How long past the expiration dates can medications retain full potency?
a. 10 years
b. 20 years
c. 30 years
d. 40 years
That’s at least 40 years, according to Lee Cantrell, PharmD, director of the California Poison Control System of San Diego and a professor of clinical pharmacy at the University of California San Francisco. Dr. Cantrell was recently able to test the potency of medications found in the back of a long-forgotten storage closet of a retail pharmacy.
The medications contained no lot numbers and some of the manufacturers were defunct, so there was no way of knowing exactly how old the medications were. However, Dr. Cantrell noted that they predated the Controlled Substances Act of 1970. Hycomine compound, which was one of the drugs Dr. Cantrell tested, contained acetaminophen, caffeine, chlorpheniramine, hydrocodone, and phenylephrine — all in one pill. Yikes.
Dr. Cantrell has also focused on the expiration dates of current medications, including EpiPens, which often expire 18 months after the manufacturing date. The cost of the life-saving medication has skyrocketed by more than 400% since 2007, a sharp increase that has patients wondering if expired auto-injection devices are safe and effective. To find out, Dr. Cantrell tested the contents of 31 expired EpiPens containing epinephrine 1 mg/ml and 9 EpiPen Jrs containing epinephrine 0.5 mg/ml. Two thirds of the EpiPens and more than half of the EpiPen Jrs contained at least 80% of their labeled concentrations up to 50 months past their expiration dates.
The findings indicated the dose available in EpiPens long after they expire would still provide therapeutic benefit, according to Dr. Cantrell. He said expired EpiPens are a better option than no treatment at all for patients who are having life-threatening allergic reactions. He also acknowledged the study’s small sample size, but said the findings provided additional information that suggests current drug manufacturing expiration dating needs to be extended for EpiPens and many other types of medications.