Articles

Cleaning Out Your Medicine Cabinet

By Janna Gordon, R.Ph.

Spring cleaning time is here. This time of the year many people make it a routine to clean out their houses. But how many make it a point to go through their medicine cabinet to clean out expired medication?

A recent survey conducted by McNeil Consumer&Specialty Pharmaceuticals has found some shocking results about patients and their medicine cabinet. The survey, conducted May 31 to June 2, 2005, was part of an on-line educational campaign to inform patients of the importance of the proper use and storage of medications. The survey of 2,311 American adults revealed the following:

-66% of American adults will typically clean out their refrigerator regularly, but only 31% said they clean out their medicine cabinets regularly.
-46% (nearly half) of American adults have taken expired non-prescription medication.
-61% of American adults always check the expiration dates of their over-the-counter medications.

Did you ever wonder how the expiration date is determined on the medication that you take?

Expiration dates for medication are determined by the manufacturer, not the FDA. The company can choose whichever date they feel is appropriate. It is common practice that the date chosen is based on in-house testing of drug stability. Often, the drug companies find that two to three years after the date of manufacture is appropriate. The expiration date set by the manufacturer is not the date after which the drug has "gone bad." It is the date after which the manufacturer can no longer guarantee that the product meets FDA standards.

How is the expiration date on the Rx bottle from the pharmacy determined?

Pharmacy law determines this date. In 1997, it became a United States Pharmacopoeia requirement that, unless otherwise specified in compendium standards, the expiration date on a dispensed medication should be no later that the expiration date on the manufacturer's container or one year from the dispensing date, whichever comes first.

Are expired drugs dangerous?

The short answer is that not all expired drugs are dangerous. Some drugs that degrade easily such as sublingual nitroglycerin and insulin would be dangerous if expired because of loss of potency and subsequent loss of therapeutic benefit. In general, the concern with expired medications is diminished efficacy, not toxicity. However there are some that decompose into a different chemical compound and become dangerous: aspirin degrades to salicylic acid, and expired tetracycline has been associated with nephrotoxicity.

The expiration date set by the manufacturer or pharmacist is assuming that the medication will be stored properly. How and where a medication is stored will affect its long-term stability. So what is the best way to store medications?

It is best to store the medication is the closed container in which they were dispensed, in a cool, dry environment. Exposure to heat, light, and humidity can all adversely affect the stability of drugs. So contrary to popular practice, the bathroom is not necessarily the best place to store over-the-counter and prescription medications. Steam from hot showers and baths can create heat and humidity that can deteriorate drugs faster than usual. Storing medicines in a high heat or humid environment may shorten the lives of drugs and make them ineffective before their expiration date. Kitchen window sills, are often less than ideal too. Medications stored here will be exposed to lots of bright light, and sometimes steam and humidity from the kitchen sink. A cool, dry place is recommended for storage. For example, a linen closet is preferable. Also, if small children are in your household, store medicines in hard to reach places out of a child's reach. Most medicines can be dangerous if accidentally ingested by a child.

A bit of advice on antibiotics: Never keep any prescription antibiotics in your medicine cabinet past the date for which you need them. Always take all antibiotic medication unless your doctor tells you otherwise. Most people will begin to feel better a few days into their antibiotic regimen; however it usually takes a full week for all of the harmful bacteria that caused the infection to be completely killed off. If you find any antibiotics in your medicine storage cabinet, throw them away. Even if you think that you might use them again, you probably won’t have enough left to provide a full course of treatment. Plus, all antibiotics are not considered equal. Each antibiotic that your doctor prescribes for you is designed to target the specific microorganism that you have. So chances are, next time you receive an antibiotic, it will be a different drug, designed to kill a different type of infection.

Here is a list of important, non-prescription medications to keep handy in your medicine cabinet:

-Pain reliever&fever reducer, such as ibuprofen or acetaminophen
-Antibiotic ointment, to put on scrapes, cuts, or burns to reduce chance of infection
-Antacid, for heartburn relief
-Antihistamine, such as loratadine or diphenhydramine for allergy symptoms
-Decongestant, such as pseudoephedrine for relief of stuffy nose
-Hydrocortisone cream, for relief of itching and inflammation
-Antiseptic, such as alcohol or iodine, to prevent infection from minor injuries

Make it a routine of checking your medicine cabinet at least yearly for expired medications. This goes for first-aid supplies too. Discard outdated products, damaged containers, and old supplies. Make a list of what you throw out, and replace supplies at your next visit to the grocery store or pharmacy. Keep all medicines in the containers that they came in; this will prevent you from taking the wrong medicine on accident. Following these guidelines will help you to be better prepared for minor emergencies in the future.