• Do They Mean Anything?

Having one of those days, the car wouldn't start, cats knocked the milk off the counter, kitchen sink is clogged? So you go to your medicine cabinet for something to take for that headache you can feel forming – only to find that the expiration date was back about the time you were struggling through all the paperwork to refinance your home. So, now what? You toss several things around in your mind, risk taking it (is this going to be fatal or just not work), or just deal with the headache.

Well, let us give you some informed choices.
“Debate exists regarding the relative potency of medications beyond their labeled expiration dates. Expired medications
have not necessarily lost potency, since the expiration date is only an assurance that the labeled potency will last at
least until that time.
Clinical situations may arise in which expired drugs might be considered owing to lack of viable alternatives
Financial concerns.
Ongoing studies show that many medications retain their potency years after their initially labeled expiration dates.
We sought to characterize the potency of some prescription medications that had expired decades ago.”
Archives of Internal Medicine - “Stability of Active Ingredients in Long-Expired Prescription Medications” October 2012

Most of what we now know about medications with expired dates is due to a request placed by the US Military, faced with massive amounts of expired drugs in their inventory that is used to treat our military members. “The Shelf-Life Extension Program (SLEP) checks long-term stability of federal drug stockpiles. 88% of 122 different drugs stored under ideal environmental conditions had their expiration dates extended more than 1 year, with an average extension of 66 months (5 ½ years) and a maximum extension of 278 months (23 years).” -Harvard Medical School

This is the chart from one study done with 14 drugs.
The test was done with medications 28-40 years
past their expiration dates. Drugs found with less
than 90% of their labeled potency were

amphetamine and aspirin in both samples tested
and phenacetin in 1 of 2 samples tested. Aside from
aspirin, all drugs in Fiorinal (butalbital, aspirin,
caffeine, and codeine phosphate) had almost 100%
of labeled concentrations, while those of
Codempiral No. 3 (phenacetin with codeine
phosphate) were all less than 95%. Since the
codeine measured in Codempiral No. 3 was also
lower than that of Fiorinal (90% vs 99%), this
suggests that Codempiral's packaging was less
intact, allowing moisture to penetrate, which can
promote hydrolysis. Because phenacetin has an amide functional group, it is more prone to this type
of degradation than codeine.

These published findings were also presented at the 2011 North American Congress of Clinical Toxicology, September 23, 2011 in Washington, DC. Excluding aspirin, nitroglycerin, insulin, and liquid antibiotics, most medications are as long-lasting as the ones tested by the military. Placing a medication in a cool place, such as a refrigerator, will help a drug remain potent for many years.