Certain medications in your cupboard can be amazingly helpful for family life. Whether you’ve got a cold or are fighting an infection, certain products can be very helpful to have to hand for yourself and your children.
However, while building up a selection of medication to use when necessary, you may find that certain products you have stashed away are approaching or past their expiry date. When things are busy - between parenting, work and everything else - it is understandable that you might be tempted to still use them.
However, as we will explain - with the expert insight of two superintendent pharmacists, Carolina Goncalves of Pharmica and Abbas Kanani of Chemist Click - using medicines that have gone off may not only be ineffective in helping symptoms but can be dangerous. As such, we will share the importance of expiry dates and why medications degrade over time, as well as the warning signs they may be no longer safe to use and how best to store them.
Additionally, it is always important to follow official NHS guidelines on medicines and seek personalised advice from a healthcare professional where necessary.
Can medicines go off?
“Over time, the active pharmaceutical ingredient within a medicine can undergo various chemical reactions that degrade its potency and potentially form harmful by-products,” explains Goncalves. She adds: “Improper storage conditions, such as high humidity and temperature, can further amplify these degradation processes.”
Kanani also told us, “Packaging can affect the stability, such as the type of material used and how well it is sealed. Some medication is also light-sensitive. What’s more, liquids tend to be less stable than solid medicines, such as tablets, because of the higher risk of bacterial growth.”
There is an important difference between expiry date and how long it should be used after opening - and you should always refer to both on the packaging. For example, common family medications include:
- Calpol (paracetamol suspension): Usually lasts for about two years unopened. Once opened, it should typically be used within six months.
- Piriton (chlorphenamine): Has a shelf life of about two years. Once opened, it's best used within six months.
- Ibuprofen (syrup or tablets, depending on a child’s age): Generally lasts for around two to three years unopened, and should be used within six months of opening.
- Antibiotics (for example, amoxicillin): Often need to be discarded if unused seven to 14 days after being reconstituted (mixed with water).
6 signs medication has gone off
“The signs that a medication has degraded will vary depending on the specific medication,” notes Goncalves. “Changes can suggest that the active ingredients may have broken down, potentially reducing the medication's effectiveness and safety. It is important to regularly check medications for these signs of degradation and consult a healthcare professional if any changes are observed.”
Common physical indicators include:
- Changes in colour
- Development of a potent or unusual smell
- Alterations in texture, such as the medication sticking together or becoming harder or softer than it originally was
- Presence of precipitates or cloudiness in liquids
- Tablets that are powdery or crumbly
- Capsules may be sticky, hardened or discoloured
What are the risks of using expired medicine?
“They may become less effective or hazardous due to alterations in their chemical composition or a reduction in potency,” warns Goncalves. “Some expired medications are susceptible to bacterial growth, and sub-potent antibiotics may fail to treat infections, potentially resulting in more severe illnesses and antibiotic resistance.”
This is worrying not just because the medication is ineffective, but because it could be a health risk. “Chemical changes that happen with some expired medications produce harmful by-products,” he stresses. “An example of this is tetracycline antibiotics, which when degraded, can cause kidney damage. Allergic reactions and unpredictable side effects can also occur.”
Why do medicines have expiry dates?
“The expiration date on medication indicates the point until which the manufacturer can guarantee the full potency and safety of a pharmaceutical product,” explains Goncalves. “After this date, the effectiveness of the medication may diminish, and its safety cannot be guaranteed.”
However, this isn’t the only important number you’re likely to see on medication. “An expiry date discloses the shelf life of an unopened medication and the date when the product should no longer be used,” notes Goncalves. “A period-after-opening - or PAO - date reveals how long an individual has to use the product once it has been opened before its effectiveness is compromised.”
Expiration dates are carefully decided. “This is through a rigorous process involving stability testing that is conducted by the manufacturer,” explains Goncalves. “It assesses how the active ingredients in the medication deteriorate over time under various environmental conditions, such as temperature, humidity and light exposure. Based on these factors, they calculate the expiration date to determine how long the medication remains safe to use.”
So, it’s a bit like food expiry dates? Not quite. “Both food and medication expiry dates are important to adhere to, however, food expiration dates are based on the quality of the product, whereas medication expiry dates are determined by the safety of the product,” she points out. “Medication expiration dates are therefore vital to follow to prevent any safety risks and potential health complications.”
Common storage mistakes and their effects on medicine
“The correct way to store medication ultimately depends on the type of medication in question,” notes Goncalves. “Most tablet- and capsule-based medications are formulated to be stored in a cool, dry place away from direct sunlight. Therefore, a common storage mistake is to keep these medicines in places where they can be affected by changes in humidity or temperature, such as a plastic bag.”
Goncalves continues: “Another common mistake is to store medication in a car, especially on a sunny day, since doing so can cause the medication to heat up and compromise its efficacy. Additionally, storing medication in areas where children and/or pets may get to it is a common mistake and may result in potentially hazardous consequences.” Kanani adds: “Some medications are required to be stored in a fridge, which can often be overlooked.”
Experts recommend storing medication in its original packaging, away from direct sunlight, and out of the reach of children or pets.
FAQs
Can I use Calpol if it’s just past its expiration date?
It is important to only use medication like Calpol that is in date. “Expired medical products may become less effective or hazardous due to alterations in their chemical composition or a reduction in potency,” warns Goncalves.
How long can Calpol be used after opening?
Once opened, Calpol - a paracetamol suspension - should typically be used within six months. If unopened, it can be stored for two years. However, it is important to refer to the specific instructions that come with the medication.
Can I use Piriton if it’s just past its expiration date?
This is not advisable. “As well as being ineffective, chemical changes that happen with some expired medications can produce harmful by-products,” says Kanani.
How long can Piriton be used after opening?
If you’ve already opened liquid-based Piriton - or chlorphenamine - it is best used within six months. However, if unopened it usually has a shelf life of about two years. However, it is important to refer to the specific instructions that come with the medication.
Is it safe to use medicine close to the expiry date?
The expiry date of a medication denotes the date after which it may not be as effective or could be unsafe to use,” explains Goncalves. “With this in mind, using medicine before the expiry date is theoretically safe, but I would not personally recommend it.
“This is especially the case for critical medicines, such as those used to treat chronic conditions or conditions affecting key organs. Using medicine that is close to expiry in these cases can pose serious health risks. Always consult a pharmacist or doctor to be on the safe side.”
What should I do if I accidentally take expired medication?
“It depends on what type of medication it is and how long it has been since it expired,” says Goncalves. “In some cases, expired medication will simply be ineffective and may not adversely affect the body - however, in other cases, the medication may become toxic.”
Kanani suggests: “Look out for any immediate adverse effects such as feeling or being sick, dizziness or allergic reactions. Severe symptoms should have immediate medical attention.”
Goncalves adds: “The best course of action in this scenario would be to contact a GP or doctor immediately, tell them key details such as the medication name, dosage and expiry date, and follow their instructions carefully.”
If you experience any adverse effects after accidentally taking expired medication, dial ‘999’ immediately for an ambulance so you can be taken to A&E at your nearest hospital.
What is the best way to dispose of expired medication?
“It is strongly recommended that you take expired medication to a pharmacy for safe disposal,” says Goncalves. “If you are unable to do this yourself, contact someone who may be able to assist you.”
Goncalves notes that, failing this, as a last resort you can dispose of it yourself as long as you take important steps. “Remove the label from the medication packaging and throw any empty blister strips inside the packaging in the bin,” she explains. “Mix any leftover medication, such as tablets or capsules, with dirt or an inedible substance, and place the mixture in a sealable bag.” There will be disposal instructions on the information leaflet that comes with the packaging.
