Expired Drugs. Die or Ditch? New Report

[amytom]

So the Cipro and Augmenten should be good for a long while but what about the xylocaine?


Sent from my iPhone using Cruisers Sailing Forum

[Lagoon440Bora]

Blisterized dry forms hold almost forever. If you see some weird shapes or suspect moisture, then trash them. American "orange bottle" pills are more tricky, you never know how much moisture you get in there. You have to know that pharma's have to run stability validations for all their drugs and have renew them as soon as they modify the tiniest part of their operations, such as replacing a machine on a production line. This is a regulatory burden. Hence the short shelf-lives, they do not want to wait the five years to have a 5 year shelf life. Besides, a shorter shelf-life = more turn over. Blisterized dry forms usually last for 10-15 years without problem. Liquid forms are more tricky. Suppository might melt and re-form usually without altering their properties though their look might be weird. Antibiotics might (as per above post) see their property altered with time, as well as some high tech rare drugs.

[maxingout]

When we went on our circumnavigation, we purchased all of our drugs overseas at a fraction of the price that is charged in the USA. In many countries we did not even need a prescription for the meds. I just took a list in to the pharmacy and walked out with everything I needed.

Drug prices in the USA are a massive rip off. I will always replenish my sailing meds overseas.

Since I could easily get meds overseas, I throw away expired medications. No reason to take a risk with expired meds when they are cheap outside the USA.

[Wanderlust]

Thanks Mark for raising this issue and linking the study. I have had a few discussions with my family members who want me to throw out my old drugs and I refuse unless they show visible signs of deterioration.

Originally Posted by a64pilot

I assume a Pharmacist would know better than a Dr?

Sure, ask a pharmacist who makes money by selling you replacements. For either a doctor or a pharmacist, would you really expect them to go out on a limb and advise that the manufacturer's expiry date can be safely ignored. Sounds like too much risk of an expensive lawsuit for no benefit to them.

I recently used some 25 year old penicillin which I had in reserve in case of difficulty or delay getting to see the doctor. It worked perfectly.

Also, for my locally prepared seasickness medication, I called and asked them why it only had a 6 month expiry. They said it was because that period was all they had tested it for and so that was the only expiry date they could give. My take on it is they have no benefit in paying for certification for a longer period because they will lose sales to people who would otherwise throw them out.

[mcarling]

There is no reason not to the read read the link which MarkJ so kindly provided. If one doesn't follow the links in the footnotes, it's about two minutes of reading, but quite informative.

[amytom]

No opinions on expired xylocaine? Only to be used for putting in stitches.


Sent from my iPhone using Cruisers Sailing Forum

[FecklessDolphin]

my understanding is that drug companies do just pick a date "out of a hat" as the expiration date. However, they are obligated to show that the medication is still 90% effective on that date. They are not required to continue testing the drug to see when it drops below 90% effectiveness. So while a medication's expiration date may be labeled on the package, we don't know when it actually becomes ineffective. And I have seen no evidence that medications turn into something more effective or potentially dangerous. They probably just become inert.


Sent from my iPhone using Cruisers Sailing Forum

[belizesailor]

Ive had this conversation with charter guests who were docs and pharmacists. Their concensus was that almost all drugs just lose their potency. There was one drug, which I dont recall, that did atually degrade into something bad.

[Muckle Flugga]

Originally Posted by MarkJ

Cruising "out there" means long expired drugs in the cabinet or First Aid Kit.

Some cruisers say you will die poppin an expired drug. Some say they last forever.

A new reports show that its closer to Forever, and NO toxic worries.

Drugs degrade over the years, but we are talking up to 50 years. Many are fine to 5 years after expiry just maybe the dose has dropped off a bit

So have a look at this report and lets here your thoughts. (Please read the report before you comment. I will know )



https://m.medicalletter.org/w1483b


Would particularly appreciate any Medicos thoughts


Mark



Sent from a stupid phone that replaces words with weird stuff.

Well, the advice i have had from a number of physicians is that the dates on MOST drugs are more about forcing turnover to keep the sales ticking over for industrial applications. This does not apply to some, of course, which may need to be refrigerated, for example tetanus injection ampoules or ergometrine. However "most" drugs will be just fine for FAR longer than the date on the packed and I certainly would not advise throwing them away. Further, I have also discussed this a few years ago with the chief doctor in charge of ABSAR, (Antigua and Barbuda Search and Rescue) which are for all intents and purposes the go to guys for yachts and marine medicine in that area, as well as general emergency response in the Eastern side of the mainland. They get the overwhelming majority of their stock from Superyachts overhauling and renewing their kit (as no expense spared etc. and for insurance), getting rid of the out of date drugs, which ABSAR use habitually, and their staff are first world emergency medicine specialists. Their advice was the same. You do need to consider a case by case however, and unfortunately the likes of EPIPENS are not among the long lasting variety… in my understanding. For that reason if on a budget rather than autoinjectors, it is possible to ship epinephrine ampoules rather than auto injectors… though of course less easy to apply and dosage must be more carefully managed.

As always, consult an actual physician. But broadly agree.

[groundtackle]

Originally Posted by Muckle Flugga

Well, the advice i have had from a number of physicians is that the dates on MOST drugs are more about forcing turnover to keep the sales ticking over for industrial applications. This does not apply to some, of course, which may need to be refrigerated, for example tetanus injection ampoules or ergometrine. However "most" drugs will be just fine for FAR longer than the date on the packed and I certainly would not advise throwing them away. Further, I have also discussed this a few years ago with the chief doctor in charge of ABSAR, (Antigua and Barbuda Search and Rescue) which are for all intents and purposes the go to guys for yachts and marine medicine in that area, as well as general emergency response in the Eastern side of the mainland. They get the overwhelming majority of their stock from Superyachts overhauling and renewing their kit (as no expense spared etc. and for insurance), getting rid of the out of date drugs, which ABSAR use habitually, and their staff are first world emergency medicine specialists. Their advice was the same. You do need to consider a case by case however, and unfortunately the likes of EPIPENS are not among the long lasting variety… in my understanding. For that reason if on a budget rather than autoinjectors, it is possible to ship epinephrine ampoules rather than auto injectors… though of course less easy to apply and dosage must be more carefully managed.

As always, consult an actual physician. But broadly agree.

Nearly all substances degrade with time and other factors such as temperature, relative humidity, exposure to enriched oxygen and the sealed nature of the container and the presence of bacterial contaminants will affect the rate of degradation. Drugs that are indicated to refrigerate are generally so because they are subject to more rapid breakdown often due to bacterial action. Frequently these are liquid medications that are predisposed to growing bacteria. For most medications, other than those that require refrigeration, the stability of the active ingredient is going to far outlast the expiration date so long as storage is dry and not excessively hot or in a few cases excessively cold. At least that's what I've come to believe.
Nick


Sent from my iPad using Cruisers Sailing Forum

[boatman61]

Only carry Paracetamol...

[Muckle Flugga]

Originally Posted by nshawdvm

Nearly all substances degrade with time and other factors such as temperature, relative humidity, exposure to enriched oxygen and the sealed nature of the container and the presence of bacterial contaminants will affect the rate of degradation. Drugs that are indicated to refrigerate are generally so because they are subject to more rapid breakdown often due to bacterial action. Frequently these are liquid medications that are predisposed to growing bacteria. For most medications, other than those that require refrigeration, the stability of the active ingredient is going to far outlast the expiration date so long as storage is dry and not excessively hot or in a few cases excessively cold. At least that's what I've come to believe.
Nick


Sent from my iPad using Cruisers Sailing Forum

I would certainly agree with this.