How Dangerous is it to Take Expired Drugs?

Here's how much the date on the pill bottle really matters.

by Nick Keppler
Feb 16 2017, 9:07pm

Dwight Eschliman/Getty Images

We don't need to tell you that prescription medications are getting exorbitantly expensive. In 2015, spending on prescription drugs in the US rose to $457 billion, according to the Department of Health and Human Services, an 8 percent jump from the previous year. How much you paid out of pocket probably depends your issues and insurance, but consumers are feeling the increase. 

A recent Consumer Reports survey found that a third of patients reported an increase in prescription drug costs, with most of them absorbing an average of $39 more per refill. Much of this problem is due to spikes in the prices of generic drugs. Among those for whom the price of pills shot up, 40 percent spent less on dining and entertainment, and 32 scrimped on groceries.  

So given that people are bracing themselves at the CVS checkout, some might be tempted to swallow an expired antibiotic or pull an old pill jar from the back of the medicine cabinet. But is that really such a good idea? 

"Long story short, if it is a tablet or capsule and is being used for a non-serious disease, where the results of sub-potency aren't devastating, it's likely okay to take it up to a year or two after the expiration date," says C. Michael White, head of the department of pharmacy practice at the University of Connecticut's School of Pharmacy.

Companies need to assure people that a medication has at least 90 percent of its intended potency when it reaches its expiration date, White says. However, there are no standards about how much potency it must retain afterwards, so the issue hasn't been studied much. 

In one almost impossible-to-replicate case study from 2012, however, researchers at the University of California San Francisco's School of Pharmacy got their hands on the stash of common meds that were left in "ideal" storage at a retailer for decades. All had expired 28 to 40 years before testing. Twelve of the 14 drug compounds tested still had 90 percent potency, even though the most recent use-by dates were in the middle of the Reagan administration. 

"There is good reason to believe that many drugs are still good for a few years after their expiration date," White says, "but there are some very important caveats people need to understand." 

Of course, throw out any meds that look funky—pitch anything discolored, moldy, or crumbling, White says. Also, adhere strictly to the expiration dates of liquid drugs; for anything injected or dropped into the eye, both potency and sterility are issues. And some drugs might completely miss their desired effects with a small drop in potency; these include epinephrine; theophylline; oral contraceptives; and drugs for epilepsy, heart disease, and thyroid issues. 

Antibiotics are also complicated. "By treating an infection sub-optimally, you will get antibiotic resistance," says Christopher Carrubba, a physician and development and education director at Med School Tutors. Bacteria develops resistance to antibiotic medication and is especially prone to do so if confronted by a weaker drug. Essentially, the bacteria will use your expired, sub-potent antibiotic to train and get stronger. For that reason, Carrubba advises against saving antibiotics for common infections, like a urinary tract infection, for the next time the issue arises. 

There's not much risk of harm in taking most expired medications, though, he says. "You're not going to have a situation where you have a weird reaction to the medication. You're just not going to get the maximum effect."

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