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Injectable medications, which have become cloudy or discolored or show signs of precipitation should not be used.
Certain medications have a narrow therapeutic index and little decreases in the pharmacological activity can result in serious consequences for patients.
The expiration date is only an assurance that the labeled potency will last at least until that date.
Ongoing research shows that stored under optimal conditions, many drugs retain 90% of their potency for at least five years after the labeled expiration date, and sometimes longer.
According to The Medical Letter (2015) the only report of human toxicity that may have been caused by chemical or physical degradation of a pharmaceutical product is renal tubular damage that was associated with use of degraded tetracycline (GW Frimpter et al, JAMA 1963; 11).
Since then, tetracycline products have been changed to eliminate the problem .
The active ingredients tested for were: aspirin, amphetamine, phenacetin, methaqualone, codeine, butalbital, caffeine, phenobarbital, meprobamate, pentobarbital, secobarbital, hydrocodone, chlorpheniramine, and acetaminophen.
The results showed that 11 (79%) of the 14 drug compounds were always present in concentrations of at least 90% of the amount indicated on the drug label, which is generally recognized as the minimum acceptable potency.
There are virtually no reports of toxicity from degradation products of outdated drugs.In general, drugs expiration date is 2-5 years from production date.FDA regulations do not require manufacturers to determine actual long-term drug potency and stability.The lack of other reports of toxicity from expired medication is reassuring, however expired medication toxicity is not a well-researched field.Drugs in liquid form (solutions, suspensions) are not as stable as solid dosage forms (tablet, powder, capsule).