Safety Concern: Good Drugs Can Go Bad

Whether over the counter or prescribed by a doctor, all medicines must be handled with care when their shelf life runs its course.

“If pills are thrown in the trash, they’re accessible to curious individuals who may not know what the drug is for,” said Dr. Addison Taylor, professor of medicine, pharmacology, and molecular physiology and biophysics at Baylor College of Medicine in Houston. “One of the biggest causes of poisonings in children is the inadvertent ingestion of things that were supposedly disposed of but in fact were not done so properly.”Pets, whose sensitivity to drugs is different than that of full-grown humans, are counted among the curious and at-risk.”The pills that you may take without any adverse effects whatsoever could be potentially lethal for your cat or dog,” said Taylor. “The pet’s size and ability to get rid of that drug may be quite different than it is in a human.”To properly dispose of medication, incineration is ideal – either at a filtered city incinerator or through a medical facility’s waste disposal system (both typically require a fee) – because drugs that are discarded in the trash wind up in landfills and could conceivably leak into and contaminate ground water. However, a more practical solution for most people, Taylor says, is thoroughly dissolving unused medicines in water and then washing them down the sink or flushing them down the commode.”Disposing of medicines in the water system is probably the next safest course of action,” says Taylor. “Even people who are prescribed radioactive drugs either for diagnostic or therapeutic purposes generally can flush those down the commode with copious amounts of water as well.”While some medications become toxic when they exceed their expiration dates (such as those containing sodium nitroprusside, which ultimately converts into cyanide if not protected from light), most drugs simply lose their potency. Degradation can also happen if a medication is stored at extreme temperatures (above 86 degrees for most medicines). Keeping medicines in cars over extended periods, for instance, runs such a risk.”In most cases of using expired medicine, all you’re suffering is a loss of potency, but in some rare circumstances, there’s a build-up of toxic materials,” said Taylor. “You definitely want to avoid those drugs that may deteriorate into something that can cause some real medical problems.”The first step toward proper medicinal maintenance starts with reading the instructions on the container. But even then, a drug’s decomposition can be difficult to gauge. The Food and Drug Administration, for instance, stipulates that medications must deliver within 15 percent above or under the advertised dosage – a wide and unpredictable range from which to determine precise potency for many medications.”The shelf life is determined by the point in which the medication dips below that fairly broad range, in which you’re losing the effect in many cases,” said Taylor. “And that’s the most concerning change that happens when you don’t pay attention to the shelf life.”(Source: Baylor College of Medicine : July 2007)