OTC expiration dating - cc pharm

[Bob41081]

I am newbie. I found this board from reading Patriot Aid Station and have been and will be a lurker. I have no trining other than Basic Re Cross First aid but have always been interested. My father was and my brother is a doctor. Now my ?. A poster on Pliansma's Cabin where I hang was asking about expiration date on OTC med's and wondered how long you can keep them after they have expired before potency loss and toxicity problem arise. I will(with permission) trasfer the answer to PC
Bob

[tangent]

there are posts on this topic in this forum, in pre-hospital care, in the medical convention and in the pharmacy. Please note that some forums have more than one page of topics - small numbers on the bottom right of the topic list to go to the next page - you might have missed those.

I've been meaning to collect all of those into one place - they really belong in the pharmacy, as does the only 3 drugs thread, but I hate to take them out of open forums and put them in a closed one, considering how popular the topic is and how many lurkers we have, that don't register.

there is also a long thread on the topic over at AW, that I ought to drag at least parts of over...

http://assaultweb.net/ubb/Forum32/HTML/000225.html

hope that helps

[this has been dragged over and is in the pharmacy]

[Reasonable Rascal]

Bob, feel free to use such info as you desire, with the caveat that sometimes it is little more than informed opinion and should be regarded as such.

The info in the closed forums however is there because it can be potentially abused through misuse, hence why it is kept beyond the casual lurker. If someone won't bother to register then perhaps they aren't disciplined enough to use such information wisely.

Now that I have that out of the way to general consensus is that OTC meds with the exception of aspirin don't become toxic with age, but rather lose potency. Some, such as topical antibiotics ointments, present little danger even from reduced effectiveness as they aren't used in a way that means potential life/death. This is opposed to say Adrenaline (Epinephrine) where lack of efficacy could mean death as a result in a critical emergency. Not because it became toxic - it does not - but because the desired action no longer occurs.

Aspirin's toxicity is exhibited by way of increased stomach upset. The be lethal you'd have to take a dose that would at or near lethal even if it were fresh. The potential lehtality of aspirin comes from its tendency to cause internal hemorrhage in high doses because of its effect on the digestive tract.

A general caveat to this overall rule, however, would be OTC antibiotics such as obtained from aqarium sources. There if there was a severe loss of potency could you suffer harm because the expected antibacterial action did not take place. For instance if you were using aqarium Penicillin for anthrax exposure as a precaution. Were it severely degraded you could develop a full-blown infection as a result. Once active infection occurs the simple remedies are no longer effective and you are looking at IV antis instead.

We as a group, that is the austere medicine community, have yet to come up with a definitive chart listing high certainty useful periods beyond printed expiration dates. Even the Air Force studies of chemical stability of medications stored under severe conditions have shown that differing lots of the same medication from the same production batch deteriorate at different rates. But surprise of surprises, Tetracycline, the antibiotic most often listed as becoming toxic (another thread by itself) was rated as not only effective but recertifiable by the FDA for additional periods of 12-18 months and longer as a result of the study.

For *myself* I regard OTC's as safe and efficacious until they are visibly degraded. I have no problem using for instance enteric coated aspirin several years out of date so long as it is not breaking down (powdery and very strong vinegar smell). Calamine, Tagamet tabs, antidiarrheals, etc I regard the same way.

As stated in another thread modern medicinal formulations are such that meds do not become toxic with age but rather less effective. Cool, dry, dark storage slows the rate of decay, and in the case of virtually every form of DRY medication freezing does in fact extend the useful full-potency shelf life significantly.

Not a concrete answer I know but the best I can offer at this time.

RR

[Javahed]

Just an add on, because I see so many people asking about vet meds. True, you can, and I have used 'em on people at times. I am not certain of every difference - but our Group vet did stress to us that tetracycline - vet form - becomes extremely toxic to humans shortly beyond it's exparation date, unlike the human grade stuff.

I don't know the base differences or chemistry behing this - just passing the info along.

Dan

[tangent]

very interesting! - can you ask him for more info? - maybe some refs?

thanks!