How Bad Is It To Take Expired Medication
Liquid suspension medications are vulnerable to contamination from bacteria and fungus.
Life-saving medications should never be taken past their expiration date, except one.
At one time or another, many of us have been tempted to reach for a bottle of expired medication to help alleviate a head cold, migraine or infection. But, is it safe? Will it work? What are the risks? Sarah Pace, MD, MPH, a board-certified internal medicine physician at Mission Heritage Medical Group, helps us understand the risks of taking expired medications, why expired medications may not be effective and when we should avoid them all together.
Q. Taking expired medication in pill form will not yield the maximum benefits, but are there other specific health concerns with doing this in some cases? What about liquid suspension medications?
A. Most expired pills and tablets are not harmful to your health as long as they are stored in a cool, dry place. Expired gel capsules must be used with a great deal of caution because they are sensitive to heat and humidity. Before ingesting any medication, you should examine the pills and bottles to make sure they are not broken, open, sticky or discolored.
Q. Medication toxicity from degradation of outdated drugs is not a well-researched field. In your experience are there certain prescription or over-the-counter medications that should never be taken after the expiration date? If so, why?
Q. What is the difference between shelf life and expired medications?
How Long Does A Complicated Uti Last
Complicated UTIs can last a couple of weeks. According to theAmerican Urological Association, a number of different factors can determine if a UTI is complicated, including:
- whether you’re pregnant or post-menopausal
- if it’s caused by bacteria that’s resistant to multiple drugs
- something abnormal in your urinary tract
- if you have a catheter, stent, nephrostomy tubes, or other medical devices
- if you have a chronic condition, like diabetes or a compromised immune system
If you’ve got a complicated UTI, you’ll need treatment with a longer course of oral antibiotics, and potentially intravenous antibiotics, as well, per the AUA. But while treatment will last 14 days, you’ll probably feel better much sooner. “As your body starts to fight infection, that burning with urination will improve,” says Dr. Moore.
Treatments For A Urinary Tract Infection
The type of treatment you are prescribed and the length of time you need to take medicine depends on your health history and the type of bacteria found in your urine.
Medications
Doctors commonly prescribe antibiotics for urinary tract infections. Amoxicillin is a type of antibiotic medicine that stops the growth of bacteria in your urine.
Amoxicillin comes as a capsule, tablet, or liquid to be taken by mouth. The medicine is taken two or three times a day with or without food. If you have a UTI and are prescribed an antibiotic like amoxicillin, you should start feeling better within a few days. It is important to remember that even though your symptoms may start to subside within a few days, you should continue to take your medicine as prescribed by your doctor. The treatment length depends on your unique circumstances.
Home care
A healthy lifestyle that includes methods like regular bathing and good hygiene may help you control and prevent urinary tract infections. These techniques include:
- Choosing NOT to use douche or feminine hygiene products containing perfumes
- Avoiding bath oils
Also Check: What Antibiotics Best Treat A Urinary Tract Infection
The Expiration Date And Redistribution Of Medications
We discussed some broad FDA and USP guidelines and regulations above, but lets bring it back to a more line medic-style focus.
How often have you been in the field, deployment, etc., with a bottle of 500 tabs, and you divvy them up into little baggies to hand out pill counts of 20, 30, or 40?
Well, do you know how this redistribution affects the expiration date?
The FDA released guidance that shortens the expiration date of these repackaged containers to either:
whichever time period is shorter.
So, heres a helpful infographic summarizing these recommendations with an example:
Much shorter than you probably thought, right? However, it is important to note that there are several FDA-mandated conditions that come with its recommendations, two of the most relevant of which are below, with commentary:
Most likely, the answer to both questions above is probably no. This means you are technically giving likely expired meds without any true FDA backing as to their efficacy and/or safety.
Mind blown, right?
But, hey, lets work our way around that thought-provoking obstacle, and try to pretend that we are all not sitting here rethinking about how we have been repackaging and dishing out many of our commonly carried medications.
How Long Do I Need To Take Antibiotics To Treat A Uti
How long you take antibiotics for a UTI depends on how severe your UTI is and which antibiotic youre prescribed. Some medications like fosfomycin only require one dose, while a more severe UTI might require 14 days or more of treatment. Most require 3 to 7 days of treatment.
Within the first 1 to 2 days of starting your antibiotics, youll probably notice your UTI symptoms start to fade away. If your UTI is more severe or youve had symptoms for a while before starting antibiotics, it might take a few more days for you to notice improvement.
In any case, its important to take all the antibiotics youre prescribed, even if you start feeling better before finishing them. Stopping antibiotics early can lead to antibiotic resistance, which means the medication might not work as well as it should if you need it to treat an infection in the future. It can also mean your UTI might come back if you havent treated it completely.
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Typical Dosing For Cefdinir
Adults and adolescents age 13 years and older: The typical dose is 300 mg by mouth every 12 hours. For bronchitis with bacterial infection, throat or tonsil infection , or sinus infection , you can take 600 mg once daily instead.
Children age 6 months to 12 years old: Take 7 mg per kg of body weight every 12 hours by mouth. Children with ear infection , throat or tonsil infection , or sinus infection can take 14 mg per kg of body weight once daily instead.
Cephalexin Could Increase The Risk Of Repeated Utis
Cephalexin belongs to a category of antibiotics called cephalosporins.
I recently came across a study that demonstrated that another drug from the cephalosporin group promotes vaginal colonization with Escherichia coli , the number one bacteria causing UTIs.
The study looked at monkeys and the antibiotic was placed directly into the vagina . While another study shows that low dose daily cephalexin does not affect the vaginal flora, it is definitely possible that if you take full dose Cephalexin regularly, this e may have a detrimental effect on the vaginal microbiome.
Unfortunately, if your vagina is colonized with E. coli, you are almost guaranteed to have repeated UTIs after sex.
Healthy vaginas normally have the ability to deter E. coli bacteria and therefore play a key role in preventing UTIs. If your vaginal health is compromised, your risk of chronic UTIs is higher.
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What The Study Found
The team behind the new studyled by Ruth Milanaik, D.O., director of the Neonatal Neurodevelopment Follow-Up Program at the Cohen Children’s Medical Center of New Yorkconducted a national survey of 496 parents.
Just over 48 percent of parents said they saved leftover antibiotics that had been prescribed to their children. Of parents who saved unused antibiotics, 73 percent said they later used them or shared them. Parents were most likely to reuse leftover antibiotic liquids or drops and least likely to reuse tablets.
While this is still preliminary data, it adds to previous research suggesting that the use of unprescribed antibiotics is widespread. In one previous study, about a quarter of adults said they would personally use antibiotics without getting a doctors prescription.
Can You Take Expired Antibiotics Do They Lose Their Potency And Efficacy
The potency and efficacy of antibiotics or any other medications will start degrading from the point of manufacture. But further testing has been carried out on this.
Ongoing research states that if the right storage conditions are met, medications including antibiotics can retain 90% of their potency for up to as much as 15 years after expiration.
Therefore, it is believed that antibiotics can retain a significant portion of potency for up to 10 years after their expiration date.
The best evidence that antibiotics and other similar medications may retain their potency beyond expiration is the Shelf Life Extension Program undertaken by the FDA for the Department of Defense. This program was carried out to reduce medication costs for the military.
The SLEP program found that around 88% of 122 medications, including antibiotics, retained potency for more than one year. The program determined that the average expiration extension should be 66 months and a maximum extension of 278 months, depending on the medication, of course.
Its also important within the question, can you take expired antibiotics, to add that these antibiotics were stored in optimal storage conditions. These may be different conditions than many people would store them. More on storage shortly.
Also Check: Signs Of Allergic Reaction To Antibiotics
You May Be Tempted To Use Leftover Drugs Originally Prescribed For Friends Family And Even Pets Here’s Why Thats A Terrible Idea
Your head aches your nose is stuffy and your throat is raw. Rummaging around in the medicine cabinet for something to help you feel better, you come across a leftover prescription and wonder: ‘How long do antibiotics last anyway?’ And in that miserable moment of sickness, you figure it can’t hurt and dose yourself with whatever antibiotic you have on hand. A new study shows you aren’t alone.
In fact, one out of four people say that they would use antibiotics without their doctors okay according to a recent survey of 400 patients treated in primary-care clinics in Houston, Texas. And five percent of respondents admitted to doing exactly that in the past year.
In the study, published July 11 in the journal Antimicrobial Agents and Chemotherapy, 14 percent of respondents also told researchers that they keep a stash of antibiotics at home. People who actually used antibiotics without a prescription reported getting them from a variety of sourcesleftovers from a previous illness, friends or family members, or outside the U.S. A few even resorted to taking drugs intended for the family pet.
In most cases, the antibiotics likely didn’t help. People most commonly used the drugs to treat cold and sinus symptoms, which typically clear up without medication.
Whats more, overuse and misuse of antibiotics has promoted the rise of dangerous superbugsstrains of bacteria that have acquired resistance to multiple antibiotic drugs.
Are Expired Antibiotics Toxic
Decades ago, a handful of cases were reported with expired oral antibiotic tetracycline causing toxic reactions.
This is where a reversible form of kidney damage called Fanconi syndrome was identified in patients who took oral antibiotic tetracycline after it expired.
Many believe this toxicity could have resulted from tetracycline degradation products .
These patients also suffered from nausea, vomiting, and metabolic acidosis within 2 to 8 days of taking the expired antibiotic. However, no such toxic cases with expired oral antibiotic tetracycline or related antibiotics, such as doxycycline, have been reported lately.
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Cipro And Herbs And Supplements
Some vitamin and supplement products can bind to Cipro and prevent your body from absorbing it. This can decrease how well Cipro works. These supplements include:
- multivitamins
- iron
- zinc
To avoid this interaction, you should take Cipro at least two hours before you take these supplements, or at least six hours afterward.
Cephalexin & Uti: My Experience
I had my share of UTIs several years ago. Fortunately, I was able to get rid of this chronic problem, mostly by relying on a specific type of probiotics and some lifestyle changes.
If this is your first UTI and you are treating it with Cephalexin, there is no guarantee that the UTI wont come back.
Remember, the antibiotics will kill the bacteria that invaded your bladder, but antibiotics will not address any of the underlying health conditions that may have caused the UTI in the first place.
If you do not want to experience the horrors of UTI again, make sure to implement smart prevention strategies, and do not rely solely on the antibiotics. Here are some tips to get you started:
- Improve your vaginal flora composition
Read Also: Low Dose Antibiotics For Recurrent Uti
How Should I Use This Medicine
Take this medicine by mouth with a glass of water. Follow the directions on the prescription label. Take after meals. Take your doses at regular intervals. Do not take your medicine more often than directed. Do not skip doses or stop your medicine early even if you feel better. Do not stop taking except on your doctor’s advice.
Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.
Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.
NOTE: This medicine is only for you. Do not share this medicine with others.
Can You Flush Out A Uti With Water
Patients with urinary tract infection are usually advised to drink six to eight glasses of water every day to flush the infection out of the urinary system. The best way to get the infection out of the system is by drinking liquids until the urine is clear and the stream is forceful.
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Cipro And Other Medications
Below is a list of medications that can interact with Cipro. This list does not contain all drugs that may interact with Cipro.
Before taking Cipro, be sure to tell your doctor and pharmacist about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.
If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.
Antacids
Many antacids contain calcium carbonate, magnesium hydroxide, and aluminum hydroxide. These ingredients can bind to Cipro and prevent your body from absorbing it. This can decrease how well Cipro works.
To avoid this interaction, take Cipro at least two hours before taking an antacid, or six hours afterward.
Anticoagulant drugs
Taking Cipro with oral anticoagulant drugs such as warfarin might increase the anticoagulant effects. This might result in increased bleeding. If you take an anticoagulant, your doctor may need to monitor your bleeding risk more frequently if you take Cipro.
Drugs that prolong the QT interval
Certain medications prolong your QT interval, which means they might affect the rhythm of your heartbeat. Taking Cipro with these drugs can increase the risk of having a dangerous irregular heartbeat. Cipro should be avoided or used very carefully with these medications.
Examples of these medications include:
Clozapine
Diabetes drugs
Methotrexate
Probenecid
Ropinirole
Consider Switching Birth Control
Some older research suggests that certain contraceptives may contribute to the cause of UTIs in some women.
If you use diaphragms, spermicides, or nonlubricated condoms and get frequent UTIs, it may be worth talking to your doctor to find other methods of birth control.
Its not uncommon for UTIs to go away on their own with at-home care and without the use of antibiotics.
Some research estimates that 25 to 42 percent of UTIs can go away on their own. This is usually only common in women with no other health issues.
However, there are some serious risks that can come from leaving a UTI untreated, including pyelonephritis and .
UTIs are painful, but with treatment, you can alleviate an infection and prevent recurrent infections. Talk with your doctor if you have symptoms of a UTI. With proper treatment, you should begin to feel better in a few days.
Take your antibiotics as instructed even after your symptoms improve to prevent complications or a secondary infection.
If the UTI doesnt resolve after antibiotic treatment or you end up with multiple episodes of a UTI, your doctor will likely do further testing.
This could be in the form of:
- cystoscopy
- urodynamic testing
You may be referred to a urologist, depending on the severity of your UTI or if you have chronic infections.
Certain strains of bacteria can cause UTIs. They can range from mild to severe. The degree of severity depends on multiple factors, including:
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Can You Take Expired Antibiotics Heres When You Can
Wondering if you can take expired antibiotics? You arent the first to ask this question. So, heres the guide on can you take expired antibiotics, along with reasons and suggestions.
But first, heres a quick response to get you some important information, then well cover more of the details.
Can you take expired antibiotics? 90% of the potency and efficacy of antibiotics can be retained 5 years from the expiration date if stored correctly. But like other medications, antibiotics do expire. Potency can remain for solid forms of antibiotics. However, taking expired antibiotics, unless for an emergency, is not safe and may be toxic.
According to the FDA, medications, including antibiotics, do expire, and expiration dates hold an important meaning that should not be ignored.
Because of this, the Center for Drug Evaluation and Research officially recommends that medications, including antibiotics past their expiration date, should be disposed of.
An expiry date is a point at which the drug manufacturers have tested the potency, efficacy, and safety of the medication towards a relevant health condition.
This also means that the drug manufacturers have tested the use of antibiotics only up to the printed expiration date and cannot guarantee their effectiveness beyond that point.
We cannot stress enough that the antibiotic may not be safe to use beyond the printed expiry date and is unlikely to provide the expected results.
