Harvard Health Letter

Medicine cabinet makeover

Remove expired medications to avoid hazards such as accidental poisoning or ineffective treatment.

Like any cupboard in your house, the medicine cabinet can easily become overstuffed with pills, potions, and creams that have expired or are no longer needed. But holding on to them can be dangerous. That’s why experts recommend weeding through your medicine cabinet regularly. “Check it every six months or when you change your clocks,” recommends Joanne Doyle Petrongolo, a pharmacist with Harvard-affiliated Massachusetts General Hospital. “Make it a regular habit to protect your family.”

Medicine cabinet risks

For all their value, the substances in your medicine cabinet pose some risks beyond the side effects of the drugs:

Accidental poisoning. The CDC reports that unintentional overdoses among children ages 5 or younger results in 60,000 emergency room visits each year. More than 90% involve children who get into medication on their own.

Drug abuse by other family members. Research suggests that 60% of people who misused opioids in 2015 did not have a prescription, and 40% obtained the drugs from family or friends.

When medicines are outdated or unnecessary, these risks become unacceptable. In addition, if medications have expired they may no longer be as potent. That could be very dangerous, for example, if you’re taking a drug for an unstable heart rhythm.

Expiration vs. dispensing dates

When you get a prescription drug, the label on the bottle is stamped with the dispensing date (the day the pharmacist filled your prescription). But the dispensing date is not the same as the expiration date.

“The expiration date is the day the manufacturer can no longer guarantee 100% potency of the product,” Doyle Petrongolo explains. “You won’t see expiration dates on prescription medications, but they’re generally within one or two years of the dispensing date.”

You will see expiration dates on nonprescription drugs, such as anti-itch creams like hydrocortisone or over-the-counter painkillers like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin). The dates may be stamped on product’s label, box, or crimp (the end of a tube).

Beyond expiration

Can you use a product beyond the expiration date? “It depends,” says Doyle Petrongolo. “Some products degrade quickly, including liquid antibiotics and compounded medications. You should get rid of those immediately after the expiration dates stamped on the label.” Compounded medications are created just for you and made in a form you can tolerate, such as a suspension liquid instead of a pill.

What about other products? Some government studies have suggested that many prescription drugs are good even three years after the expiration date. Should you automatically apply such an extension when you see that a remedy in your medicine cabinet has expired? “It’s best to talk to your pharmacist first, since each medication has different stability properties,” Doyle Petrongolo counsels. She recommends that you don’t keep drugs that have been shown to fail stability tests past expiration dates, such as aspirin, nitroglycerin, and insulin.

Medicine cabinet staples

Keep these basic nonprescription remedies on hand to help provide relief when you need it.

  • Aspirin for emergency heart attack response (chew one 325-mg tablet and call 911 if you think you’re having a heart attack)
  • Painkiller, such as ibuprofen (Advil, Motrin), naproxen (Aleve), or acetaminophen (Tylenol)
  • Hydrocortisone cream for itch relief
  • Antibiotic ointment for minor cuts
  • Antacid for heartburn, such as combination magnesium and aluminum (Maalox, Mylanta)
  • Artificial tears to relieve dry eyes
  • An antihistamine for allergy relief or itching, such as diphenhydramine (Benadryl)
  • A medicine for diarrhea, such as loperamide (Imodium)

Disposal

Don’t just throw old medications in the garbage, where they can wind up in the landfill, and don’t automatically flush them down the toilet, where they can wind up in the water supply.

The FDA urges you to dispose of medications properly. The best way is to take advantage of drug take-back events held by local law enforcement agencies. The U.S. Drug Enforcement Administration sponsors these events every April and October; for information and collection sites, see takebackday.dea.gov. In addition, many communities and hospitals have drop boxes you can use all year round.

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