What Really Happens When You Take Antibiotics After Their Expiration Date

Giurgi C.
By Giurgi C. October 11, 2018 06:56

What Really Happens When You Take Antibiotics After Their Expiration Date

We all know that the expiration date on food is more of a guideline than a rule that has to be followed strictly – but what about antibiotics? Every medicine sold in the USA comes with an expiration date marked on the package, but a lot of us don’t take these too seriously. Medicines seem like they should last a lot better than food. Leave a Tylenol caplet and an apple on the counter and see which one rots first. No prizes for getting that one right.

Sadly it isn’t that simple, though. Medicines might not visibly spoil like food, but their active ingredients can break down over time. Sometimes that means they won’t work as well as they should. Sometimes they can become toxic. There are a lot of medicines you can safely use years after the date stamped on the box, but you need to know what ones they are – and what ones to avoid.

What Do The Expiration Dates Mean?

In 1979 the FDA passed a law requiring all drug manufacturers to put an expiration date on their products. Officially, that date tells you how long the drug can be relied on to have the desired effect as long as it’s been properly stored. In reality manufacturers, wary of being sued by someone who’s taken drugs that have become ineffective or toxic, are pretty conservative with the dates they use.

They pick a date that they’re confident is well within the limit, then build in a little more slack to allow for poor storage. Effectively, the expiration date is one the company is happy to stand by in court. Pharma companies tell people to dispose of expired drugs. Yes, they want you to buy another pack of their product. Actually, the main reason is that when lawyers come knocking because someone got sick from taking expired tablets, they can point at their advice and say “We told you not to do that.”

The reality is that most medicines will stay safe and potent long after the expiration date on the package. This isn’t just a guess, either. We know for a fact that plenty of medicines will work just fine ten, 20, even 40 years after they officially expire.

Related: How to Make the Most Powerful Natural Antibiotic

DoD

The DoD is one of the USA’s largest buyers of medicines. Every military post has a medical center. Field hospitals and ambulance units hold large stocks of medicines in their deployment stores, and because they never know where they’ll be going and what they’ll have to treat, they have to keep a wide range of drugs. A lot of the drugs the DoD buys never get used. They’re bought, stored in a container ready to be loaded on a plane and flown somewhere dusty, then ten years later they’re taken out, incinerated and the whole process starts again.

In the mid-1980s the DoD started to get fed up paying for medicines that were just going to be incinerated someday, and launched the Shelf Life Extension Program to see if they could hold on to their stockpiles a little longer. Results from that program have been coming in for a few years now, and in general they’re pretty good news.

SLEP

SLEP results published in 2009 found that of 122 medicines tested in one study, 88% of them were still safe and acceptably effective at least one year after they expired – and many were good for much longer than that. In fact the average extension time for all drugs in military storage was 6.5 years. Current DoD policy is not to extend shelf life for more than ten years, but at least one drug was found to be safe and effective 23 years after it expired.

Many medications are based on a few common ingredients, and SLEP has only found two that have lost a lot of their potency a year after expiration – aspirin and amphetamine. Insulin and epinephrine (EpiPens) are two other medications that should never be taken after they’ve expired. They lose effectiveness rapidly outside their planned shelf life.

However, acetaminophen (Tylenol), caffeine, codeine, methaqualone, butalbital, phenobarbital, pentobarbital, secobarbital, meprobamate, hydrocodone and chlorpheniramine are among many common ingredients that stay safe and potent after the expiry date.

What About Antibiotics?

Probably not many preppers are holding a stock of amphetamines, and most people can use Tylenol as a substitute for aspirin, but one type of medication preppers do worry about is antibiotics. These have saved millions of lives since the 1940s, and they’ll be essential after the SHTF. Who wants to survive the EMP apocalypse, then die because a cut finger got infected? So there are good reasons why preppers talk about ways to get their hands on off-prescription antibiotics. But, once you’ve got them, how long can you store them for?

Some antibiotics need to be disposed of when they reach their expiry date. Tetracycline, a popular broad-spectrum antibiotic, is one of them. Using expired tetracycline can cause fatal kidney damage.

Amoxicillin is used for many common infections and is often supplied as a liquid suspension. This shouldn’t be stored for more than 14 days after it was mixed, as it can be infected with resistant bacteria.

Tablets or capsules of amoxicillin are stable, though – the problem only affects liquid forms. Other liquid antibiotics, including eye drops, are also potentially dangerous when they get old, and should never be used after the expiration date. A key point here is that any bacteria in them have already evolved antibiotic resistance, and you really don’t want them getting into your body if you can help it.

Related: Emergency Bag to Keep In Your Car In Case Of An EMP

Other antibiotics can be used well after their expiration dates. These include ciprofloxacin, which is used to treat diarrhea, respiratory infections and typhoid as well as many other diseases. It’s a very useful one to store.

Captopril tablets, flucloxacillin capsules and theophylline tablets will also last for at least 18 months past the expiration date if they’ve been stored properly. Between them these antibiotics will handle most bacterial infections. Overall, if you stick with antibiotics that come in tablet or capsule form they should stay effective for anywhere between two and 15 years after their expiry date.

Unfortunately there are too many examples of medicines that are and aren’t safe after expiry. There’s no space to list them here. If you notice that medicines in your stockpile are close to expiring, and they aren’t mentioned here, the best thing to do is check online if they can still be safely used. The FDA has a page on SLEP that lists some of the drugs that have extended shelf lives. It’s worth a look.

In a real emergency, unless a drug is known to become dangerous past its expiry date, is in liquid form or is obviously spoiled (Excedrin tablets with a vinegary smell, for example) you might as well try any expired medicines you have. They probably won’t hurt, and according to the DoD there’s an 88% chance they’ll help. If you have the option it’s always better to use unexpired medicines, but prepping is all about staying alive when options are scarce. If expired – but probably still effective – medicines are all you have available, it’s usually better to take the chance than do nothing.

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Giurgi C.
By Giurgi C. October 11, 2018 06:56
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12 Comments

  1. zelmer October 11, 14:17

    My question is if you store them in vacuum packed bags such as a food saver brand and then store them in a cool dark place will they last much longer?

    Reply to this comment
    • Claude Davis October 11, 15:49

      Storing them in a cool, dark place is usually recommended anyway; if you DON’T do that, they might not even last until their expiration date. As for vacuum packing them, that probably isn’t going to make much difference. Unused antibiotics should be in a sealed container anyway.

      Reply to this comment
    • left coast chuck October 11, 17:22

      Typically the recommended storage parameters are 65°F and 50% humidity in a dark storage. That doesn’t mean that you must store them in the back corner of the basement. I store my expendables in cardboard boxes. That makes it dark. It doesn’t have to be the absolute darkness of some deep cave. Don’t freeze them as freezing can render some things useless. Much like the urban legend of storing your batteries in the freezer of your refrigerator.

      Many drugs come in brown or orange bottles. That is the equivalent of “dark”, although in my opinion, orange is a poor substitute for dark brown. I think it is a compromise color. Clear enough to see the contents, dark enough to cut the ultraviolet light waves that do the aging. It’s hard to see the meds in a brown bottle.

      Reply to this comment
  2. RajunCajun October 11, 16:56

    Funny thing is my family likes to joke with me cause I like to prep. Never once thought about it that I’m a two time transplant patient. Was brought to my attention in one of their joke sessions that without my transplant meds I wouldn’t last a few months. Sort of made me look at things differently. But I still like to prep, at least I can assure my kids and wife are in a better spot.

    Reply to this comment
    • left coast chuck October 11, 20:27

      It’s not just for ourselves that we prepare, it is for those who are dependent upon us for their sustenance and protection.

      Reply to this comment
      • Carla Maria October 14, 15:53

        I prep also so that any of my family who inherits my house will automatically be prepared. I think of it like putting money in a savings account. If I don’t use it during my life, my family can use it or pass it on to the next generation. I speak of durable items: fire starter, solar oven, solar grill, water purifier, tent, bug out bag, survival books, solar chargers, etc.

        Reply to this comment
  3. Floyd Lloyd October 11, 19:12

    Always appreciate your articles. But what frustrates me is when an author starts to investigate a subject and then begs off with the excuse that “There’s no space to list them (or go into that) here.” I looked at the SLEP link and it was not very informative. You would think that this is a subject of great importance to, not only the prepper community, but everyone who needs, takes or has pharmaceuticals that they rely on for continued good health. Is there a source for this information? If not, could someone provide such info?

    Reply to this comment
    • left coast chuck October 11, 20:31

      Floyd: I too looked at the SLEP web link and it was typical government pub, full of meaningless words signifying nothing. Even clicking on one of the links on the SLEP site only referred to Tamaflu which was a couple of years ago.

      I wondered if I was missing something, but apparently at least two of us found the link to be not quite helpful.

      That’s why, when I wrote my article on bicycling and alternative vehicles for bugging out it was a three part series. Too much needed information for a 250 word twitter message.

      Reply to this comment
  4. Alex October 12, 16:07

    Just trying to make the message a little bit more precise the following can be said:
    -the date of expirement is mainly a juristical term. On
    this date the manufactur´s warranty ends.
    -this has little do do with the effectivness of a drug,
    Some people believe that usage on the following day
    can be dangerous. This is clearly nonsense, since
    most medications degradate quite slowly if packed and
    stored properly.
    -three factors have to be considered: temperature, light
    and oxygen. The most has been said already.
    -solutions or liquids in bottles allow oxygen from the
    air to come in contact with the liquid once they are
    opened up. These should not be used more than 2-4
    weeks after opening the bottle.
    -the best packaging for pills, tablets. capsules and
    similar forms are blisters, containing nitrogen
    (=chemically nearly inert gas). This nitrogen filling
    preserves the properties of the drug best.
    But not all those blisters contain
    nitrogen. Some people claim they can smell or taste
    nitrogen, it´s something dull or muggy. You may know
    this taste from whipping ceam in spray cans tasting
    differently from freshly whipped cream containing air.
    Not easy to perform on blistered drugs, but you can try
    to put your nose near to the blister when you remove a
    tablet from the blister. A safer way is to ask the
    manufacturer what kind of gas is in his blisters.
    -packing pills and tablets in bottles is in fact an obsolete
    packing method as it shortens the time of proper
    usability.
    But manufacturers have absolutey no interest for this
    topic as it is detrimental for their buisiness, They want
    to sell the same medication again and again.
    -creams, pastes, salves, unguents, emulsions and
    similar products unmix and deteriorate with time.
    Everyone knows the phenomenon when after opening
    an older tube some liquid will drop out of it. So the
    possible storage time of all those products is much
    shorter than of pills, tablets or capsules. In most cases
    this is not really dangerous but unsavory. If the tube
    had been opened already, the effect of oxygen to the
    first part of the content has to be considered. Pressing
    out a small amount of the content will make the rest of
    the tube usable. You may know this from toothpaste.
    -keeping drugs in a normal fridge (+8 centigrades) will
    decelerate drug deteroration and extend usability.

    Please feel free to ask me further questions if desired.

    Reply to this comment
  5. Carla October 14, 06:40

    Colloidal silver just might be the answer to many of the antibiotic questions. There is a reason that most of the victims of the black plague were poor, and very few were wealthy. That proverbial ‘silver spoon’ saved many lives, due to the tiny traces of silver that made it through the digestive system, into the bloodstreams of the wealthy. The poor, often not having spoons at all, lived (germy) hand to mouth.

    Reply to this comment
    • Claude Davis October 14, 16:24

      I know colloidal silver is popular, but I wouldn’t want to rely on it if my life was in the balance. Silver can kill bacteria, including antibiotic-resistant ones, but there’s no evidence at all that it can do that once the bacteria are in your body. Colloidal silver also interferes with your body’s ability to absorb other drugs, and it can turn your skin blue as well.

      Reply to this comment
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