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Three Letters Re: Stocking Up on Prescription Medications
Sir:
Regarding your blog entry on the subject of prescription medications,
I wish to provide you with information regarding expiration dates: I work for
a pharmaceutical company. While profit is a reason why expiration dates can
be conservative, it is not due to "planned obsolescence."
Here is the way things work in the U.S.: drug companies are required to put
an expiration date on all drugs. Companies are required to prove to the FDA
that the drugs will remain safe and effective through the expiration date on
the drug (when stored as described on the label). Generating that proof is
expensive, and it gets more expensive the farther the expiration date is from
the date of manufacture. So the drug companies don't want to spend money on
expiration date studies (known in the industry as "stability studies")
any further in the future than is necessary, but must spend money on stability
studies (at a minimum) that will avoid an expiration date that is too close
to the date of manufacture (defined as expiration dates that could be reached
prior to the drug being sold, or would cause customers to avoid the purchase
of drugs that will soon expire).
What does that mean for consumers who want to store drugs beyond the expiration
dates? There is not one answer for all drugs. Some drugs are truly ineffective
or unsafe very soon after their expiration dates. Others can be almost "as
good as new" for decades after the expiration dates have passed. Thanks
for the great novel, and a great blog. - Mr. Pharmacopoeia
Greetings, Jim:
As a practicing pharmacist I want to reply to the questions raised re: expiration
dates of RX meds. The dates placed on the label are generally one-year from
the date of dispensing and do NOT reflect actual expiration in most instances.
The Dept. of Defense did a study on their extensive med stockpile, many of
which were expired, and concluded that many drugs were "good" for
ten years. I have meds that are several years old and do not hesitate taking
them. I store them in a cool, dry place, in the dark. Follow this rule of thumb.
And desiccants are great! If any have strange smells, discard them.
BTW, stockpiling of RX meds is a good step. If the SHTF in our country there
is only about a 3-5 day supply of meds on our shelves to dispense. If an epidemic
strikes consider it about a 2-3 day supply, at best. I'm not kidding. We routinely
run out of meds on a GOOD DAY. Don't get caught behind the curve on this! Better
yet, get healthy and reduce your dependence on artificial substances now while
you can. - Concerned Pharmacist
Dear James,
Your site is "must reading" for me. I am a physician and have spent most of
my career in the pharmaceutical industry. Here is my 2 cents on this topic.
Most
solid dose form (tablets and capsules) medicines retain sufficient potency
for several years beyond their expiration dates if stored per the label directions.
Some medicines may retain potency for several decades if not contaminated or
subject to excess humidity. Viet Cong used antibiotics and other medications
in the 1960s and 1970s that were "liberated" from the French in the
1940 and 1950s.
If there is medication that has a substantial impact on your health, such as
insulin, blood sugar testing, and syringes for diabetics or anti seizure medications
for epileptics, etc., talk with your doctor and pharmacist about long term
supply and stability.
On the other hand aspirin breaks down quickly to a less potent pain reliever
so I advise buying it in small quantities. Probably best practice for survivalists
is to keep their old medicines for a rainy day, stock up on essentials in tightly
closed, unopened "stock bottle" containers that have pharmaceutical
desiccants placed by the manufacture, but ask a knowledgeable person if there
is any specific toxicity or loss of potency with that particular medicine.
Always follow any labeled handling and usage information and advice.
Other exceptions to the general rule that properly stored medications last
for several years are suspensions and other liquid formulations made by the
pharmacist for immediate use. For example, it is common for very young children
that the pharmacist adds water and perhaps a flavoring agent to an antibiotic
powder and mixes this up. This suspension is designed to be refrigerated after
being mixed, and to be used within a month or even sooner. To prevent contamination
do not let mouth germs enter the bottle. If the pharmacist is going to mix
two or more bottles at once for a single prescription ask for only one to be
mixed until the second is actually needed. Add you own clean water when needed
and shake as directed.
Another exception is for any sterile liquid such as eye drops or any medicine
for injection that may become contaminated and/or infected. Please read the
product description. If the label says, "Solution must be clear. Do not
use if cloudy, yellow or brown." then take this to heart.
Another exception is for use of old tetracycline and related antibiotics (doxycycline
and minocycline). There may be a nephrotoxicity or damage to kidneys from breakdown
of old tetracyclines.
Here is some info that I took from another web site:
There are four chemical instability reactions that can potentially take place
when it comes to tetracyclines. The first is conversion to anhydrotetracycline
via dehydration, when stored under acidic conditions. This occurs when tetracyclines
age and through improper storage, which leads to nephrotoxicity. In basic mediums,
tetracycline will open its ring and form isotetracycline. In acidic solutions
with a pH around 4, an inactive form will result. This occurs through epimerization
of tetracycline at the 4-position from the alpha to the beta position. This
was accounted for in the old tetracycline capsule with an overfill of 15%.
The
last reaction
that can take place as described previously is phototoxicity. This is common
with compounds containing a chloro-substitution at the 7-position. This leads
to sunburn from free radical formation with sun exposure.
Regards, - Yorie in Pennsylvania
