Expired medications and their effectiveness

In the article, “Drugs Past Their Expiration Date”, authors hypothesized that expired medication can be effective in providing that drug’s original therapeutic effect.  The article referenced a study about the effectiveness of Asthmo-Kranit, a medication marketed from 1952-1989.  This medication was a mixture including Theophylline, Aminopyrine, Phenobarbital, Ephedrine, Atropine, and Benzylethyldimethoxyisochinoline.  According to this study a patient ingested 22 tables of Asthmo-Kranit that was 35 years old as a suicide attempt.  According to the toxicology testing of these stored and old tablets, researchers found an 80-83% of effective drug.  This 80-83% active drug was enough to cause grade 1 Theophylline toxicity and observed signs and symptoms of Theophylline overdose.  The article reported results of other research that varied from 90% original potency of 28-40 year old sealed medications to less stable liquid solutions containing effective dose after 50 years after expiration dates.

The authors describe how storage can influence drug potency and report that an increase in heat and humidity would increase the rate at which the drug lost its effectiveness. The authors use a study in where a sodium powder stored at 40 degrees Celsius and at 75 % relative humidity was stable after 1.5-9 years. The authors also describe how cloudy, precipitant, or discolored solutions are not to be consumed.

These results can impact healthcare positively in the sense that medications can last longer and can be used in a wider period of time, thus decreasing the amount of refills and cost of new prescription.  This may help people continue to take their medications instead of stopping and causing their diseases to get worse due to the lack of the medication itself.  The biomedical ethic principle of justice can be applied here because many patients without insurance or access to continued care can benefit from using the medications they already have.  This could also be positive in the sense that fewer medications can be wasted and put to therapeutic use in clinical settings.  Less wasted medication can also mean less toxic chemicals thrown into the environment and making less people sick from exposure.  A negative impact can also be assumed.  If drugs last longer, pharmaceutical companies can use this fact to increase cost of medications and further decrease access to medication to patient’s who cannot afford them, therefore causing more harm and violating the principle of non-maleficence.

References      

Drugs Past Their Expiration Date | The Medical Letter, Inc. (n.d.). Retrieved from https://secure.medicalletter.org/w1483b