Should I really be concerned about the expiration date on medications?

Dr. John Connolly

You bet there's something to expiration dates. Yes, some prescription and over-the-counter products keep on working long after their expiration dates. The Food and Drug Administration (FDA), in fact, recently ordered pharmaceutical companies to test their products to determine how long they would still deliver as promised.

Counting on expiration dates to be bogus, however, can get you into trouble. There are well-known ways that certain products show their age. Aspirin begins to smell of vinegar as its active ingredient breaks down. Hydrogen peroxide no longer bubbles when you apply it to a wound. Cough syrup--actually its sugar component--crystallizes, a sign of that medicine's diminished effectiveness.

The above products do nothing for you beyond their expiration dates; if you're taking aspirin to thin blood, that's risk enough. But another product, tetracycline, can be poisonous if it's outdated or even poorly stored. (When you are correctly following your prescriptions, no tetracycline or any other antibiotic will be left after the last day.) Another well-known medicine, nitroglycerin, also may do nothing--which can be fatal for heart patients.

There are few things worth knowing about drug expiration dates. First, the fact that pharmaceutical companies will soon be testing the longevity of their medicines and supplements does not mean that a given product will invariably last as long as stated. Products, after all, are tested under ideal conditions: storage within a specific temperature and humidity range, and away from light. Truth to tell, most medicine cabinets are too warm and humid for long-term storage of medicines. To make matters worse, a prescription drug begins its slow march to expiration once its original container is opened (at the pharmacy), not necessarily the day you buy it.

Here are a few tips to helping medicinal bygones be long-gones

• Make a good scan of your medicine cabinet and toss out all expired drug products
• Store medicines in their original containers--but without the cotton, which can promote fungal growth
• Whether or not they have expired, throw away all discolored medicines along with ointments showing marked separation. Ditto for any medicines you cannot identify
• If your doctor instructs you to take a prescription medicine "as needed," pay particular attention to expiration dates but get the date from the manufacturer (say, two years from purchase), not from the pharmacist. In many states, pharmacies are permitted to write their own, earlier expiration dates on medicines. And
• When you do dispose of medicinal products, be sure they are out of reach of children and animals

Should the milk in your refrigerator get too old, you'd pour it out--yet its curdled nature would do little more than give you a stomach ache. With medicines, over-the counter as well as prescription, you aren't just inviting indigestion. Depending on the medicine and its condition, you could also be playing Russian roulette with your health

Dr. John Connolly is President & CEO of Castle Connolly Medical Ltd., America's "trusted" source for identifying top doctors. He has an extensive background in management and healthcare. For more than a decade, he was President of New York Medical College where he successfully revitalized the school while insuring its financial security. Dr. Connolly is extensively involved in healthcare activities including serving as a director of the New York Business Group on Health, as founder, a director and past chair of the American Lyme Disease Foundation, as a member of the Presidents Advisory Council of the United Hospital Fund of New York, and as a Fellow of the New York Academy of Medicine. He has also served on the boards of two hospitals and as chairman of the board of one, and is currently Chairman of Professional Examination Service, Inc. He also is a frequent guest on regional and national TV and radio shows, including 20/20, CNN and Good Morning America.