Medicine stock up/clean out

[lovinmyboys]

I decided to organize our medicines today and I am having trouble deciding what to do. Do you throw away expired medicine? It seems the consensus is that medicine works much longer than its expiration date. I have some from 2016 which I am embarrassed to admit has come with us for three moves. Which brings me to my next question, do you keep a fully stocked medicine cabinet or do you just go buy things when you need it?

Im considering throwing everything away that expired in 2022 or earlier and then just stocking the stuff we use regularly (not replacing things that expired 8 years ago). But I feel like Covid made me want to always have stuff stocked.

 

Edited February 22 by lovinmyboys

[mlktwins]

I take our expired meds to a CVS med drop off box. They are located near the pharmacy. They do have some rules so I would look at those, such as amounts of liquid meds allowed, before you go.

[TheReader]

I do keep a pretty decently stocked medicine box, but also limit it to shoebox size so that I don't accumulate too much. So, we always have things like the various pain relievers/fever reducers, sinus/allergy stuff, tummy stuff, and cold/cough stuff. Then we have a few Rx things, those of course we can't stock up on.  And I have a shoebox of first aid stuff as well, which has all of the band-aids, wraps, ointments, itch cream, gauze/tape, etc. 

For expiration dates....when we were in Brazil, we didn't toss anything and just kept using it. Now we try to go with maybe 2-3 yrs at the most (DH would rather a year max but that feels wasteful to me). 

It helped when everyone finally learned to swallow pills and we could quit keeping chewables of everything on hand in addition to the grown-up stuff, but I do like to have some of everything just in case something hits in the middle of the night and someone needs something. (then again, I'm the same person that also takes a whole mini medicine cabinet when we so much as go away for the weekend, so maybe I'm not the one to ask about this....). 

[Pawz4me]

I will keep most medications for a year beyond the expiration date, but longer than that and I toss or take to a drug take back location. About the only OTC medicines we stay stocked on are Tylenol and Motrin, Afrin nasal spray, and a variety of BandAids and self-stick gauze.

[prairiewindmomma]

I have a one year past expiration general rule of thumb. I have a few meds I keep around but do not usually use—loperamide for diarrhea is one of those. Nebulizer solutions are another. We no longer have 24 hour pharmacies near here and so I plan around that. 

[MercyA]

These are the things I keep stocked: 

First aid items

Tums, Pepto-Bismol, Imodium, Ex Lax

Tylenol, Aleve, Advil, baby aspirin (for dog)

Nighttime and daytime cold/flu meds, cough suppressant, antihistamines, decongestant, cough drops, nasal spray

Sleep aids

Poison ivy prevention and treatment

Anti-itch gel, cortisone cream

Rubbing alcohol, hydrogen peroxide, witch hazel

Sunscreens

Contact supplies

Shampoo, soap, moisturizers

Deodorant, toothpaste

A few extra favorite makeup items

A few other misc. things

(I use mostly generics meds but I used trade names here.)

I do keep most prescription meds. I am cheap and I have some chronic conditions for which prescription meds are helpful. Plus, who knows what's going to happen in the world. I think I've only had one (very old) prescription not work as well as a newer one, but other than that no problems. I store them away from the main medicine cabinet. Liquid medications I don't keep as long.

[kathyl]

I keep things for about a year after the expiration date, then toss.  Dh keeps things forever unless I find it and toss it. 

The medicines I try to keep on hand are:  liquid children's Tylenol, regular Bayer aspirin, liquid Benadryl, lots of peroxide, Otrivin nose drops, and triple antibiotic ointment.  And Covid tests.  

Dh keeps Ibuprofen around and uses it no matter how old it is.  He's also on blood pressure medicine but he uses that up and has to go to the doctor to get more prescribed (I think).

None of the rest of us are on prescription meds.

I don't stock up on things because we don't use them fast enough and I don't like taking expired meds, or having to throw away expired meds.

 

Edited February 22 by kathyl

[Tap]

When the kids were little, I kept common cough/cold items on hand all the time. Even if that meant storing an unopened box to keep it on hand for nighttime illnesses. Once they could take adult doses, I stopped keeping a back up supply. There was pretty much always an open box/bottle of common items on hand, plus the mishmash of things like Midol or diarrhea meds for my youngest. 
 

I toss between 1-2 years expired. Some meds do go bad. Aspirin is one of them. Otc meds aren’t so expensive that I can’t replace them. I do have a bag of expired prescriptions but most just need to go to the disposal site. I keep extra inhalers, steroids and antibiotics. But again, I generally toss with 2 years. I always keep extra fresh rescue inhalers for asthma and epipens. Not messing around with expired ones of those!

 

[Miss Tick]

😂 Dh had a bad cold last week (tested C19 neg) and I made him take the antique Cough & Cold we had from 2003 and 2005. Judging by the departure and subsequent return of symptoms it still worked. Personally, I only keep pain killers, cough drops, and the food decongestant on hand. The rest is leftovers that I cull when the shelf gets full.

[Wheres Toto]

We have a lot since we have various muscle/arthritis/injuries plus allergies.  Besides prescriptions we have:

Advil (my preference)
Tylenol (dh can't take advil anymore)
Children's Tylenol and/or aspirin (ds can't swallow pills but is now old enough for aspirin)
Benedryl
children's Benedryl
Dayquil
Cough drops
Tums
Pepto-bismol tablets
Benedryl cream
neosporin creams
Magnesium gel
Icy-hot type muscle ache stuff
peroxide
alcohol
Vicks vapor rub
Advil PM (which is really just advil and benedryl so not sure why we bothered)
 

[KungFuPanda]

I just replaced my expired-in-2016 Tylenol. I buy smaller bottles now. The Motrin tends to get used before it expires. I do like to keep DayQuil/Nyquil on hand so I’m not trying to buy it during cold/flu season. We haven’t really needed any for years now so I should check those dates. 

[HomeAgain]

We don't throw away expired meds.  If we don't have a drop off day come up, we ask our pharmacy/doctor's office.  They're usually willing to take it back from us.  In fact, you just reminded me that I have a drawer full of Sudafed to get rid of.  It did nothing for ds.

Our on hand stock is kept pretty low:

• motrin
• Zyrtec
• Nyquil/Dayquil
• vitamins/Tums
• zinc and elderberry lozenges
• Alka Selzer Cold & Flu powdered drink mix (surprisingly super effective and fast!)
• Vicks Vaporub

Most get used regularly enough. DH has some pain meds that are strong and must go back to the doctor if he doesn't finish them when issued.  I'm not sure Vick's ever truly expires. 😄 That's ds14's drug of choice and he will literally carry the little container around when he has a cold, like it's an emotional support cream or something.  I do throw away things like Neosporin and iodine.

About once a year we go through our first aid kits and medicine cabinet.  Our kits are all stocked differently (sports, outdoor rec, basic car emergency) and we just go through to make sure everything is still active.  Medicines in the cabinet tend to be replaced often enough on their own, so I guess we do buy as we go along...ish.  Like, we're going on vacation this spring and I'm making sure to have everything ahead of time that we may need if people get sick.

 

[Corraleno]

The "expiration dates" on most medications are not based on any actual data — most manufacturers just slap on an expiration date of 1-2 yrs from manufacture to cover their butts, they're not doing studies to see how long the medication actually lasts. The US government regularly tests the drugs they keep in the national stockpile, and they've found that most retain full potency for years past the expiration date. 

There was an interesting study (here) in which scientists tested several prescription drugs that had been expired for 28 to 40 YEARS, and 12 of 14 ingredients retained full potency, including codeine, hydrocodone, pentobarbital, and acetaminophen. The two that did not were aspirin (which was basically down to zero at that point) and amphetamine, which still had about 50% potency left even after decades. So I ignore expiration dates and keep unused Rx meds in a secure place.

I also keep a stock of OTC meds in the main bathroom: assorted cold & flu meds, Sambucol, melatonin, ibuprofen, generic Benadryl (which doubles as a sleep aid), Tums, Pepto, GasX, hydrocortisone & some other anti-itch stuff (DD has eczema), antibiotic ointment, gauze pads, vet wrap, and various sizes of bandages. 

 

[EKS]

28 minutes ago, Corraleno said:

The "expiration dates" on most medications are not based on any actual data — most manufacturers just slap on an expiration date of 1-2 yrs from manufacture to cover their butts, they're not doing studies to see how long the medication actually lasts.

This is not correct.  They don't just "slap on" an expiration date.  They do stability studies.  There's "actual data."  I know.  I used to be in charge of our company's stability program.

What they don't necessarily do is determine when a medication really does go bad.  This means that they will run stability studies out to a certain point and then may discontinue them.  So if your medication says it's good for two years, then the manufacturer has determined that it is good for two years, but they might not have determined that it is good for five years or fifty years.

Edited February 23 by EKS

[Corraleno]

12 minutes ago, EKS said:

This is not correct.  They don't just "slap on" an expiration date.  They do stability studies.  There's "actual data."  I know.  I used to be in charge of our company's stability program.

What they don't necessarily do is determine when a medication really does go bad.  This means that they will run stability studies out to a certain point and then may discontinue them.  So if your medication says it's good for two years, then the manufacturer has determined that it is good for two years, but they might not have determined that it is good for five years or fifty years.

This does not contradict what I said — manufacturers choose a completely arbitrary date, generally 1-2 years from manufacture, within which they guarantee that an ingredient remains potent, but that is not based on any studies of when the medication actually expires. There's no reason they can't test products well beyond an arbitrary year or two, but of course they'd rather have people repeatedly throwing away and replacing perfectly good meds.

The US government does run those kind of studies, so we know that many meds last way longer than the date manufacturers put on them, and the study I linked in my previous post suggests that that many drugs, like hydrocodone and acetaminophen, seem to retain full potency nearly indefinitely. Telling consumers that their bottle of Tylenol "goes bad" after 2 years and needs to be thrown out is deceptive and wasteful — although certainly profitable.

 

[J-rap]

I do keep meds past expiration, unless it's long expired for a condition that no longer exists or the prescription has drastically changed or would be dangerous to take now.    Once we were stranded at home in a blizzard and needed antibiotics for a serious illness, and the hospital told us to take out any old antibiotics from our medicine cabinet (since roads were impossible for even emergency vehicles) and let them know what we had.  I think they were all expired, but they were able to tell us which ones we could safely take (most of them) which would tide us over.  

[EKS]

9 hours ago, Corraleno said:

This does not contradict what I said — manufacturers choose a completely arbitrary date, generally 1-2 years from manufacture, within which they guarantee that an ingredient remains potent, but that is not based on any studies of when the medication actually expires.

You said they "slap" the expiration date on and that it's not based on actual data.  That is not what happens.

[KSera]

6 hours ago, EKS said:

You said they "slap" the expiration date on and that it's not based on actual data.  That is not what happens.

Perhaps it would be more accurate if the dates they put on there said something like “good until” since that’s what they can say based on testing—that they’re still good until at least that date. When it says “expires”, that sends a message that it’s no longer any good after that date.  That’s the part that isn’t supported by data. It’s similar to the RATs for Covid. The dates on the box are just the ones they tested them as being good for, not a date they are expected to start expiring on (fortunately, they continued doing studies as time passed and published updated expiration dates as time passed, though I’m not sure if they are continuing to try to verify them beyond 18 months). 

[wathe]

I think of drug expiry dates as like warranty periods.  Guaranteed potency until dates specified, but useful life generally extends beyond warranty period.

[Corraleno]

6 hours ago, EKS said:

You said they "slap" the expiration date on and that it's not based on actual data.  That is not what happens.

An expiration date based on studies that literally have nothing to do with when the product actually expires is in fact "not based on actual data." From the study I linked above: "FDA regulations do not require determination of how long medications remain potent after that, allowing manufacturers to arbitrarily establish expiration dates without determining actual long-term drug stability."

What manufacturers do is the equivalent of giving a bunch of high school seniors an academic proficiency test but arbitrarily stopping the test after the first few questions, which are not even HS level, and then claiming that everyone who took the test only reads at a 6th grade level. Yes, they have "data," but that data is being used in an intentionally misleading way to imply that the students cannot read beyond a 6th grade level, while hiding the fact that they purposely did not test for levels above that, yet still claiming that their results are an accurate measure of the reading levels of high school seniors.

 

[Corraleno]

On an individual basis people may think that false "expiration dates" are no big deal — acetaminophen is cheap so who cares if people are tossing a Costco-sized jar that's still 3/4 full and buying a new one every 2 years? But on a population level, not only does the cost add up, but that's also a ton of extra plastic and a lot of wasted (and potentially dangerous) medication added to landfills and wastewater.

And when you think about the billions of dollars spent by federal, state, and local governments on stockpiling medications for emergencies, that's an insane amount of taxpayer money getting flushed down the toilet for no reason other than maximizing profits of pharmaceutical companies. That's why the government set up the Shelf Life Extension Program to test products in the Strategic National Stockpile — and what they found is that the vast majority of meds were good for an average of 5.5 years (and some for as long as 20 years) past the manufacturer's arbitrarily chosen "expiration" date. Just as examples, doxycycline and ciproflaxin, which have manufacturer's expiration dates of 2 and 3 years, respectively, were actually found to be fully potent for at least 7 and 13 years.

SLEP has saved the federal government hundreds of millions of dollars, but unfortunately it doesn't apply to state and local stockpiles, which are not allowed to use meds beyond the fake "expiration" dates that manufacturers put on them. It's ridiculous.

[SHP]

I refill prescriptions as early as allowed and take the few extras and store in another bottle. When I reach a 30 day supply I start rotating that with the new meds and start on the next 30 day supply.

Covid wiped out most of my emergency supply and then the recent difficulty in getting medications has wiped out my more recent emergency stash. 

[Ausmumof3]

I chuck out sunscreen and stuff that has a temp warning as mostly I find with our climate it degrades. I think the same is true for hydrogen peroxide if it’s exposed to light that’s why it’s in a brown bottle? But for basic pills like paracetamol or vitamins I’m not super fussy however we go through it enough it’s rarely been a problem 

[Resilient]

I didn’t know about aspirin expiration. That’s helpful. 

I keep chewable children’s motrin—orange not that yucky grape stuff—alongside adult ibuprofen   When I need help, I take one adult and one children’s. That dose works for me, usually, and the chewable gets into my system faster. 

Same with Benedryl. If I’m at home I just use children’s liquid, but I carry adult and the children’s dissolvable everywhere else. Same rationale. 

Pepto tabs, Tums, acetaminophen, ibuprofen, Benedryl—children’s, adult, AND topical—Delsym, simalasin eye drops, Xclear nasal spray, bandaids, duct tape, prescriptions, arnica, and a garage shelf full of Puffs. Narcotic prescriptions get tossed when the immediate need is gone.  

I am going to try homeopathic antihistamine as it works for my friend and I’m a little spooked about recent Benedryl info. 

[cintinative]

7 hours ago, Resilient said:

duct tape

Okay, this one jumped out at me. What do you use duct tape for that is medical?

[goldberry]

I just cleaned out our med cabinet as well. I tossed 2 years past expiration. I really struggle with this because I have girl scout syndrome and want to have everything there. Especially after COVID. But yes most things do expire before I get to use them except Advil and Mucinex.

[kbutton]

I toss really old stuff when it gets unwieldy and don’t replace it because it seems like we are unlikely to need it.

I do keep things that are dual purpose (mucinex can help symptoms from allergy cough as well as colds).

There are some things we go through like water, and we generally keep stocked up on those.

We have a lot of Rx stuff to manage as well as specific supplements recommended by our clinicians (I run low on many nutrients in spite of a good diet—in a Zombie apocalypse, I’m a goner). We tend to hang onto extras.

[prairiewindmomma]

recent study on post-expiry drug strength of albuterol and montelukast as measured by liquid chromatography, fwiw: https://www.sciencedirect.com/science/article/pii/S2405844022013925

I do agree that many, many meds retain efficacy long past expiry date expiration. I also think that medications that require sensitive storage conditions (a lot of injectables) or that contain tiny doses of medication with a lot of filler but that need a precise dose for efficacy (like thyroid meds) probably should be used up in their guaranteed efficacy and safety window.

[Corraleno]

1 hour ago, prairiewindmomma said:

recent study on post-expiry drug strength of albuterol and montelukast as measured by liquid chromatography, fwiw: https://www.sciencedirect.com/science/article/pii/S2405844022013925

I really wish the FDA would require manufacturers to actually do these studies, or at least require them to update expiration dates when such data exists. That study showed both of those drugs retain full potency for more than 15 years!

[Resilient]

7 hours ago, cintinative said:

Okay, this one jumped out at me. What do you use duct tape for that is medical?

Getting rid of warts!  https://www.health.harvard.edu/diseases-and-conditions/how-to-get-rid-of-warts

Duct tape is also a cheap and super-sticky  way to secure wrap-around gauze, like you might use around a wrist if a watch or bracelet has chafed the skin.  Or if you need the keep an elastic bandage (Ace) from further fraying where they cut a thumb-hole, you can cover the fraying edge with duct tape.  

Or it can be a short term replacement for the sticky part of a bandaid if you find out you’re allergic to that stickum.  
 

 

[Ditto]

Thank you so much for this thread!   Thanks to you, I FINALLY cleaned out and organized the med boxes.    I have been putting it off for months.  It feels good to have it completed.

[horsellian]

On 2/23/2024 at 2:35 AM, Corraleno said:

The "expiration dates" on most medications are not based on any actual data — most manufacturers just slap on an expiration date of 1-2 yrs from manufacture to cover their butts, they're not doing studies to see how long the medication actually lasts.

This isn't true as this kind of testing is part of what I do for a living! But expiry dates are often much shorter than effectiveness because most studies run only 3 years, and expiry dates are calculated from date of manufacture. It's not in any drug company's financial interest to run a 10 year stability study.  And no-one would fund one on generic medicines - again, no commercial benefit.

I also know from stability testing them that some vitamin tablets have very short shelf lives. Off the top of my head, vitamin C and folic acid are two that will be well below dosage after the expiry date, particularly if you live in a hot humid climate.

Edited February 25 by horsellian

[wathe]

17 minutes ago, horsellian said:

This isn't true as this kind of testing is part of what I do for a living! But expiry dates are often much shorter than effectiveness because most studies run only 3 years, and expiry dates are calculated from date of manufacture. It's not in any drug company's financial interest to run a 10 year stability study.  And no-one would fund one on generic medicines - again, no commercial benefit.

I also know from stability testing them that some vitamin tablets have very short shelf lives. Off the top of my head, vitamin C and folic acid are two that will be well below dosage after the expiry date, particularly if you live in a hot humid climate.

This is the role of government funded science:  doing important scientific work that has no commercial benefit.  Also driving important social change that has no commercial benefit, for the benefit of all citizens.

We live in a world where we produce colossal amounts of waste because "commercial benefit" to corporations is more important than anything else (more important even that having a habitable planet).  Litigiousness of American society is also a factor. 

Drug waste is a huge issue.  As are drug shortages.  Extending expiration dates to match actual stability of products would constitute wise use of resources on a population level.  It would require government intervention and regulatory change.  I don't know if that would be possible in the current American political landscape.

IME, a stable, affordable, and socially responsible drug supply should be a public good.

 

[horsellian]

22 hours ago, wathe said:

This is the role of government funded science:  doing important scientific work that has no commercial benefit.  Also driving important social change that has no commercial benefit, for the benefit of all citizens.

Unfortunately, this would only work if the required studies were a one-time deal.  Regulatory requirements mean stability must be started on fresh batches of each product each year.  It would therefore be uneconomic for the government to fund 10+year studies for every formulation of every drug from every manufacturer so that expiry dates could be longer. (Think how many different studies would be required every year just for paracetamol, aspirin and ibuprofen.)

I agree that drug waste is a major issue, but it can be tackled more effectively by not over-prescribing than by trying to extend shelf-lives, particularly for cheaper generic drugs which are not in short supply.  For consumers of OTC drugs it's not hard to only buy what you need, and not stockpile excessive quantities at home.