Does Medication Really Expire?

Does the expiration date on a bottle of a medication mean anything? If a bottle of Tylenol, for example, says something like “Do not use after June 2006,” and it is August 2009, should you take the Tylenol? Should you discard it? Can you get hurt if you take it? Will it simply have lost its potency and do you no good?

In other words, are drug manufacturers being honest with us when they put an expiration date on their medications, or is the practice of dating just another drug industry scam, to get us to buy new medications when the old ones that purportedly have “expired” are still perfectly good?

Here are the simple facts:

First, the expiration date, required by law in the United States, beginning in 1979, specifies only the date the manufacturer guarantees the full potency and safety of the drug — it does not mean how long the drug is actually “good” or safe to use.

Second, medical authorities uniformly say it is safe to take drugs past their expiration date — no matter how “expired” the drugs purportedly are. Except for possibly the rarest of exceptions, you won’t get hurt and you certainly won’t get killed. A contested example of a rare exception is a case of renal tubular damage purportedly caused by expired tetracycline (reported by G. W. Frimpter and colleagues in JAMA, 1963;184:111). This outcome (disputed by other scientists) was supposedly caused by a chemical transformation of the active ingredient.

Third, studies show that expired drugs may lose some of their potency over time, from as little as 5% or less to 50% or more (though usually much less than the latter). Even 10 years after the “expiration date,” most drugs have a good deal of their original potency. So wisdom dictates that if your life does depend on an expired drug, and you must have 100% or so of its original strength, you should probably toss it and get a refill, in accordance with the cliché, “better safe than sorry.” If your life does not depend on an expired drug — such as that for headache, hay fever, or menstrual cramps — take it and see what happens.

One of the largest studies ever conducted that supports the above points about “expired drug” labeling was done by the US military 15 years ago, according to a feature story in the Wall Street Journal (March 29, 2000), reported by Laurie P. Cohen. The military was sitting on a $1 billion stockpile of drugs and facing the daunting process of destroying and replacing its supply every 2 to 3 years, so it began a testing program to see if it could extend the life of its inventory. The testing, conducted by the US Food and Drug Administration (FDA), ultimately covered more than 100 drugs, prescription and over-the-counter. The results showed that about 90% of them were safe and effective as far as 15 years past their original expiration date.

In light of these results, a former director of the testing program, Francis Flaherty, said he concluded that expiration dates put on by manufacturers typically have no bearing on whether a drug is usable for longer. Mr. Flaherty noted 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. “Manufacturers put expiration dates on for marketing, rather than scientific, reasons,” said Mr. Flaherty, a pharmacist at the FDA until his retirement in 1999. “It’s not profitable for them to have products on a shelf for 10 years. They want turnover.”

The FDA cautioned there isn’t enough evidence from the program, which is weighted toward drugs used during combat, to conclude most drugs in consumers’ medicine cabinets are potent beyond the expiration date. Joel Davis, however, a former FDA expiration-date compliance chief, said that with a handful of exceptions — notably nitroglycerin, insulin, and some liquid antibiotics — most drugs are probably as durable as those the agency has tested for the military. “Most drugs degrade very slowly,” he said. “In all likelihood, you can take a product you have at home and keep it for many years, especially if it’s in the refrigerator.” Consider aspirin. Bayer AG puts 2-year or 3-year dates on aspirin and says that it should be discarded after that. However, Chris Allen, a vice president at the Bayer unit that makes aspirin, said the dating is “pretty conservative”; when Bayer has tested 4-year-old aspirin, it remained 100% effective, he said. So why doesn’t Bayer set a 4-year expiration date? Because the company often changes packaging, and it undertakes “continuous improvement programs,” Mr. Allen said. Each change triggers a need for more expiration-date testing, and testing each time for a 4-year life would be impractical. Bayer has never tested aspirin beyond 4 years, Mr. Allen said. But Jens Carstensen has. Dr. Carstensen, professor emeritus at the University of Wisconsin’s pharmacy school, who wrote what is considered the main text on drug stability, said, “I did a study of different aspirins, and after 5 years, Bayer was still excellent. Aspirin, if made correctly, is very stable.”

Here is my advice: if you have anything in capsule form, discard it after its expiration date as capsules are not airtight and oxygen is the key factor in rendering drugs unusable. If you have tablet forms, keep the drugs as they are compressed and no oxygen damage can be done other than a very slow natural degredation. Your savings could be significant, and you won’t have to make an ER visit for that prescription you know always treats your condition.


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Raw Foods Can Hurt Your Thyroid

If you find you’re gaining weight eating a lot of raw veggies, check out this list of foods that may be hurting Read more

Potassium Carbonate Better Than Bone Drugs

Twelve-month daily alkali therapy with potassium citrate supplements resulted in a nearly 2% increase in lumbar spine and hip bone mineral density (BMD) in a small randomized controlled trial of postmenopausal women with osteopenia. These results, published in the October 2006 issue of the Journal of American Society of Nephrology, suggest that citrate partially reverses the high acidity of the modern Western diet and that this promotes better skeletal health, the researchers, led by Sigrid Jehle, MD, at the Department of Medicine, University of Basel in Bruderholz/Basel, Switzerland, write.

“We showed that BMD was significantly increased in the lumbar spine and the hip after 12 months of a very modest amount of alkali (30 mmol of inexpensive K [potassium] citrate daily) in postmenopausal women with low bone mass (T scores at the lumbar spine of -1 to -4). This was achieved with virtually no side effects.”

The women were randomized to receive tablets of potassium citrate or potassium chloride (3 times 10 mmol daily), and all subjects also received calcium carbonate (500 mg of calcium) and 400 IU of vitamin D3 daily. They were instructed to maintain their current eating and exercise habits.

Study Highlights
Inclusion criteria were women who were nonvegetarians, at least 5 years postmenopausal, younger than 70 years of age, and had T scores at lumbar spine L2 to L4 of -1 to -4.

Women were instructed to continue their self-selected diet and exercise regimen. 89 women were randomized to 10 mmol of trivalent potassium citrate in 3 daytime doses, yielding 30 mmol of potassium and 30 mmol of base (bicarbonate) daily, and 92 to 30 mmol of potassium chloride. Both groups received calcium carbonate containing 500 mg of calcium and 400 IU of vitamin D daily.

I’ve been telling women since 1986, when early FDA studies on bone drugs were compared to the known benefits/response of taking potassium carbonate, that you can achieve the same or BETTER response WITHOUT the side effects of pharmaceutical drugs, simply by taking potassium carbonate.

Now we can improve on this by taking liquid bioavailable minerals containing silica which works synergystically with potassium carbonate. Just one dropper twice a day is all you need. Here’s to better bone health!


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Your Sex Drive – Is It HIS Fault?

Forget the fancy perfumes. If you want your sex drive to pick up, just slip some odorless pheromones into his aftershave and watch your interest soar. Think I’m crazy? Scientists and researchers have been focusing on increasing women’s hormones, blaming low testosterone on our lack of ability to swing from the chandeliers with our mates. However, one interesting fact has slipped by their focus: as we age, our sense of smell dramatically declines, beginning around age 40.(1)

Pheromones are odorless chemical attractants found in all forms of life, especially plants and animals. Unlike hormones, pheromones are species specific and for good reason – imagine being sexually attracted to a boar or a mouse! So let’s take a closer look at these natural chemicals.

Pheromones are scents produced by a species in order to communicate and attract others nearby for the sole purpose of mating. Known as “sex attractants.” these odorless chemicals affect the way a mother and newborn child bond. Different pheromones influence our sexual orientation, helping to differentiate lovers from genetically similar relations.

As we age, a pair of organs in the nose, called the vomeronasal organs, lose their ability to detect pheromones. Couple this with lowered reproductive hormones that help us to produce these pheromones in both males and females over 50, and you can see why sexual relations seem to vanish for many couples.

As we enter menopause, five factors determine if a woman is viewed as attractive:

1) How we physically appear: the color of our hair, in short the way we groom ourselves.

2) Social skills. How well we flirt, exude confidence and appear balanced.

3) How motivated we are in the romantic contact and lovemaking.

4) Sexual performance skills.

5) The amount of sex attractant pheromones we excrete.

The more fertile a woman appears to a man, the more sexually attractive she is. The same applies to women. The more a man appears to be able to protect a woman and her offspring, the more sexually attractive he becomes. It’s all about scents.


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Break a Hip and Die! The Impact of Osteoporosis

Even a minor accident or fall could result in a potentially disabling fracture for as many as 60 percent of Canadian women over age 50. That’s just one of the disturbing findings of the Canadian Multicentre Osteoporosis Study (CAMOS), a major, ongoing study of osteoporosis involving more than 9,000 people across Canada. This study is made possible by a recently renewed grant from the Canadian Institutes of Health Research (CIHR).

Although common in older people, osteoporosis is often not diagnosed or treated, according to CAMOS researchers. “We found a significant ‘osteoporosis care gap,’” says principal investigator, Dr. Alan Tenenhouse, Director of the Division of Bone Metabolism, Department of Medicine, McGill University Health Centre (MUHC). “Many cases of osteoporosis, especially in men, go undetected.” People with untreated osteoporosis are at high risk for fractures. Hip fractures are particularly dangerous. About one quarter of the 25,000 Canadians who fracture a hip die within a year of their injury. Only half ever regain normal function.

“Other fractures, including spinal fractures, also have a very negative impact on quality of life,” says Dr. Tenenhouse. “ That’s disturbing, because X-rays showed at least 15 percent of men and women over age 50 in our study had spinal fractures, although many of these did not cause symptoms. “We found that even being diagnosed with osteoporosis caused a decline in quality of life, because people with the condition worry about the threat of fractures. The objective of CAMOS is to free older people in Canada from this threat.” Phase 2 of CAMOS is now underway. To assist them in their work, researchers will be using a made-in-Canada reference standard for bone density developed during the first phase of CAMOS.

“We are studying factors that promote maximum bone size and strength during youth, and the relationship between bone mass in youth to bone loss in older people,” says Dr. Tenenhouse. “Understanding these processes and relationships is essential to the development of an effective strategy for fracture prevention. Ultimately, we hope CAMOS will help us develop better ways to reduce the human and economic impact of osteoporosis.” Osteoporosis, sometimes called porous bone disease or brittle bone disease, is characterized by reduced bone density and strength. The disorder affects as many as one in four Canadians over age 50, and is associated with increased risk of disabling fractures of the vertebrae, ribs, wrists and hips. Osteoporosis costs the Canadian economy an estimated $1 billion annually, and that figure is expected to double over the next 30 years as the population ages.

While walking is one of the healthiest and most popular exercises, it also results in more trips to the emergency room for women than any other non-equipment exercise, a University of Arkansas study revealed. The study, conducted by associate health science professors Ches Jones and Lori Turner, has been accepted for publication in the summer 2005 issue of the “Journal of Women and Aging.” Jones presented the results at the 7th World Conference on Injury Prevention and Safety Promotion held recently in Vienna, Austria.

Jones and Turner studied data gathered by the National Electronic Injury Surveillance System (NEISS). The NEISS compiles reports from over 100 emergency rooms across the nation, then estimates the frequency of each type of injury. The study looked at data from 851 reported injuries from 1994 to 2001. The researchers focused on emergency room visits among women age 65 years and older, who were injured while doing non-equipment exercise. Non-equipment exercise refers to any activity done without equipment, such as walking, aerobics, hiking, swimming, stretching, yoga or tai chi. “We looked at how people exercise without equipment,” Jones said. “We asked, ‘How can people get injured that way?’” Walking was the most common non-equipment activity cited in the study and also was linked most frequently to injury. Falls were the major cause of injuries, according to Jones. “Environmental hazards were a big issue — like when you’re walking or hiking, and you encounter obstacles such as street curbs, rocks, holes and even animals,” he said.

Jones was surprised at the number of non-equipment injuries, which increased each year, despite adjustments for population increases. He speculated that contributing factors include increases in activity, more active people living longer, better health care, and health care physicians prescribing activity to patients, among other things. The number of falls among older women is a concern due to the increased risk for fractures among that age group. “It brings up the question, ‘Is walking the best activity for this age group?’” Jones said. “It is obviously popular and healthy, but is it the best?”


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