When expired medicines can still be used

Generally, there's no doctor or pharmacist with professionalism and ethics who can advise you to use expired medications. But since medicines are wasted in Italian homes, partly because 40 percent of packages are past their expiration date, it's important to answer some questions. Is it really dangerous to use expired medications? Are there exceptions? And if so, which ones?

The expiration of a drug

The expiration date of a drug should be considered mandatory. However, there are several scientific studies, especially from American sources and the Department of Defense, which demonstrate how some solid drugs They remain stable even years after the expiry date, provided they are stored in perfect and controlled conditions.

The most important study on the subject was published in 2006 on Journal of Pharmaceutical Sciences and it is titled Stability profiles of drug products extended beyond labeled expiration datesConducted under the program Shelf‑Life Extension Program (SLEP), promoted by Food and Drug Administration (FDA) for the United States Department of Defense (DOD) analyzed 122 different drugs, for a total of 3,005 batches. Main result: 88 percent of the tested batches were still "extendable" at least 1 year beyond the original expiration, with a average extension of approximately 66 months (i.e. 5-6 years). The study concludes that many medicines – if stored optimally (original container and under controlled conditions) – “can exceed their assigned expiration date.”

Medicines that may exceed their assigned expiry date

Following the thread of the American study, confirmed by other, subsequent research, medicines that may exceed their assigned expiry date However, they belong to a well-defined and limited group of drugs. They are the most stable of all because they contain minimal water and the active ingredient is less susceptible to degradation. For example:

• Analgesics such as ibuprofen, naproxen, paracetamol (in tablets)
• Antihistamines such as  loratadine and cetirizine
• Thyroid medications like levothyroxine (less stable than others but still more stable than liquids)
• Antacids in tablets
• Multivitamin tablets (although vitamins lose potency over time)
• Some medicines in hard capsules (gelatin)

Never use expired lifesaving medicines

Once the perimeter of the drugs that can be used has been limited, possibly even after the expiry date, it is important, in order not to waste one's health, to clarify well which are the drugs that under no circumstances and for no reason can they be used after their expiry date, starting with life-saving drugs.

They define themselves lifesaver all the drugs that theAIFA (the Italian drug control agency), an excellence of our country) defines as medicines essential for the survival of the patient, such as for example drugs anticancer drugs, anticoagulants or insulin for diabetics. These are drugs generally characterised by daily and long-term administration, but also emergency administration as in the case of antidotes to various poisons or toxic substances. Precisely for this reason their effectiveness must be absolutely maximumIf taken after the expiration date, they may be less effective and therefore pose a real threat to the life of the user. In these cases, it is necessary to strictly adhere to the date indicated on the packaging.

Never use expired antibiotics

AIFA, following the lead of many scientific studies, has warned about the dangers of degradation of the active ingredient or excipients of antibiotics. Even very low doses could trigger allergic reactions or Fanconi syndrome, a very rare disease that causes serious kidney damage. Expired antibiotics should never be used for three main reasons: reduced effectiveness (they do not eliminate the infection which can thus worsen), specific risks of chemical degradation (some expired antibiotics become toxic), and clinical safety issues (the microbiological risk is very high).

Also the formulation of the medicine It is important in choosing whether or not to consume them after their expiration date. Recent studies on the stability of drugs have shown that tablet formulation remains stable 100% up to 24 months after the expiration, this is not the case for medicines in liquid form, such as injectables, eye drops, syrups, which should never be used after their expiration date because they may have deteriorated. Check carefully whether the liquid appears cloudy or has sediment: This is a sign that the medicine has been altered. However, changes in the drug are not always visible to the naked eye, so the rule is to discard liquid medications after the expiration date.

The same care and caution as with antibiotics should be applied to drugs for infants and children. The situation is always the same: even if the toxicity is non-existent, allergic reactions could develop due to the degradation of drug components. Having a

Stability and toxicity studies require optimal storage conditions. Improperly stored drugs cannot guarantee their full efficacy or non-degradation.

Let's forget about the drawers of the bathroom, or the kitchen cupboard: these are the two hottest and most humid rooms in the house, not exactly ideal for storing medicines safely.
In fact, to be consumed even long after opening and the expiry date, they should be kept in cool, dry places, with stable temperatures not lower than 10 degrees and not higher than 24-25 degrees, therefore it is necessary to keep them in rooms of the house different from those where we usually keep them.

Much better the stay or the bedroom, in places that are not easily accessible to children. The deterioration of medicines can, in fact, be accelerated by agents such as humidity, direct light, heat sources and high temperatures.
Be careful with vaccines or injectable drugs, which often involve the Store in the refrigerator at a temperature between 2 and 8 degreesIf in doubt, always follow the package leaflet or instructions on the packaging.

When the date of starting use of the medicine also matters