Out with the old! It is the fresh start of a new year, which means it is time to get rid of what has surpassed its usefulness. To people and stuffs that no longer serve you:
Medicines are no exception. Whether you have a family member in the household who takes many medicines on a daily basis – or you are just a ‘medicine hoarder’ who takes comfort in having ‘just in case’ medicines– it is always good to take stock of the medicines that have lapsed their expiry dates and dispose them properly.
Throw them away?! Feels so ‘sayang’ leh. Well, if it is only expired by a few months, it should be no big deal, right?
Never, never be tempted to use expired medicines. The appearance of an expired medicine may still look the same, but you have no idea what has changed in the content.
Is medicine expiry date ‘real’?
Expiry dates of the medicines are not determined arbitrarily. Rather, it is a critical decision that is made based on cumulative scientific evidence gathered through numerous experiments that test how long the medicine strength will last. For example, the manufacturer will intentionally expose the finished medicines to different environments with varying temperatures, humidity levels and storage periods to examine how medicine degradation will respond to these external factors.
You can always find the expiry date on the medicines’ packaging. For some tablets, the expiry date is printed on the aluminium foil strips.
📝 Many people love to cut their tablet strips in half for easier storage, but you should not do that. This is because the expiry date is printed only on one side of the strips, cutting it in half means that the other half of the strip has no expiry date printed on it. That way you could not know what is the expiry date of that half of the tablet strips!
Expired medicines can be risky
Expired medicines can be less effective or risky due to a change in chemical composition or a decrease in strength. This can mean if you take an expired Panadol® for fever, your fever may not resolve as expected. Worse still, imaging lifesaving medicines such as glyceryl trinitrate (GTN, for chest pain and heart attack) has expired. One day, the user of GTN experiences a chest pain, he or she takes the expired GTN and expects it to work (which of course, it may not work). This could potentially worsen the chest pain or even lead to heart attack that kills!
The same goes to medicines in liquid or injectable forms. It is not recommended to use expired injectable medicines as using these compounds inappropriately will place patients at greater risk. For example, epinephrine in the EpiPen auto-injector (for severe allergic reactions) has been shown to lose its strength after the expired dates; similarly, insulin (for diabetes) also displays comparable degradation patterns after expiry. The loss of strength can also be a major concern for antibiotics. Taking expired antibiotics that have subpar effectiveness not only can lead to failure in eradicating your infections, but it may also contribute to more serious infections and antibiotic resistance.
The bottom line is this: once a medicine has passed its expiration date, there is no guarantee that the medicine will be safe and effective.
Expired medicines can be abused if not disposed properly
Medicines that you keep in the cabinet for years are highly susceptible to diversion, misuse and abuse. In addition, expired medicines are also not just a risk to the person they were prescribed for, and can injure children and pets if taken by mistake. This is why you should not only clear out expired medicines regularly, but you should do it right.
What to do with expired/unwanted medicines?
Step 1: Read the medicine’s label and follow any specific disposal instructions that may be included.
Step 2: Separate medicines that are expired, no longer used, damaged, changed based on the physical characteristics and types of medicines in which they were originally labelled. Put the medicines that have been separated into an appropriate container, such as a box or paper bag.
Step 3: Bring the medicines to the nearby government hospital or health clinic for further action. This is known as the Return Your Medicines Program, launched by the Pharmaceutical Services Division, Ministry of Health (MOH) in 2010. Medicines that are no longer needed can be returned to the pharmacy counter or medicine return box provided at all pharmacy facilities in government hospitals and health clinics.
Alternatively, if returning those medicines to the government hospital or health clinic is not an option for you, considering disposing the medicines along with your household trash – with care.
It is very important that you follow the following recommendations from the United States Food and Drug Administration (FDA) when disposing your medicines:
However, certain medicines are specifically recommended for flushing down a toilet or sink because they could be especially harmful, even fatal, to a child, pet, or anyone else if taken accidentally. Don’t know if your medicines are more suitable for flushing? Check out this list here.
Note: Return Your Medicines Program is the drug take-back option in Malaysia.
Most importantly, don’t waste.
Malaysians in general are lovely people, aren’t we? But we have to admit Malaysians are also notorious for wasting resources, and that is not something to be proud of. Not only do we waste food and clothes, we even waste medicines! From 2014 to 2016, the Ministry of Health has destroyed a whopping RM2mil worth of expired or spoilt medicines. One factor is perhaps the generosity of our public healthcare system that gives out medicines at extremely low prices or even free.
Wastage of medicines are also contributed by the following:
-
Stops taking medicines when the patient is feeling better
-
Gets the medicines from multiple sources (different GPs, hospitals and pharmacies)
-
Stops taking medicines because the patient is not convinced that taking medicines can cure the condition or illness that he is having
-
Stops taking medicines due to doctor’s advice
-
Did not take medicines as instructed by the doctor
-
Doctor has changed the patient’s treatment regimen
-
Patient forgot to take the medicines
-
Patient had passed away
Some reasons are valid but some are just...completely avoidable. Medicines supplied by the government hospitals are made possible because of the taxpayer’s money, so let’s not waste such a precious resource. Take the supplied medicines as instructed so that you can recover from your illness. Discuss with your doctor or pharmacist if any problem arises. If your medicine is expired, do not take them and dispose of them using the proper methods.
