Better Health & Living

Issue: September 2008
Why-And How-To Toss Expired Drugs
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Why-And How-To Toss Expired Drugs

by Susan Flagg Godbey

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Blame it on laziness, penny-pinching, or simply not reading the labels. For whatever reason, 65 percent of Americans take medicines that are past their expiration dates, according to a recent national survey. 

The problem? Past-their-prime drugs lose effectiveness. ”“Drugs can degrade, even if there’s there’s no visible change, and lead to potential harmful effects,” ,” says Vibhuti Arya, PharmD, a spokesperson for the American Pharmacists Association. ”“Expired drugs can also lose their potency over time. That could be a problem if you keep something like an EpiPen on hand to open your airways during a potentially fatal allergic reaction.”.”

Here’s what you need to know about the dangers of using expired drugs—and how to dispose of them.

I keep old prescription drugs on hand in case of an emergency. What’s the problem with that?

There are actually a couple of problems. First, some drugs lose their effectiveness, including nitroglycerin, some antibiotics, insulin for diabetes, and the epinephrine used to stop anaphylactic shock in people with life-threatening allergies to bee stings and certain foods. You don’t want to find out in a medical emergency that the drug you’re using doesn’t work.

Keeping old drugs on hand can also contribute to drug mix-ups, especially for anyone who takes several medications every day. You want to be able to see very clearly what you’re supposed to be taking. Having other medications in similar-looking bottles on the same shelf can be confusing.

Keeping extra drugs in the house could also lead to prescription-drug abuse, a growing problem among teens and adults. Clearing expired and unused medications out of your house can help prevent this.

I’ve heard that expiration dates are really a scam to make us replace pain relievers and other drugstore remedies that are actually still effective. What’s the truth?

The expiration date shows how long a manufacturer can guarantee a drug’s safety and full potency. Critics say that manufacturers put very conservative dates on packages, but they have to take into consideration how the drugs will be stored. Under ideal conditions—when drugs are protected from temperature and humidity extremes as well as from bright light—some may remain effective far longer. But each prescription and over-the-counter medication is different, and the way most consumers store them isn’t ideal. Drugs break down more quickly in bathroom medicine cabinets and kitchen cabinets, where temperature and humidity can fluctuate.

I’ve heard warnings about flushing unused prescription drugs down the toilet. What’s changed? 

Until recently, flushing was recommended as the safest way to get rid of unused drugs because it kept medicines away from kids and pets. But there’s a lot of evidence that this contributes to rising levels of prescription drugs in community water supplies and in streams and lakes. Studies have found that wastewater treatment facilities can’t always remove small amounts of drugs and their by-products from the water supply. So far, these trace levels haven’t been shown to threaten human health, but it’s it’s still smart to minimize them.

Better options are throwing the drugs away using a special method or disposing of them through a community household hazardous waste collection program (your local government will have information on these programs). Some towns also offer special prescription-drug disposal programs.

However, a handful of drugs can be flushed. According to the FDA, to cut the risk of unintended overdoses or abuse, about a dozen medications should be sent down the toilet if you don’t have access to a disposal program. These include strong, narcotic pain relievers and other controlled substances such as Actiq (fentanyl citrate), Daytrana Transdermal Patch (methylphenidate), Duragesic Transdermal System (fentanyl), OxyContin tablets (oxycodone), Avinza capsules (morphine sulfate), Baraclude tablets (entecavir), Reyataz capsules (atazanavir sulfate), Tequin tablets (gatifloxacin), Zerit for Oral Solution powder (stavudine), meperidine HCl tablets; , Percocet tablets and capsules (oxycodone/ acetaminophen), Xyrem (sodium oxybate), and Fentora (fentanyl buccal tablets).

What’s the safe way to throw away prescription drugs?

Put pills or capsules in a zipper-seal bag and tap it the bag with a hammer to crush themthe contents. Then open the bag and mix in cat litter, dirt, or coffee grounds so the drugs are less visible and less appealing. Seal the firstthat bag and put it in a second bag, ; then put it both in the trash. For more information, go to http://www.smarxtdisposal.net, a partnership between the U.S. Fish and Wildlife Service and the American Pharmacists Association.

By Susan Flagg Godbey and the editors of Better Health & Living®

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