OTC drugs past expiration. Any danger?

My mom once told me that once over the counter drugs hit their expiration date, they might become less potent, but they won’t actually hurt you.

Is this generally the case? Are there exceptions? I related this rule of thumb to my fiancee the other day when I told her I was taking an Immodium one month past the expiration date. She seemed to think it was a big deal. I said I couldn’t imagine anyone would let something on the market (OTC, no less) that would become poisonous after a certain length of time.

What’s the dope?

Momma is always right. Don’t cross her advice.

From a practical standpoint the expiration date does not trigger an UNUSEABLE product. It is merely a guide line to avoid liability or some such. Use common sense and if two years past date toss 'em! Or maybe 1 yer for liquids.

Basically, the expiration date reflects the timeframe under which the product is KNOWN to be stable. If, for example, a product was studied at different conditions for 3 years, and the potency and levels of impurities etc have not changed, then that’s likely to be the expiration date (from the day of manufacture). Beyond that, there exists no data to support the claim that the product is still good, therefore for liability reasons, it is not recommended that you consume them. Scientifically speaking, of course, there is no degradation time bomb, and in most cases, if you were to test it, the product would still fall within accepted ranges. I remember reading a study that 20+ year old tylenol and such was tested, and everything was still acceptable.

If the drug has special storage conditions, such as store in the dark (e.g. birth control hormones), or store in the fridge, etc, then there is a good chance that light and/or heat WILL cause known degradation, and so it isn’t advisable to take it much after it expires.

Generally, though, you should be ok. 2 years might be my cut-off for OTC products… I don’t think I’ve ever had to consider whether or not to take anything that was expired!

Didn’t the military do a study of several-year-old medications? IIRC, the conclusion was that they were okay if not stored in a humid area (i.e., the bathroom). I’ll see if I can find a cite.

Here you go: https://www.healthforums.com/library/1,1258,article~11942,00.html

Some opposing advice is presented in this article, as well as some products that are less likely to fare well over time.

Aspirin breaks down to acetic acid (vinegar) and salicylic acid. You can smell the vinegary smell if it gets too old. Salicylic acid is a much stronger stomach irritant than acetylsalicylic acid (Aspirin), so in that sense taking expired Aspirin can cause discomfort.

Worse than that. Even relatively weak solutions of salicylic acid can cause gastric bleeding after a relatively few doses. Gastric bleeding can be a medical emergency – especially aspirin-induced, since aspirin inhibits the platelet clotting pathways. That’s why willow tea, known by pre-Roman Druids as an analgesic , was avoided by Roman physicians (“salicylic” acid comes from “salyx”, Latin for “willow”)

While a single dose of a slightly out of date aspirin for a headache may only give you a sore belly, Stale aspirin is more likely to be taken by heavy users in serious pain (e.g. gout, arthitis) with may only respond to larger than OTC doses and longer term use. I’ve known severe arthritics who tke 6-8 tablets with each meal because “nothing else works”. Though high-dose aspirin is not a mainline treatment for gout anymore, I mention it for two reasons: a) low dose aspirin actually increases uric acid levels, often making the gout worse, while very high doses can cause the body to "dump’ uric acid; and b) the Roman citizens had a tendency to “saturnine gout” due to lead contamination from their newfangled “plumbing” (plumbium is Latin for “lead”) plus high consumption of alcoholic products (which aggravate gout, and were often lead contaminated to boot) – so Roman docs saw many cases of death in mere days from willow preparations.

In fact, that is the whole point of aspirin: a chemist at the Bayer company found that tacking an acetyl group onto salicylic acid created a compound that was much less irritating to the stomach, but it would break off, safely, when pancreatic juices neutralized the stomach acid, in the duodenum. When you take vinegary aspirin, you’re going olde skoole, and not in a good way. That vinegar is formed when the protective acetyl group combines with water.

While I’d never advise anyone, professionally, to take expired meds, I have taken (not very) out-of-date OTC meds. The problem is: I have some idea idea of which ones to avoid, and what to look for. Most people won’t. I’d avoid vinegary aspirin even if it wasn’t expired (due to e.g. poor storage), but many laymen would take it if it was “in date” – especially once it is removed from the bottle. An aired-out tablet may not have a strong smell, but the bottle quickly does.

This isn’t medical advice. You’re much too smart to take medical advice from a stranger on an Internet BBS, right?

I’d think “heavy” users would be less likely to have old meds just because they’re gulping the stuff down in large, frequent amounts. Before my surgery, a bottle of Tums had a life expectancy of about three days in my hands. Now, the same size bottle would last me about three years.

As for aspirin going vinegary, to my nose, even a brand-new bottle smells like vinegar.

Manufacturers put a healthy (ha!) amount of cushion into the “use by” dates to cut the chances that someone will take something on the last month and have it be bad. My MD says with good storage (the ever-popular cool dark place) meds are generally good for a year beyond date.

Just an anecdote: one of my neighbors once took a Tylenol PM that was past its expiry date (don’t know how far past) and quickly wound up in an ambulance.

Every once in a while, I scour the medicine cabinets and chuck out anything that’s been in there longer than the date on the box, just to be safe.

That makes me think was from taking an expired medication, or from whatever discomfort was spurring your neighbor to take medication in the first place? :slight_smile:

OTC meds are cheap. Why not toss 'em out and get new ones? Now, sure, if the date sez “6/2006” you are pretty safe taking a couple today. But just go get new ones.

Mostly because I’m a cheap bastard.

I get the runs maybe twice a year, so I always end up with this surplus of Immodium every time I buy it. I hate throwing it out.

As far as aspirin goes, I’d better check my desk for the bottle that’s been sitting there for four years or so…

Thanks for the advice.

The Medical Letter on Drugs and Therapeutics addressed this in 2002. Here is their conclusion: “There are virtually no reports of toxicity from degradation products of outdated drugs. How much of their potency they retain varies with the drug and the storage conditions, especially humidity, but many drugs stored under reasonable conditions retain 90% of their potency for at least 5 years after the expiration date on the label, and sometimes much longer.” The full text is available free if you register at http://www.medletter.com/html/PRMreg2.htm