Are Expired Medications Safe?

Medically reviewed by Femi Aremu, PharmD

Chances are that your medicine cabinet contains some medications, including over-the-counter (OTC) drugs, prescriptions, and supplements, that are at least a few months expired.

Drug expiration dates exist on most medication labels, including prescription and OTC drugs, vitamins, and supplements. You may wonder how seriously it will take their expiration dates.

Could you still use them, or must they be trashed immediately?

Since 1979, the Food and Drug Administration (FDA) has required drug manufacturers to label their products with expiration dates. The manufacturer guarantees the full potency and safety of the medication until the date printed on the label.

Nonetheless, the speed of deterioration regarding the efficacy and safety of certain pharmaceutical products differs based on the drug's ingredients, uses, and storage methods.

This article will review the guidelines surrounding the use of expired drugs and discusses the types of medicines that cannot be taken past expiration versus those in which exceptions may be made.

My Medication Is Expired: Can I Still Take It?

Generally, drug manufacturers and the FDA do not recommend taking medications after expiration.

However, once a drug has reached its expiration date, it has continued working or become dangerous beyond that date. The date indicates that the manufacturer cannot guarantee it will remain safe and effective.

Examples of this include medications for minor pain or heartburn, including TUMS (calcium carbonate), Tylenol (acetaminophen), or nonsteroidal anti-inflammatory drugs (NSAIDs), such as Advil or Motrin (ibuprofen). These drugs are usually safe and effective for at least a year after expiration.

Nonetheless, whether you can or should take medication after it expires depends on why you’re taking it and the type of drug.

Which Medications Are Unsafe After Their Expiration Date?

Most medications' most significant risk is not toxicity but the loss of potency after expiration. This means that the drug may stop working or not work as well after the expiration date.

In the case of lifesaving medications, this can be very serious or lead to highly undesirable consequences.

Some examples are:

• Nitrostat (nitroglycerin), used to treat angina (chest pain) and heart attacks are susceptible to heat and moisture. These can cause it to break down, and the drug may fail to stop a heart attack.

• Insulin breaks down quickly after the expiration date, making it less effective. This can lead to hyperglycemia (high blood sugar levels) and other dangerous complications. Make sure you understand how to store insulin properly.

• The EpiPen (epinephrine) is used to stop allergic reactions that may be life-threatening, such as anaphylaxis. It breaks down quickly after expiring and may be unable to prevent allergic reactions. Note, however, that in an emergency, taking expired epinephrine is better than taking none at all.

• Oral liquid antibiotics can potentially become contaminated with bacteria after they expire. They could fail to treat the infection for which they were prescribed and could also cause further infection.

• Eye drops may become contaminated with bacteria and lead to an infection, such as conjunctivitis (pink eye), if used after expiration.

• Birth control could become less effective once its expiration date passes. This could easily lead to unwanted pregnancies and breakthrough bleeding and spotting.

The only medication known to be toxic to humans past its expiration is tetracycline.

What Medications Are Likely Safe After Their Expiration?

Besides the medications listed above, most are likely safe after expiration. However, beyond the immediate safety-related implications, other factors, such as efficacy, should be considered when considering an expired drug.

For example, using a bottle of Zestril (lisinopril) after it has expired may not cause direct harm, but if it fails to control your blood pressure, your risk of cardiovascular (heart) disease may increase.

Even so, most medications do remain potent following their expiration date:

The results of a 2019 study revealed that 90% potency was maintained at least five years after the expiration date listed on over 100 drug products. However, in this study, the tested drugs were in unopened containers that had been stored properly.

Potential Consequences of Taking Expired Drugs

Taking some medications after expiration can be highly dangerous or have undesirable outcomes, especially if they are lifesaving medications that lose potency past expiration.

Examples of these potential consequences include Nitrostat (nitroglycerin) failing to stop a heart attack, insulin failing to lower blood sugar levels, or birth control failing to prevent pregnancy.

How Can I Properly Store Medication?

Storing medications properly can help extend how long they remain safe and effective.

Most medications are best stored in a cool, dry place, away from sunlight and harsh light. Examples include a bedside table, dresser drawer, or kitchen cabinet.

Keep bottle caps tightly closed and always keep medications out of reach of children and pets.

Some refrigerated medications, such as insulin, may also be kept at room temperature for a limited time and should be marked with the date you remove them from the fridge.

Always ask your pharmacist any questions regarding the proper storage of your medications.

What Should I Do With Expired Medication?

The best and safest way to dispose of expired or unneeded medication is to bring it to a drug take-back location. Many hospitals and clinics, police departments, and community pharmacies offer drop boxes where you can drop off expired medications.

National Drug Take-Back Days also occur a couple of times a year, typically in April and October, when different drop-off locations accept unwanted medications. These are sponsored by the Drug Enforcement Administration (DEA).

Instead of throwing medication in the household trash, crush and mix it with used coffee grounds, kitty litter, sawdust, dirt, or flour.

This may help keep your medications from being accidentally ingested by a child or pet.

Don't flush unwanted medicines down the toilet or pour them down the drain. This can lead to environmental problems. Even if only some of the drug is removed during water treatment, it can end up in the water supply, raising the chances of contamination.

The only exceptions to this rule are the medications listed on the FDA's approved flush list.

Summary

It is best practice to use medications before their expiration dates. Doing this guarantees the medicine will still work at its total capacity.

This is especially important for potentially lifesaving medications such as Nitrostat (nitroglycerin), EpiPens (epinephrine), and insulin.

But most medications, especially those that come as tablets, are likely safe and effective for at least a year after expiration. Storing medications properly in dry places will also help extend the medication's life and safety.

When in doubt, speak with a healthcare provider if you have concerns about the safety of your medication regarding its consumption and existing potency.

Frequently Asked Questions

Can drug expiration dates be extended?

Drug expiration dates can be extended, but the process depends upon the drug's manufacturer updated tests and data following a protocol approved in the new drug application (NDA) or abbreviated new drug application (ANDA).

Moreover, there are certain circumstances in which the FDA can extend expiration dates for some products, such as when supply is low or when the benefit to the public outweighs the small risk of lowered safety or potency.