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I am hesitant to post this question here as the naysayers and the internet ninjas are certainly going to chime in with the expertise they don't have. So please, Im not yaking away for the sake of typing. If you have a credible response to the following question then please respond. Responses that are of the "I think" nature will be ignored. Im an EMT so I know enough to make myself dangerous.

I have asked countless people for credible information about the longevity of medications post expiration date. Obviously the shelf life is going to be medication specific so my question is.....

Does anyone know where to find out the effective life of a given medication is after its posted expiration date?

This information has been elusive and after asking MANY, I have yet to be given a valuable resource. Im looking for a chart or resource of somekind that would show that:

"Metoprolol has an FDA expiration date of 2 years after manufacture however its still 90% effective 4 years after manufacture." I may be completely dreaming as the FDA and the Pharm companies want to keep sales up. My hunch is that the real expiration date is way beyond the printed expiration date.

This information would be super handy in cases where you would need Albuterol, Metformin, Lamictal or any myriad of other meds that could be a MUST HAVE if the local pharmacy went empty.
 
Your spot on, it's going to be med specific.

It is also true that the longer from the expiration date the less effective they all get.

Keeping them air tight and in a cool environment will extend the life of the drugs.
 
Your spot on, it's going to be med specific.

It is also true that the longer from the expiration date the less effective they all get.

Keeping them air tight and in a cool environment will extend the life of the drugs.
I 100% agree. However the question remains.

It is elusive information and again, its not something that the pharm companies and FDA want people to know....$$$$$$$$$
 
After all, If pharm company xyz is making drug 123 that YOU NEED, and they know that the actual life is 5 years... I can totally see them saying something like the expiration date is 2 years from manufacture. So in the name of safety, we are forced to buy more.
 
After all, If pharm company xyz is making drug 123 that YOU NEED, and they know that the actual life is 5 years... I can totally see them saying something like the expiration date is 2 years from manufacture. So in the name of safety, we are forced to buy more.

True but unless your paying out of pocket, most pharmacys will only fill so much medication and even then you need a doctors scrip to get anything other then over the counter stuff.


Maybe @bolus could shed some light.
 
I am hesitant to post this question here as the naysayers and the internet ninjas are certainly going to chime in with the expertise they don't have. So please, Im not yaking away for the sake of typing. If you have a credible response to the following question then please respond. Responses that are of the "I think" nature will be ignored. Im an EMT so I know enough to make myself dangerous.

I have asked countless people for credible information about the longevity of medications post expiration date. Obviously the shelf life is going to be medication specific so my question is.....

Does anyone know where to find out the effective life of a given medication is after its posted expiration date?

This information has been elusive and after asking MANY, I have yet to be given a valuable resource. Im looking for a chart or resource of somekind that would show that:

"Metoprolol has an FDA expiration date of 2 years after manufacture however its still 90% effective 4 years after manufacture." I may be completely dreaming as the FDA and the Pharm companies want to keep sales up. My hunch is that the real expiration date is way beyond the printed expiration date.

This information would be super handy in cases where you would need Albuterol, Metformin, Lamictal or any myriad of other meds that could be a MUST HAVE if the local pharmacy went empty.


The expiration date is the date that the drug company can say the drug still has full potency. They dont study how long they last because it is not necessary for them to continue to make proftis.

I have not seen the actual study but apparently FDA did a study on meds that the military were stockpiling so they did not have to replace their stockpiles every year. Apparently 90% of the 100 or so drugs they studied still carried 100% potency after 15 years.

But no one studies that regularly because no one expects patients to stockpile meds for decades.

Some are well known to go bad quickly, like nitroglycerin. Others probably last as long as they are in pill form. I would not trust liquid meds to last as long as ones in pill form.

How they are stored is important. I've had some nausea pills that turned to unusable powder in 6 months of humid conditions in their original bottle. I'd had patients say their albuterol inhaler that was over a year old did not work as well as a new one

If I wanted to stockpile pills (as a physician I dont, for many reasons) I would ask the pharmacy to put the doses in blister packs (they do that for nursing homes) and then store that in a vacuum sealed container with moisture and oxygen absorbers (both sold on Amazon)
 
True but unless your paying out of pocket, most pharmacys will only fill so much medication and even then you need a doctors scrip to get anything other then over the counter stuff.


Maybe @bolus could shed some light.

I've written for up to a year of a medication for patients who did not want to go to the pharmacy. The pharmacy does not care (unless they are controlled drugs) as long as they get paid.

I'd also written "emergency meds" for people going hiking in some far off jungle for a month. Meds for pain, nausea, diarrhea, various antibiotics, severe allergic reactions, etc. I also trusted the patient to use them appropriately

I've also told a Local TV news Director politely to F off when he asked for a year's worth of Cipro and Tamiflu during one of the flu epidemic scares (that he was himself pushing on his news station). He told me "I hope you and your family die in a FEMA line waiting for your cipro."

That was 15 years ago. Still alive A-Hole!
 
Metoprolol is something I probably need to stock up on, but if I ran out I think I could do without it. My prescription is for the full tablet, but I only need to take half (per the cardiologist) - so I could pretty easily build up a supply. If it has an actual 4 year effective date, then IMO that is going to work for me in the most likely SHTF scenarios. If the SHTF situation is so bad that we can't get basic drugs after a year or two, then I am probably going to be dead shortly anyway.

I am seeing the cardiologist again this next week to go over my test results and to talk about prescriptions in particular - whether I need to adjust the amounts or not.

I have a family member that needs a drug that is shipped to them every month, must be refrigerated, costs $40K+ per year if they had to pay for it out of pocket, so there just is no way, unless they won the lottery, that they will ever have more than about a month's supply on hand. Once off the drug, it is likely that the condition that they take drug for, will deteriorate - maybe noticeably at first, then maybe slowly after, over months to years, possibly quickly though as the drug is used to keep the condition from progressing fast, although there is no cure for the condition. There really is no way to predict how quickly or how bad it would get, but it probably would not be good and stress exacerbates the condition.
 
I have hydrocodone/tylenol that is well over ten years old - it does seem to be decreasing in effectiveness, although some of that may be due to tolerance (not a lot though as I rarely take it).

The oxycontin (no tylenol or aspirin or ibuprofin - just 5 mg tabs) I have (for kidney stones) is still effective after more than five years. Just took two a couple weeks ago after the chiro screwed up my neck and it did dull the pain and relax the muscles enough to be a remedy. That was only the second time I have taken it - last time was a few years ago for a migraine.

With something like metoprolol I think it might be hard for some to know whether it is still effective - I don't notice any real difference when taking it (maybe I need to take a full tablet?). Lisinopril - that I notice because of the diuretic that usually comes with it. The Lipitor I will only know after I see my blood test results next week.
 
Metoprolol

That should be on the $4 list at Freds and Walmart. so $40 for a years worth. But it will probably be a generic brand made in India. And even though the FDA says generics are equivalent they dont police them unless it is a huge problem. So I've seen generics out of india not do as well and when you complain to the FDA they just forward the complaint to the India company and wipe their hands of it.
 
That should be on the $4 list at Freds and Walmart. so $40 for a years worth. But it will probably be a generic brand made in India. And even though the FDA says generics are equivalent they dont police them unless it is a huge problem. So I've seen generics out of india not do as well and when you complain to the FDA they just forward the complaint to the India company and wipe their hands of it.

I've had generic prilosec that came from India and it seemed ok.

My cardiologist gave me 11 months of refills on all of my heart meds, including the metoprolol and nitro. I have not taken Walgreens up on the 90 day refills yet until I know exactly what I will need per my followup blood tests. Ran out of Lisinopril this week, that script is from my GP (an NP) who did not return the calls from Walgreens to renew the script, so I am going to either get the cardiologist to give me a script for it or call the GP if he doesn't.

Expensive ($500) and hard to get cardiologist appts but until we work out what my problem is I will continue. My out of pocket and deductible are met, so I should not have any more large bills this year - got up to $45K in insurance billings so far, and the procedures have primarily been just tests. I would hate to see what happens when something really serious and complicated was needed.
 
I've had generic prilosec that came from India and it seemed ok.

My cardiologist gave me 11 months of refills on all of my heart meds, including the metoprolol and nitro. I have not taken Walgreens up on the 90 day refills yet until I know exactly what I will need per my followup blood tests. Ran out of Lisinopril this week, that script is from my GP (an NP) who did not return the calls from Walgreens to renew the script, so I am going to either get the cardiologist to give me a script for it or call the GP if he doesn't.

Expensive ($500) and hard to get cardiologist appts but until we work out what my problem is I will continue. My out of pocket and deductible are met, so I should not have any more large bills this year - got up to $45K in insurance billings so far, and the procedures have primarily been just tests. I would hate to see what happens when something really serious and complicated was needed.

Best of luck. Call your GP about the refills. We would have pharmacies say the doctor never replied when in reality they never sent it or would send it to some doctor who did not even know the patient. I hate when they blame me for their incompetence.

I was just thinking about a patient that asked me for a prescription of 100 viagra tabs (older cranky guy). At $30 a pill and not covered by insurance I asked if he was sure he wanted $3000 worth of viagra. What if he dropped it in the toilet? He wanted it. And if he was lucky enough to use 100 Viagra at his age I said good for him, here's a script for 100 tabs.
 
The toughest one for me is Humalog. Insulin doesn't keep well, and must be refrigerated for maximum storage. At best, it will last (according to the info available online) for 3 months - assuming the vial hasn't been opened (punctured by a needle). In an SHTF situation, it's the most important med I will need. And without refrigeration, it's going to be tough to try and keep a supply on hand. That said, I would do my best to keep it as cool as possible (store underground, if an option, for example) and hope that supplies will be available within that time span. I would continue to use insulin past that 3 months, if I had it on hand, just to try and keep the blood sugars at bay. At any one time, I have 30-60 days extra on hand, in date. As a Type 1 diabetic, I can't go for long without it, so it's a big tripping point in any SHTF planning I have.
 
The toughest one for me is Humalog. Insulin doesn't keep well, and must be refrigerated for maximum storage. At best, it will last (according to the info available online) for 3 months - assuming the vial hasn't been opened (punctured by a needle). In an SHTF situation, it's the most important med I will need. And without refrigeration, it's going to be tough to try and keep a supply on hand. That said, I would do my best to keep it as cool as possible (store underground, if an option, for example) and hope that supplies will be available within that time span. I would continue to use insulin past that 3 months, if I had it on hand, just to try and keep the blood sugars at bay. At any one time, I have 30-60 days extra on hand, in date. As a Type 1 diabetic, I can't go for long without it, so it's a big tripping point in any SHTF planning I have.

What about powdered insulin? Does that keep longer? Can all diabetics use it? In emergencies?
 
What about powdered insulin? Does that keep longer? Can all diabetics use it? In emergencies?

Honestly, I don't know anything about it. I've never used it and don't know if it could work for me. I do have a rescue injection on hand at all times for severe low blood sugar reactions - it's a powder that gets mixed with a liquid right before injecting it - and those can last up to one year at room temperature.

Maybe @bolus knows something about powdered insulin?
 
Honestly, I don't know anything about it. I've never used it and don't know if it could work for me. I do have a rescue injection on hand at all times for severe low blood sugar reactions - it's a powder that gets mixed with a liquid right before injecting it - and those can last up to one year at room temperature.

Maybe @bolus knows something about powdered insulin?

I'm not familiar with any insulin powders that you reconstitute and inject
There is Afrezza, a powdered inhaled insulin. I have never prescribed it. Looks like it needs to be refrigerated as well and costs $1500
Afrezza | Rapid Acting Inhaled Insulin for Type 1 and Type 2 Diabetes

in insulin pens (that have cartridges) can be (dont quote me on all of them) at room temp, unused for 4 weeks.

In a disaster you could dig a hole to store the insulin. lower you go the lower the temp. Here is a graph of temperatures based on depth of hole dug based on time of year

time-lag-vs-depth.gif

You might research what countries like India does for diabetics. They have a lot of people who dont have refrigeration.
 
Your spot on, it's going to be med specific.

It is also true that the longer from the expiration date the less effective they all get.

Keeping them air tight and in a cool environment will extend the life of the drugs.

Vacuum packing in Mylar bags sound like a effective option .
 
I have first hand knowledge. Medications will still work effectively far after their expiration date so long as they are stored in a cool dark place. sunlight kills. and as you would surmise, there are many meds that have a def shelf life and do not pertain to my previous statement.
 

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