Can you take medication that has expired?

By: Chium Feng Yong, Senior Pharmacist, National Cancer Centre Singapore (NCCS)

Before taking your medication, always remember to read the instructions on the label and packaging. (Credit: iStock.com/ amenic181)

Ever wondered whether you can take expired medication? How can you tell when a medication has gone bad? Is pill hoarding a bad idea? The NCCS pharmacy team has the answers to your questions here.

1. Is it safe to consume medications that are past their expiry dates? What are the potential side effects?

You should not consume medication that has passed its expiration date, because the chemicals in them would have broken down, making them ineffective or potentially harmful to your health. For example, using an expired anti-itch cream is not only ineffective in relieving itchiness but may also leave the skin more irritated and inflamed. Expired medications may not be effective to manage symptoms or the disease condition. This could lead to further complications or delays to effective treatment and recovery.

2. Other than expiry dates, what other factors influence the safety, efficacy and potency of medications?

• Storage Conditions – Medications should be stored in a cool, dry place, away from sunlight and heat, unless otherwise specified. Not storing the medication at the right temperature may alter active ingredients and decrease the effectiveness of the medication or in some cases, cause them to become harmful.

• Administration – Read and understand the advisory and cautionary instructions on medication labels. Examples of common instructions include “swallow whole” (do not crush), “take before food or on an empty stomach”, “take at night or in the day” “take after food”, etc.

For example, Nifedipine, a medication to lower blood pressure, is a long-acting tablet designed to gradually release medication into the body over a period of time. The advisory states to take it whole. It should not be crushed and taken as it could lead to a sudden drop in blood pressure that can be dangerous.

• Food & Drug Interactions - Some food and fruit can negatively affect the efficacy and toxicity of certain medications. For example, it is not advisable to take grapefruit with Tamoxifen as an enzyme in grapefruit decreases the effectiveness of Tamoxifen.

• Drug & Drug Interactions – Some medications may negatively affect the efficacy and toxicity of other medications. For example, it is advisable to consume Dacomitinib (a lung cancer drug) at least 6 hours before or 10 hours after taking Famotidine (gastric discomfort relief medicine). Using them together may lead to decreased absorption of Dacomitinib, and therefore decrease effectiveness of the lung cancer drug. If in doubt, consult your pharmacist about the different drugs that you currently take, to check for any significant drug interactions.

3. How can you tell if a medication has gone bad even if it has not passed its expiry date?

Incorrect storage and handling may result in deteriorated or damaged medication. Do not consume medication that has changed colour, texture, smell, become cracked or powdery.

Do not consume medication that has turned powdery. 
(Credit: iStock.com/pedphoto36pm)

4. How should we dispose unused or expired prescription medication?

Follow these general guidelines:

• Remove and destroy all personal information on medication labels to protect your identity and privacy.

• For tablets and capsules such as Paracetamol and Tramadol, it is good practice to dissolve them in water and mix the liquid with dishwashing detergent. Place the mixture in a sealed plastic bag and dispose of it with your trash. This reduces the likelihood of children or pets accidentally consuming the medication.

• To dispose injections, re-cap the needle immediately after use to prevent injury.

• For larger liquid medication quantities exceeding 250mL, dispose of them over a few days. Empty the contents onto absorbent materials such as newspaper.

• Unused or expired controlled medications and cytotoxic drugs can be returned to the public health institutions pharmacy where they originally got the drug. The pharmacy will ensure proper and safe disposal of the drug. Examples of controlled medications include Morphine, Fentanyl, Oxycodone, Ketamine, Methadone, Methylphenidate, Pethidine.

5. Some patients hold on to extra medication thinking that it will come in handy in the future. Is it safe to share prescribed medications with family members?

It is not safe to share prescribed medication with others. While some conditions may appear to share similar symptoms, they may be caused by different diseases or disorders. Sharing medication that has been prescribed to you, with others, may cause harm instead of helping them. Different people also react differently to the same medication, especially if they are allergic to an ingredient in the medication.

While it is important to have your medications on hand when you need them, it is also necessary to be responsible and practice safe medication use, storage and disposal. Make it part of your medication routine to regularly check for any drugs that have degraded or passed their expiration date. If you ever have any questions about a medication’s expiration date, safety or effectiveness, it is always best to check with your pharmacist.