Is An Expired Drug Harmful?
Lata rushed into my consulting room with tears rolling down her cheeks. She was angry and visibly upset. Lata’s both kids were delivered by me. She was an experienced mother. She was very diligent about the baby’s health and never missed on the vaccination schedule.
She had been taking her kids to the same pediatrician for years together. One fine day, her pediatrician told her that the child was given a vaccine that had expired a month back…and Lata was shattered.
Lata was literally fuming. She said. “I trusted that doctor so much and how could she be so negligent to me and my child?” It was a clear case of medical error. The pediatrician was extremely apologetic and felt sorry about the whole incident. Medication errors are the commonest errors in healthcare. Actually, this mistake was caused due to a goof up in the pattern of writing expiry dates. We know that Americans write the date in “mm/dd” format and in India we use the “dd/mm” format. This was precisely the cause of this blunder.
Lata was extremely worried and tensed about the ill effects of the expired medication. “Doctor, I even check a loaf of bread for the “consume best before” date. I don’t allow anyone to eat even a slice after that date. We make fresh food every day. We don’t consume “Basi” (stale) food at home. And look here. My little one has been injected with a vaccine which has expired a month back!!!” Lata blew off.
She was not wrong at all. Most people believe that medication post expiry, like food, may rot or turn into some poisonous substance and be very harmful if consumed. So is this true? What is the meaning of expiry date? This article focuses on these issues.
Do Medicines Expire?
A few years ago, the US Air Force found a huge stock of medications worth thousands of dollars stored in odd places like bathrooms at various locations in the country. They had just dumped those expired medicines since they did not know what to do with them. Purely out of interest, an intelligent pharmacologist decided to conduct a study on these drugs. And Bingo! Almost 90% of the medicines had retained their potency although they had expired few months to few years back.
On the basis of these findings, the US Air Force and Food and Drug Administration created a program called “Shelf life extension program”. Under this programme, the expired medicines were rechecked for potency, revalidated and re-used for medical treatment successfully. It saved millions of dollars for the government. A few medicines, sprays and liquids had more chance of losing their potency as compared to injections and vials containing medicine in powdered form. But one thing came out loud and clear
… none turned into poisonous substances or created harm!
The system of writing expiry dates began in in the United States in 1978. The same system was followed across the world. So what does the expiry date mean? Is it the date beyond which medicine becomes completely ineffective? Is it the date after which the drug will rather cause harm?
The answer to both the questions is “No”.
The expiry date is the date beyond which the company does not assure full potency of the medical ingredients. It is a conservative estimate by the company.
A few clear messages emerge out of research on this topic:
- Medicines do not get stale or rot or turn poisonous post-expiry.
The above sentence may not hold true especially in case of syrups containing substances like glucose.
- If the bottle/ vial is opened then bacteria can grow into it. But if the injections or vials
containing dry powders are stored correctly in a sealed pack they cannot “rot” or get
- The expired medications may not have the same potency. Hence, one may need to revalidate the potency or simply take an additional dose.
- In a nutshell, if expired medication (tablets/ injections) gets used inadvertently, no guarantee can be given about its effectiveness but it will not cause harm or untoward effect too.
So what did Lata do? Lata met two pediatricians and discussed the matter. Both suggested that the child should be given another dose of vaccine. Sadly, the child had to take additional injections but Lata was assured that there was no harm caused to the child. Her pediatrician gave an additional dose of vaccine to the baby.
Lata continues to follow up with the same doctor. She and her doctor both have become more vigilant about the medications as they both know that human errors are possible.
Some of the data referenced here has been researched from Google.
Also read: A single vaccine to battle 6 diseases!
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