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If you’ve ever reached for a bottle of ibuprofen when you had a headache only to find the expiration date has passed, you might be wondering if you can take an out-of-date medication, if it will make you sick, or if it simply won’t work once it’s past its intended shelf-life.
The answer isn’t a simple yes or no. Some medications—both over-the-counter and prescription—lose their potency when they stay on the shelf too long but some can become dangerous and even toxic.
A drug’s expiration date is when its active ingredients are no longer at full potency, as determined by the drug manufacturer. In addition to not working, some medications are also unsafe when they are past their expiration date.
Is it safe to take expired medicine?
There’s no specific time period past an expiration date that a medication can be guaranteed safe and effective. Assuming risk when you take expired drugs comes down to how dangerous it is to take that particular medication and how badly you need it.
“Most medications are not toxic after they expire,” says Christina M. Madison, Pharm.D., the founder of The Public Health Pharmacist. However, there are several drawbacks to popping those pills past the “use by” date:
- Medication will begin to lose efficacy, potency, or may not work as directed. This is problematic or dangerous if you’re taking it to manage a serious condition, such as taking aspirin to manage a heart problem.
- Side effects may worsen. Meaning, any adverse event you may already experience could be magnified once an Rx is expired.
- Expired medications can be at risk for bacterial contamination. It’s best not to add a new illness because of bacterial growth in your old meds.
“To be safe, only use medications that are not expired,” says Kelly Johnson-Arbor, MD, medical toxicologist and medical director at the National Capital Poison Center.
If you can at all help it, do not use expired medicines. However, if it’s a life-saving treatment—such as nitroglycerin or albuterol—it might still work if you don’t have any other options. It’s best to stay on top of refills to make sure you don’t have to use old prescriptions, but you can call your healthcare provider or pharmacist if you are in a pinch and need advice.
Which medications are unsafe after their expiration date?
There are some medications that should not be used after their expiration date. For example, certain antibiotics should never be taken after their expiration date. That being said, you should rarely have expired antibiotics as a full course should be completed when prescribed. Stopping your antibiotics before finishing the recommended course can contribute to antibiotic resistance.
Medications that were studied and found unstable—showing signs of physical decay and lost potency—after their expiration date include:
- Liquid antibiotics
- Aspirin
- Nitroglycerin
- Insulin
- Tetracycline
- Mefloquine
- EpiPens
In these cases, context matters. Meaning, if you need nitroglycerin for a dangerous heart problem, or if you have life-threatening allergies, “use of expired allergy medication may result in inadequate control of allergy symptoms,” says Dr. Johnson-Arbor. Make sure you are well-stocked with up-to-date prescription medications if you have a serious health condition where full efficacy of your drugs really matters.
Additional extenuating circumstances may arise in which the expiration dates of life-saving medications may be reconsidered. In 2021 when a severe shortage of EpiPens occurred, the drug company Pfizer coordinated with the Food and Drug Administration (FDA) to extend expiration dates as a management strategy. This was done after detailed review of stability data, and applied only to certain lots manufacturered of this medication indicated for severe allergic reactions.
Which medications are likely safe after their expiration date?
“No medications should ‘technically’ be used beyond their expiration date, but there are some instances that expiration dates could be extended in response to a drug shortage,” says Dr. Madison. In these instances, the U.S. Food and Drug Administration (FDA) will indicate if a drug is deemed safe after the “use by” date on the package. Similar to what happened with EpiPens, additional examples include COVID-19 vaccines, COVID-19 therapeutics, and antiviral medications used to treat the flu, such as Tamiflu.
However, research has found that many medications retain their full potency even many years after the expiration date. Some examples of these drugs that may lose some efficacy, but are most likely safe and effective include:
- Over-the-counter (OTC) painkillers, such as acetaminophen
- Prescription painkillers, such as hydrocodone, codeine, and butalbital
- Sedatives, such as methaqualone and pentobarbital
- Allergy medications, such as Zyrtec or Claritin
There may be more medications that are safe long after their expiration date. Yet, most of the research done is dedicated to prescription drugs used by the military or in government stockpiles, rather than the meds most commonly found in your medicine cabinet.
To maximize the safety and effectiveness of all your medications, make sure to store them in a cool, dry place, and keep them in the original containers. They are designed to protect them against sun and moisture damage.
What should you do with expired medicine?
Proper disposal of expired and unused medications is very important to prevent accidental poisoning, as well as preventing damage to the environment. Depending on the medication, there are a few main ways to get rid of old drugs:
- Use a drug disposal event or drug take-back programs.
- Flush dangerous meds, like opioids.
- Mix medication with an unpleasant substance, such as coffee grounds or kitty litter, and throw it in your household trash.
RELATED: How to get rid of unused medicine
If you’re uncertain whether a medication is safe to take, you can always ask your pharmacist or you can reach out to Poison Control for advice at poison.org or by calling 1-800-222-1222. Both options are free, confidential, and available 24 hours a day.
