Hope I won’t get shot down in short order for asking this question: I’m not asking for medical advice nor advice about anything illegal (AFAIK).
But since I’ve moved overseas, I’ve had a bottle of hydrocodone (Vicodin) in our medicine cabinet left over from some oral surgery I had a couple of years ago. I just ran across it and notice that the expiration date was two years ago.
I’m debating whether to throw it out or hold onto it. I’d really like to do the latter, as for some kinds of severe pain, hydrocodone is the only thing that seems to work well (taking just one, or half, in an evening) and I’m not sure whether I can get a prescription for it here.
With a splitting headache you reach into your medicine cabinet for some aspirin only to find the stamped expiration date on the bottle has passed - two years ago. So, do you take it or don’t you? If you decide to take the aspirin will it be a fatal mistake or will you simply continue to suffer from the headache?
This is a dilemma many people face in some way or another. A column published in Pyschopharmacology Today offers some advice.
It turns out that the expiration date on a drug does stand for something, but probably not what you think it does. Since a law was passed in 1979, drug manufacturers are required to stamp an expiration date on their products. This is the date at which the manufacturer can still guarantee the full potency and safety of the drug.
Most of what is known about drug expiration dates comes from a study conducted by the Food and Drug Administration at the request of the military. With a large and expensive stockpile of drugs, the military faced tossing out and replacing its drugs every few years. What they found from the study is 90% of more than 100 drugs, both prescription and over-the-counter, were perfectly good to use even 15 years after the expiration date.
So the expiration date doesn’t really indicate a point at which the medication is no longer effective or has become unsafe to use. Medical authorities state expired drugs are safe to take, even those that expired years ago. A rare exception to this may be tetracycline, but the report on this is controversial among researchers. It’s true the effectiveness of a drug may decrease over time, but much of the original potency still remains even a decade after the expiration date. Excluding nitroglycerin, insulin, and liquid antibiotics, most medications are as long-lasting as the ones tested by the military. Placing a medication in a cool place, such as a refrigerator, will help a drug remain potent for many years.
Is the expiration date a marketing ploy by drug manufacturers, to keep you restocking your medicine cabinet and their pockets regularly? You can look at it that way. Or you can also look at it this way: The expiration dates are very conservative to ensure you get everything you paid for. And, really, if a drug manufacturer had to do expiration-date testing for longer periods it would slow their ability to bring you new and improved formulations.
The next time you face the drug expiration date dilemma, consider what you’ve learned here. If the expiration date passed a few years ago and it’s important that your drug is absolutely 100% effective, you might want to consider buying a new bottle. And if you have any questions about the safety or effectiveness of any drug, ask your pharmacist. He or she is a great resource when it comes to getting more information about your medications.*
Safe? Yes. 100% effective? No. Worth keeping? I would… and only you can determine the value to you. But a 90% effective vicodin is better than a 100% >insert other pain reliever<.
Vicodin is Acetaminophen and Hydrocodone, so my comment doesn’t apply to it, but I think the article cited is misleading re Aspirin. As I recall, Aspirin (acetylsalicylic acid) does break down into acetic acid and salicyclic acid. As such, it’ll still help your headache, but you may end up trading it for a gut ache; salicylic acid is a lot more irritating to the gut than acetylsalicylic acid.
Every prescription medication I’ve taken in the past two years has an expiration date exactly one year after the medicine was dispensed. It’s amazing how everything deteriorates at precisely the same rate.
Not only that, my eyes also deteriorate in precise one year increments. At least, that’s what my optometrist seems to be telling me when I try to buy more contact lenses.
About 5yrs ago, I had my wisdom teeth yanked,* and got a bunch of them along with ibuprofen and penicillin. I go through 80% or so and then just threw them into the parent’s medicine cabinet. Fast forward to last autumn. I’m staying with the parents for a few days, and I get a really bad toothache over Labor Day weekend, meaning I have to wait 3 days to see the dentist. I took a few to no ill effect and lived through the weekend to get a root canal. The only possible problem I noticed was that I had something like a hangover in the morning after having taken one at night. That could be because they had broken down and were metabolized differently, they were the same but my body reacted differently, or something entirely unrelated. With regards to Vicodin, it would obviously be better to get it ‘fresh,’ but it still works when old and is much better than whatever you get OTC for the big stuff.
*- Fun story here. I arrive at the dentist at 7:30 for an 8:00 appointment. After checking in and sitting down for a couple, they give me a sublingual tranquilizer. I remember nodding at my mom, since I couldn’t really talk with something under my tongue, while I read Parenting magazine (I could’ve played with the awesome little toys…). Things started to get foggy, so they led me to the chair where I promptly pass out. I somewhat come to later, drooling blood all over my little paper bib with the dentist wiggling one of the teeth out. His gloves are covered in blood and my eyes grow wide. He says, “I’m not trying to kill you, just go back to sleep.” When I awoke, I’m lying in my bed, pillow covered in blood. I may have been missing a kidney.
heh, something similar happened to me when I got my wisdom teeth pulled. They gave me gas first, then the IV. The IV totally put me out…supposedly. I clearly remember opening my eyes and seeing doctors in white with face masks and caps on standing over me. I clearly remember thinking, “Wait a second, I’m not supposed to be awake,” and voluntarily closing my eyes again. Next thing I remember, I was in their recovery room.
I do have red hair, and I’ve heard that redheads have something of a higher “resistance” to anesthesia than others…not sure if that had anything to do with it, but still, you’re not the only one who’s woken up at a bad time.
Different rules apply to liquid medicines, such as for kids.
When I was young, the family went down to a vacation home we had in Florida and one of the things on the agenda was to go to Disney World. That morning I had a bit of a sniffle, so my mom gave me a tablespoon of some purple cold medicine that had been in the cabinet from the last time we were there (or maybe even earlier).
What was a simple sniffle became 24 hours of constant vomiting. I threw up on the turnpike on the way there, the parents just figured I was nervous/excited about going to Disney World. As soon as I got into the park, I threw up into a trash can, then we went on a few non-ride attractions, two of which I threw up while in line. After a few hours and seemingly no end to the upchuckery, we all returned home having done approximately nothing at the park.
Once home, we realized the cough syrup I’d taken in the morning was over a year past-expiration. It had probably fermented into some kind of 150-proof codeine liqueur.
Because of that, I tend to be a bit over-cautious with med expiration dates (even pills). Hydrocodone, though, I have too much respect for to throw away unless it were 2 or 3 years passed. I get kidney stones every once in a while, and when those hit having some left-over vicodin from my last stone or having my wisdom teeth out makes an atheist like me believe in miracles.
IAAPS (I Am A Pharmacy Student), expiration dates are normally determined by something called Advanced Stability Testing, where the medication is put into conditions where it degrades faster then normal and they use that to determine how long the medication would stay potent. The longest they can verify using AST is 3 years, and longer requires actually testing a bottle.
How long after an expiration date I would take a medication totally depends on the medication, and what it degrades into. Some medications could turn dangerous, some are just less potent, when others might be totally fine. For the case in the OP, Hydrocodone/APAP, they don’t degrade into anything toxic, so, I would be ok recommending it for 2 years after the expiration date. I wouldn’t be willing to take it myself, or my love ones, for any longer then 3 or so years after though.
Actually, there is a reason for this. The expiration date printed on the stock bottles is under controlled storage (USP Room temperature normally, with humidity control). When you take the medication out of the controlled environment, normally by repackaging it, the rules state that you should put an expiration date of one year, or the actual, whichever is less.
Now, there are exceptions to the normal expiration dates, the most common being reconstituted medications (normally antibiotics for children) which have a 14 day expiration, and Multi Dose Vials for injection (normally insulin) which is normally 28 days from first use.
Fascinating! It’s like reading a CE article. Which sounds weird, but I love reading them.
(Minor hijack: Lantus is the only insulin vial I’ve seen that specifically says to discard after 28 days, are the other ones like that too but don’t advertise it?)
Sounds like a CE? I don’t know if I should take that as a compliment or not
Well, the 28 day limit was actually a recent change under USP 797, don’t know exactly when it too effect, I actually just learned of that change during my last rotation.
I know this is an old post, but thanks to google I ran across it. Hopefully someone sees it…
Make it short. More than once now, opiate painkiller expiration date is BS.
Hours ago I had some dental fillings “redone” and a “core build up” for a crown.
Couple hours after leaving the dentist, the pain started getting worse and WORSE. Was getting so bad I was about to go to urgent care for pain meds. BAD! Worse than when I fractured a bone. Talking made it worse, pain was growing by the minute.
Found some 4 year old 5mg vicodin from a old injury…20-30 minutes later…I don’t know where to begin. Like a miracle. Minutes by minutes, pain…got less and less…
I’m “slowly” typing this a couple hours later. Jaw is still sore, but before I took the 2 5mg pills, the pains was insane. It was getting worse.
Summary…opiate pill expiration…BS. Like “most” expiation dates. NOT all, but most.
What about codeine cough syrup? I’ve got a bottle somewhere from an episode of bronchitis in which I was coughing so badly I couldn’t sleep. By the time I got to my GP, he said if I’d waited any longer, he would have sent me to the ER to deal with the bronchiospasms. Happens every few years or so. Should I ditch it?
A study came out in 2012 that studied a number of drugs that had sat on a shelf for decades. The great majority, including hydrocodone and codeine, were still at 90% or better efficacy even 30-40 years after their expiration. The glaring exceptions in the small group of pills they studied I believe were aspirin and amphetamine.
So no taking ten year-old aspirin to relieve that ten year-old amphetamine headache ;). But opiates apparently hold up very well. At least in pill form.
