 months past expiry. Cantrell et al. evaluated EpiPens up to 50 months post-expiration, indicating 61%-56% retained epinephrine content. The Shelf Life Extension Program (SLEP) data supports this, showing an average extension of 66 months for various drugs, including antibiotics.

Beyond pills

Limited data exist on non-pill forms, but studies like Reis et al. exploring expired eye drops found no significant difference in efficacy compared to fresh drops. However, it’s essential to note that contamination and irritation risks exist, especially in eye drops.

Inhalers’ longevity

For those using inhalers, particularly Albuterol, for intermittent symptoms, the news is positive. Kutty et al.’s study on Albuterol inhalers and solutions up to 20 years past expiration showed almost all lots maintained over 90% of product, ensuring efficacy even at 73% retained activity.

Understanding the stability of expired medications empowers practice managers to make informed decisions. While certain drugs maintain efficacy beyond expiration, caution is essential, especially for eye drops where contamination risks exist. Practice managers can play a pivotal role in guiding patients, ensuring the cost-effective and safe use of medications, even when past their official expiration date.