Do Medications Really Expire?

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Fin24
Posts: 1699
Joined: Sat 8 Mar 2008 20:14

Re: Do Medications Really Expire?

Post by Fin24 » Fri 10 Apr 2009 22:52

ask for the original bottle or label if possible
that will have a better expiry date than the phial ised for counting from bulk

here are some tidbits re expiration of meds

Jan Engle, Pharm.D., associate dean for academic affairs and clinical professor of pharmacy practice at the University of Illinois at Chicago College of Pharmacy, is the spokeswoman for the "My Medicine Cabinet" program. "So many people don't pay attention to the expiration dates when they buy medicine or when they use medicines from their medicine cabinet," Engle told Drug Topics. "We are trying to educate people to check expiration dates. If you don't use all of the medicine, it goes out of date
http://drugtopics.modernmedicine.com/dr ... ail/193798

that article also says fridge is NOT the best place to store drugs due to moisture

a cool dry place like a linen closet thats not close to a clothes dryer vent, or heating vent seems to be their "best" location for drug storage

K Hartigan-Go - The International Journal of Risk and Safety in Medicine, 2006 - IOS Press
International Journal of Risk & Safety in Medicine 18 (2006) 181–186 ... Using expired
tetracycline has been known to cause Fanconi’s syndrome

http://www3.interscience.wiley.com/jour ... 2/abstract
Stability profiles of drug products extended beyond labeled expiration dates
Robbe C. Lyon 1 *, Jeb S. Taylor 1, Donna A. Porter 2, Hullahalli R. Prasanna 1, Ajaz S. Hussain
American Pharmacists Association J Pharm Sci 95: 1549-1560, 2006
abstracted conclusion
Based on testing and stability assessment, 88% of the lots were extended at least 1 year beyond their original expiration date for an average extension of 66 months, but the additional stability period was highly variable. The SLEP data supports the assertion that many drug products, if properly stored, can be extended past the expiration date. Due to the lot-to-lot variability, the stability and quality of extended drug products can only be assured by periodic testing and systematic evaluation of each lot.

since we cannot be assured of the lot to lot variability and the storage of the drug after it leaves the manufacturer as well as our own storage PLUS the added risks of relabelling that has been known to occur within mass suppliers and wholesalers' warehouses--why would you take the chances of old, less effective or changed drugs??

the latter is the most worrisome--the deterioration of a drug that would change it into something more toxic

and as for the tetracylcine myth here are several articles that convinced me
http://www.ncbi.nlm.nih.gov/pubmed/14258922
ACQUIRED FANCONI SYNDROME FOLLOWING DEGRADED TETRACYCLINE.
J Pediatr. 1965 Feb;66:333-42.


Renal Tubular Acidosis Caused By Degraded Tetracycline

LAURENCE C. WEGIENKA, MD; JOHN M. WELLER, MD


Arch Intern Med. 1964;114(2):232-235.
We have studied a patient who presented with severe metabolic acidosis after taking outdated tetracycline. Ammonium chloride loading demonstrated a renal tubular defect for hydrogen ion excretion.

Kidney International (1981) 20, 705–716; doi:10.1038/ki.1981.200

The Fanconi syndrome and mechanisms of tubular transport dysfunction
Karl S Roth1, John W Foreman1 and Stanton Segal
cites these references
Frimpter GW, Timpanelli AE, Eisenmenger WJ, Stein WS, Ehrlich LI: Reversible Fanconi syndrome caused by degraded tetracycline. JAMA 184:111, 1963
Gross JM: Fanconi syndrome (adult type) developing secondary to ingestion of out-dated tetracycline. Ann Intern Med 56:523, 1963

Campylobacter Infections: Treatment & Medication
Author: Jocelyn Y Ang, MD
Updated: Sep 7, 2007

never administer outdated tetracyclines; degradation products of tetracyclines are highly nephrotoxic and can cause a Fanconilike syndrome

Published Online, 27 April 2004, http://www.theannals.com, DOI 10.1345/aph.1D573.
The Annals of Pharmacotherapy: Vol. 38, No. 6, pp. 1031-1038.
Antimicrobial-Associated Renal Tubular Acidosis
Brian A Hemstreet, PharmD BCPS
Assistant Professor, Department of Clinical Pharmacy, School of Pharmacy

Antimicrobial-associated RTA is a relatively uncommon adverse effect, with most reports involving amphotericin B, trimethoprim/sulfamethoxazole, and outdated tetracycline

and page 91 of the Encyclopedia of clinical Toxicology,2002 edited by Rossoff
states that not only renal toxicity " reported worldwoide" but LUPUS as well has been reported as a result of ingesting outdated tetracycline

I dont need to read anymore...but if you do, try google scholar and pubmed using
"risks of using outdated tetracyclines"
"degradation of tetracyclines"
"risks of administering outdated drugs
"expirations dates of pharmaceuticals
"accuracy of pharmaceutical expiration dates

etc

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