Monday, March 12, 2018

Your Expired Antibiotics are Still Good

Expiration dates on antibiotic pills, capsules and caplets are, essentially, a scam.

All you have to do is Google "expiration dates antibiotics" and the first citation given is from a Harvard heath letter entitled "Drug Expiration Dates - Do They Mean Anything?"

That post summarizes a 20-year study done by the FDA for the U.S. military:

"It turns out that the expiration date on a drug does stand for something, but probably not what you think it does. Since a law was passed in 1979, drug manufacturers are required to stamp an expiration date on their products. This is the date at which the manufacturer can still guarantee the full potency and safety of the drug.

"Most of what is known about drug expiration dates comes from a study conducted by the Food and Drug Administration at the request of the military. With a large and expensive stockpile of drugs, the military faced tossing out and replacing its drugs every few years. What they found from the study is 90% of more than 100 drugs, both prescription and over-the-counter, were perfectly good to use even 15 years after the expiration date.... So the expiration date doesn't really indicate a point at which the medication is no longer effective or has become unsafe to use.... Is the expiration date a marketing ploy by drug manufacturers, to keep you restocking your medicine cabinet and their pockets regularly? You can look at it that way."

The Wall Street Journal put this story on their front page a few years back.

But don't take my word for it: You can read the article, in its entirety, right here.

"Do drugs really stop working after the date stamped on the bottle? Fifteen years ago, the U.S. military decided to find out. Sitting on a $1 billion stockpile of drugs and facing the daunting process of destroying and replacing its supply every two to three years, the military began a testing program to see if it could extend the life of its inventory. The testing, conducted by the U.S. Food and Drug Administration, ultimately covered more than 100 drugs, prescription and over-the-counter. The results, never before reported, show that about 90% of them were safe and effective far past their original expiration date, at least one for 15 years past it.

"In light of these results, a former director of the testing program, Francis Flaherty, says he has concluded that expiration dates put on by manufacturers typically have no bearing on whether a drug is usable for longer. Mr. Flaherty notes that a drug maker is required to prove only that a drug is still good on whatever expiration date the company chooses to set. The expiration date doesn't mean, or even suggest, that the drug will stop being effective after that, nor that it will become harmful."

How can your doctor or vet not know this?

Well, to start with, on some important issues, veterinarians are often taught very little. The entire "course" given on canine nutrition, for example, may be a single lecture from a dog food salesman. The lecture on flea and tick remedies may be a lecture from a Merial salesperson who will detail "the spread" to be made from selling non-prescription Frontline as if it were a prescription drug (hint: it's not).

As for antibiotics, vets will learn by heart the branded and generic names of variouus drugs, and what they treat, but they may not learn other essential information.

And, as alarming as it may sound, that's true for many human doctors too.

Pharmacist and U.S. Army Colonel George Crawford, who used to be in charge of the Department of Defense's pharmaceutical Shelf Life Extension Program (SLEP) notes :

"Nobody tells you in pharmacy school that shelf life is about marketing, turnover and profits."

You might think veterinarians and doctors would learn about this stuff in a Continuing Medical Education (CME) course, right?

Except there is a little joker in the deck.

You see, those CME courses are heavily subsidized by drug and vaccine makers, who help pay the speaker fees and travel costs for many of the lecturers.

Drug and vaccine makers make money when people throw good medicine down the drain, and they make money when dogs are over-vaccinated.

The business of canine health care is business, and good health and integrity often take the hind post.

Everyone in the system -- vets, pharmacies, and manufacturers -- profit when dogs are over-vaccinated and non-expired medicines are thrown down the drain.

Billions of dollars are wasted every year as a consequence.  But do you have to be part of that? 

No, you do not.


Edze said...

YOUR vet might not know this, but my vet does, and has told me about this years ago.
It might be different in the US but here in Europe this is more of a (financial) problem for the vets than for their customers, as they are off course not allowed to sell expired meds, and loose money on meds expiring on the shelves.
I get the feeling from your blog (I am a long time reader and enjoy it a lot) that you don't have a very high opinion of your local vets, and don't seem to trust them a lot.

Anonymous said...

This is a very good article. Thanks for the reminder!
Now, the swiss governement should learn this too. Because we have a law that says every car must be stacked with a first aid kit and if you end up in a regular traffic check with a kit with products (even bandaids) past the expiration date you will get a hefty fine.
Conveniently you can buy seal wrapped kits with a single expiration date stamped on... it's either three or five years and then you have to replace the whole kit if you use any part of it... :-) great ploy. I guess that's the reason I (still) don't have one.

Jennifer said...

My father was a skeptical doctor, and good at chemistry. He noted that chemical decomposition rates nearly always increase rapidly with temperature, and taught us that if we were likely to want to keep meds on hand, refrigeration was a good idea. He would keep some drugs for family use long long past expiration date. Correlary (sp?): an expiration date that doesn't include storage temperature is meaningless.

CedarHollowJRT said...

The fish antibiotics can be brought without prescription from numerous pet catalogs. They are human grade! I compared the capsules to the ones on the internet and they were exactly the same.
Amazing, fish no prescription, 4 and 2 legs need a script. I took the 'fish' amoxicillin when I had a tooth infection in the middle of being snowed in and not able to get to a pharmacy. Saved me from massive pain.
I've kept some meds for years refrigerated and found, just like the article says, they were still efficient and did their job.