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Monday, February 17, 2014

Are expired medicines useless?-Altaf Patel

Potency of a medicine does not disappear like Cinderella’s carriage the day after it expires


    A question I am often asked, to which it is difficult to find an appropriate answer, is: is outdated prescription medication safe to take? There are dangers of taking outdated tetracycline, an antibiotic, heart medication like nitroglycerine, which deteriorates with light, and insulin for diabetes, which also deteriorates over time.
    What happens to other medicines?
    Let us say that the expiry date on the bottle is October 31, will the drug lose its potency on November 1? This seems illogical. People in the chemical industry say chemicals rarely deteriorate. A laboratory analysis of eight prescription drugs that expired between 28 and 40 years ago were found to be as potent as they were when they were made.
    Of the 14 compounds analysed, including aspirin, codeine, hydrocodone, phenacetin, caffeine, chlor pheniramine (an anti-allergic histamine), 12 maintained their effectiveness 336 months beyond expiry date, and eight, 480 months before their best before date.The authors of the article state that the study provides additional evidence that many prescription pharmaceuticals retain their full potency beyond their ascribed expiration dates. They also suggest that given the potential cost savings, current practices of drug expiration dating be reconsidered.
    The US food and drug administration permits reasonable variation so that medications marked in the United States contain 90 to 110% of the active ingredient claimed on the label. FDA regulations do not require determination of how long a medicine can remain potent after that and so manufacturers arbitrarily establish expiration dates without really determining its shelf life.
    The Shelf Life Extension Programme checks the stability of federal drug stockpiles. 88% of 122 different drugs stored under ideal environmental conditions had their expiry dates extended by more than a year,with an average extension of 66 months and a maximum extension of 278 months.
    Americans spend more than $300 billion annually on prescription medicines and extending expiry dates would yield enormous savings.
    In 2003, the prestigious British Medical Jour
nal ran an article by Woolrich Burt and Sandford Smith that maintained that outdated drugs could improve the health care of poor patients. It received mixed reactions but perhaps it is even relevant today. Most drugs degrade slowly. The manufacturers of aspirin put on the pack that it will expire within 2 to 3 years of the manufacturing date but the company has tested it after 4 years of packaging and still found it 100% effective.
    I believe that the potency of a medicine does not disappear like Cinderella’s carriage on the best before date. I myself would readily use medicines for cold, allergies, antacids and vitamins
and pain killers after their expiry dates. I would use capsule antibiotics, barring tetracycline, a few months beyond their expiry, but I would not use liquid antibiotics and insulin. It also depends on what condition you are using the medication for, so for a serious infection I would not use an out of date antibiotic.
    However,it is important to know how a medicine should be stored. Most people store them in medicine cabinets in the bathroom.
    But it not the ideal place to store medicines because the medicines deteriorate faster in such cabinets because they are exposed to heat and humidity.


Courtesy : Mumbai Mirror

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