An area of great concern is teen age suicides, drugs in medicine chests left unattended and available to those who intend to do harm to themselves. Be certain of a safety program and leave the temptation without product. I would like to recommend a sure safety disposal product simple and easy to use. Mallinckrodt Medication Disposal System, a division of Verde Technologies.
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I share pertinent articles to my circle of influence assuming sound minds read them ;) I have a lovely elderly neighbor who sees me as her companion and allows me to partner with her wellness and personal care so we go through hers bottles and I explain the above reasoning as we sort them. She, like most seniors is very reluctant to throw away what her money has paid for, but understands the expiry logic. My Mom has Alzheimer's so I have to go through her bottles while she's elsewhere and dispose of them discreetly or she'd be taking rancid oils, spoiled liquids, and storing them on top the fridge or in the windowsill. My goal is to respectfully support these dear ladies health while protecting their best interest.
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I used to work with a company that produced biologicals which are less stable than pharmaceuticals and often of variable potency. Expiration dates were based upon stability studies. Some products probably started losing some potency even before the expiration dates while others retained it past them. I sometimes had to handle calls from clinics asking about potency a short time after the expiration date, and I had to be very careful about what I said due to liability issues, usually stating that "we cannot guarantee stability after the expiration date" although the stability obviously didn't "fall off a cliff" at midnight. In that company we had a pharmacist with whom I had a discussion on potency of pharmaceuticals, and she mentioned that most retain their potency past the expiration date (with insulin being an important exception along with a couple others). I would expect common sense to play a part--e.g., expiration date last week as opposed to 10 months ago for a product having a date a year from purchase. Often a physician can provide some insight--I remember one indicating that it "doesn't matter" for a particular item whose expiration date was almost a year earlier. Essentially all items have dates stamped on them due to FDA requirements, even if they are as stable as table salt.

For many OTC items and certain prescription items such as a topical cream, one uses only a small portion and use is discontinued after the malady has resolved. When I visited Taiwan about 35 years ago, a friend needed an antacid tablet, and he was able to purchase just one pill from the pharmacy! I thought this was a great idea that would save money and also reduce the problem of "leftover" medications. I suspect the bureaucracy involved would prevent such an option in America.
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Ask your doctor - some medications never go bad - pain pills last almost forever.
Some heart medications can expire - but only your doctor or pharmacist would know.
The VA has told me that most often you have an extra year after the date on the bottle. Most often.
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I would say yes, bundle up in a sealed plastic bag. Not sure how the Pharmacy would dispose of them but better to slowly dissolve in a landfill than our waterways. If your septic is occasionally pumped; how is the wastewater disposed of? I would think landfill is still safer for all of us.
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Why take the risk? Bundle old, unwanted meds into a sealed bag, put them in a safe place and just take them with you next time you go to a pharmacy - it doesn't even have to be the one you originally obtained them from. Then the environmental question won't even arise.
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I was told that if you have a septic tank, it's okay to flush, is that true?
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If you flush ANY meds you are POISONING the environment. I don't care what the FDA says is safe to flush. If you do then you are giving all those meds eventually to the water that others will consume and aquatic life live in. We have far too many toxins in the water already!
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I have scant sympathy for anyone who takes expired medication and then grumbles that it doesn't work. Be sensible. Yes, "Big Pharma" does like to maximise its profits, and erring on the side of caution helps that aim. Nevertheless, it's up to you - you can stay within the guidelines or not, as you please, just don't say they didn't tell you.

Oh, and if you still have leftover prescribed medication hanging around the medicine cabinet after it's expired… you shouldn't have (though we've all done it, haven't we?). Take it back to the pharmacy, as you should have done at the time of the relevant illness, five years ago or whatever.
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