Have you ever grabbed a bottle of Tylenol from your medicine cabinet, discovered that it expired two years ago and wondered whether you can still take it?
You really shouldn't, cautioned Robert Frankil, a pharmacist and executive director of the Philadelphia Association of Retail Druggists, which represents about 250 independently-owned pharmacies in Pennsylvania.
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"At that expiration date, it's expected to be 100% or nearly 100% potent, and after that expiration date, it will begin to lose its potency slowly," Frankil said.
The U.S. Food and Drug Administration began requiring drug companies to put expiration dates on over-the-counter and prescription medications in 1979. Pharmaceutical companies must conduct comprehensive testing on how a drug breaks down over time and in different environments to establish a medication's shelf life. Medications can be "less effective or risky due to a change in chemical composition or a decrease in strength" past their expiration dates, according to the FDA.
Frankil advised people not to take over-the-counter medications after their expiration dates, because the medications do not hold their "stability," Frankil said. "They don't become dangerous. They just become less effective after the expiration date."
With prescription drugs, such as antidepressants, it is especially important to observe expiration dates, Frankil said.
"If you're talking about something like depression, you want to make sure your medication is potent, so I would never mess around with a drug that's treating a chronic ailment – if it was past its expiration date," Frankil said.
Some research, including a 2019 systematic review of studies, has found that many medications can be used beyond their expiration dates. "It was not uncommon that the actual shelf-life exceeded the manufacturer assigned one by three- or four-fold," the 2019 literature review concluded.
But Frankil said he, personally, would not take any medication past its expiration date.
However, he said that "... if it's either that or nothing, and you wake up at two in the morning with a bad headache," taking a common analgesic like Tylenol that is less than a year past its expiration date would be OK.
Frankil recommended grinding up unused, expired medications and throwing them out with the garbage, rather than flushing them down the toilet, which can pollute water and unintentionally expose people to medications. Burying medications in containers of coffee grounds before dumping them in the trash is another option. Also, some pharmacies have medication disposal packages, which also are available on Amazon.
The U.S. Drug Enforcement Agency has a locator for collection sites where people may dispose of certain drugs, such as opioids.