Are expired drugs harmful?
Health: Beware of Old Pills: Expired medications can be dangerous
Be it grandma's charcoal tablets or last year's cough syrup - most households have drugs that have long expired.
How exactly do you have to take the expiration date?
Which ones can you take without major hesitation, which ones not? Do you always have to be very specific about the expiration date? After all, many consumers have learned that food that has expired is often still edible.
But other rules apply to pharmaceuticals. "Patients have to take the expiration date very seriously," emphasizes Dr. Ursula Sellerberg from the Federal Association of German Pharmacists' Associations. Because the manufacturer is only liable up to this point in time.
Seeing, smelling and tasting are useless
It is difficult for a layperson to judge whether a drug is still good after this time has elapsed. "Seeing, smelling and trying", as recommended for food after the best-before date, is of little help with pharmaceuticals.
"A drug is not comparable to a yogurt," says Sellerberg. Therefore, according to the package insert, expired drugs may no longer be used. It is also forbidden to circulate them. The use-by date of medication should not be equated with the best-before date, which applies to most foods.
Every second person takes expired medication
Many Germans take it easy when a drug has expired: In a representative survey by GfK market research on behalf of the Umschau pharmacy, almost every second of the approximately 2,000 respondents said that they also take drugs after the expiry date.
Tinctures, drops, juices: once opened, liquid preparations usually spoil relatively quickly. Make a note of the opening date and only use the product within the period stated on the package insert ("can be used after opening"). Old cough syrups should be disposed of because they can contain harmful substances and bacteria. Steer clear of expired eye drops! They can be contaminated.
Nasal sprays: Should only be used by one family member for reasons of hygiene (note on the packaging). They can only be kept for a few months after opening.
Antibiotics: Only use opened packs after consulting a doctor. Otherwise resistance can develop - that is, antibiotics no longer work. Mixed antibiotic juices for children belong in the refrigerator and can only be kept for a few days.
Ointments and creams: if they smell rancid, are discolored or have oily droplets, they belong in the trash. Otherwise, ointments that do not contain water have a relatively long shelf life. Nevertheless, eye ointments and creams in particular should not be used after the expiry date due to the risk of infection.
Tablets and capsules: If stored in a dry, cool and airtight place, some tablets can last for years. If they are crumbly or stained, they should be thrown away. Acetylsalicylic acid ("aspirin") tablets that smell like vinegar have reacted with moisture and should be discarded. But they are not poisonous.
Doctors also disagree
Even some doctors do not understand that one should throw away ointments, tinctures and tablets that have expired: "Most medicines have a much longer shelf life than the expiry date stated," writes an internist on the Internet platform "esanum". A doctor has concerns about expired ointments and drops, but confesses: "I would continue to take tablets privately." Another doctor can "see no point in the rigid destruction of drugs after an expiry period".
US researchers: some drugs are still effective after 40 years
In fact, expired drugs are not necessarily ineffective or harmful. Some preparations of active ingredients even last for decades.
Last October, US researchers published corresponding results in the journal Archives of Internal Medicine: They found that the substances in eight drugs that had expired 28 to 40 years ago were mostly still almost completely effective: Twelve of 14 active ingredients were obtained in a concentration of at least 90 percent.
A long-term study by the American "Food and Drug Administration" on behalf of the US Department of Defense provided more comprehensive data. It was checked whether expired medical supplies of the army could still be used. It was found that 88 percent of the funds were still usable years after the shelf life had expired.
University professor: 100-year-old aspirin could still be up to 70 percent effective
Even 100-year-old "aspirin" tablets, if kept airtight, could still help to some extent against headaches. Because acetylsalicylic acid decreases in effectiveness relatively soon, but then remains at this level, as Professor Jörg Breitkreutz from the Institute for Pharmaceutical Technology at the University of Düsseldorf reports.
Therefore, a historical pack from great-grandfather's stocks could still be up to 70 percent effective, he estimates. However, it should never be approved again: The manufacturers must guarantee that the active ingredient content does not fall below 95 percent within the usability period - 90 percent is only sufficient in justified exceptional cases, according to the Federal Institute for Drugs and Medical Devices.
Decomposition products can be dangerous
However, the poorer effectiveness is often the smaller problem with expired drugs: "In some cases, decomposition products are created that can be dangerous. For example, some are carcinogenic.
That is more important to me than the question of effectiveness, "says Breitkreutz. For example, expired codeine cough syrups can be questionable." They can contain the substance codeine N-oxide, which is potentially carcinogenic, "says the pharmacist." Therefore belong expired cough syrups away. Especially when it comes to children! ", He emphasizes.
Even old drainage tablets are not harmless: They can contain formaldehyde - a substance that is suspected of causing cancer.
Danger of bacteria: use eye drops quickly
In principle, caution is advised, especially with overdue drugs that contain water. The pharmacist Viktoria Mühlbauer from the drug advice service of the Independent Patient Advice Germany (UPD) in Dresden says: "Bacteria grow easily in aqueous solutions."
Therefore, eye drops in particular must be used up quickly - in accordance with the package insert. Otherwise there is a risk of serious consequences, such as inflammation. In the case of syringes, such contamination can even be life-threatening.
Bacteria can also be found in expired creams, which can penetrate the skin through open areas and trigger inflammation. This is hardly a problem with anhydrous ointments - the fat they contain can turn rancid. "Nobody dies from it," says Breitkreutz. But it is questionable whether they still work well.
The refrigerator is the best place to keep medicines
Correct storage is crucial for the shelf life: namely in a cool and dry place. Medicines can spoil more quickly under the influence of heat, water and oxygen.
In the bathroom, where a survey shows that Germans particularly like to store their medication, the medicine cabinet is therefore poorly placed. Experts recommend the bedroom or hallway instead. "The refrigerator, on the other hand, is not necessarily the best place to store it," says Breitkreutz.
Because some products, such as nasal sprays or creams, can then crystallize out. Other medications, such as mixed antibiotics, must be put on the shelf. It is therefore important to read the package insert carefully.
Incorrect storage leads to rapid spoilage
If stored incorrectly, medication can spoil before the expiration date. This is why the pharmacist Sellerberg advises: "If you see tablets dissolving or a cough syrup flaking out, you should throw away the remedies or ask the pharmacist whether you can still use them." With herbal medicines, flocculation could also be normal.
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