Thursday, November 13, 2014

Expiration Dates are NOT a Guideline

One of our regular patients steps up to the window. Today she's wearing big dark sunglasses like she's Jackie Onassis.

"I think I might have pink eye," she says.

I'm glad when people say that so I can get out the alcohol and hose everything down after they leave. Plus, I send a mental note to self.

Self: Don't touch eyes until you wash your hands

The lady hands me two bottles of Sulfacetamide. She asks me if she can use them to treat pink eye. I say yes, of course, but I look at the bottles. One expired in 2008. The other expired in 2003.

You people out there! Throw away your expired medication! Seriously!

So I tell her they are expired. She asks me if she can still use them anyway.

I wonder what people think expiration dates are for. Is that something manufacturers print on a medication package for fun or because they're bored?

This is a lady that would probably argue with me, so I tried a different approach: "Suppose you go over to the meat department and find a package of hamburger with an expiration date of last month. Would you eat it?"

"Of course not!" she said.

"These medicines expired in 2003 and 2008, and you want to put it in your eye? Really?"

That seemed to get the message across.

"I'll go to Urgent Care," she said, and wandered off.


Anonymous said...

All of my prescriptions come with a one-year expiration date listed on the label. But when I get a prescription in the original (?) container (not one of the amber-colored bottles, but a white bottle with a factory-generated drug label), I can see that the expiration date is much later than one year after my prescription was filled. The prescription label still says the expiration date is one year from the date of filling.

This makes me skeptical about all expiration dates, since I'm clearly not being told the truth in at least some cases. I don't know if this is my Goofmart's policy, or if it's standard. But it seems pretty crappy to me. I err on the side of safety and I do throw them out. But money is tight and it sucks to think I'm throwing out good medicine.

Crazy RxMan said...

By law, once medication is dispensed from a pharmacy, it must be labeled with an expiration date one year from the date of dispensing, unless the actual date on the original container is a date less than one year from that date (as is the case with a lot of thyroid medication).

Medication in the original, sealed container often has an expiration date that is sometimes two or three years away. That date applies to the medication IN the original container, UNOPENED.

Once you open a bottle of medication, things are now completely different. The medication has then been exposed to the elements which starts a degradation process of potency. Add to that the fact that the FDA doesn't know how Joe Blow is storing his medication, therefore the safest and most prudent thing to do is to shorten that expiration date. Heat, cold, sunlight, humidity can all play a different role in the life of the medication. Certainly a medication stored under the most ideal conditions would last longer, but most people don't do that. They stick it in their bathroom medicine cabinet where it is exposed, like it or not, to a lot of nasties.

In the case of this blog post, we're talking about something that GOES IN THE EYE and the manufacturer listed as expired in 2003 and 2008. Who knows what bugs are growing inside those bottles now, and she wanted to stick it in her eye? Common sense would tell you that's just a bad idea. In my mind, eyesight is a lot more valuable to me than a doctor visit and a new prescription.

OldSquid said...

When I was in the Navy as a hospital corpsman, we frequently would get updates/extentions expiration dates; however, these we on typically OTC medications, APAP, pseudoephedrine, motrin, etc.

Anonymous said...

May I use your hamburger analogy the next time I am confronted with this situation? Because there will surely be a next time, and a time after that, and so on...

Anonymous said...

Thank you for the explanation!

I used to work in research, and we were trained in working with medications - proper storage, administration and so forth. I got curious and quizzed my fellow students about how they stored their personal meds at home. All of them kept prescription drugs and OTC meds in the medicine cabinet in the bathroom! So the meds that go into rats are protected against light, humidity, contamination (as best as possible), but the meds that go into your body, well, why worry?

It hurts my head.