Nearly every home has a bag or box of old medicine somewhere: half a strip of antibiotics from last year, a cough syrup from the winter, eye drops from a visit to the eye hospital. When someone gets a headache at night, the question comes up. Is the expired one still okay?
What the expiry date means
The expiry date is the last date the manufacturer guarantees that the medicine has its full strength and is safe, provided it was stored as the label says. It is based on stability testing, and companies usually set it conservatively.
After that date, most solid medicines (tablets and capsules) slowly lose strength rather than turn toxic. Studies on large stockpiles have found that many tablets kept in ideal conditions still had most of their strength years after expiry. The catch is "kept in ideal conditions". A strip that has been through a Kathmandu monsoon in a kitchen drawer is not ideal storage, and you have no way of knowing how much strength is left.
Expired medicines you should not take
- Anything for a serious or life-threatening condition. Heart medicines, epilepsy medicines, insulin, asthma inhalers used for attacks, emergency allergy medicine. A weaker dose can fail when you need it.
- Antibiotics. A weaker antibiotic may not clear the infection and adds to antibiotic resistance. Leftover antibiotics also mean a course was not finished, which is a separate problem.
- Liquids: syrups, suspensions, drops. These are more likely to degrade or grow bacteria once opened.
- Eye drops and ear drops after the "use within" period. Many say to throw away four weeks after opening, regardless of the printed expiry date.
- Anything that looks, smells or feels different. Crumbling, discoloured, sticky or swollen.
For an occasional painkiller that is slightly past its date and looks normal, the main risk is that it works less well. Even so, the sensible thing is to replace it.
"Use by" after opening
Check labels for a second date or instruction such as "discard 28 days after opening" or "use within 7 days of mixing". Liquid antibiotics for children that are mixed with water at the pharmacy usually have a short life and may need the fridge. Write the opening date on the bottle with a pen.
Can you return expired medicine to a pharmacy?
There is no general rule in Nepal that pharmacies must take back medicine from the public, and a pharmacy cannot resell it once it has left the shop. Policies vary. Some pharmacies will accept old medicines for disposal along with their own expired stock, which they are required to keep separate and send back to suppliers or for proper destruction. It is worth asking at your regular pharmacy.
If you bought something that was already expired or damaged when you got it, take it back with the receipt. That is a fair complaint, and the pharmacy should replace it.
How to dispose of old medicine at home
If no take-back is available:
- Keep tablets in their blister strips or bottle, so they are not loose.
- Mix loose tablets or liquid with something unappealing, such as used tea leaves, soil or wet waste, in a sealed bag. This stops children, animals or anyone else from picking them out.
- Remove or cross out your name and personal details on labels and prescriptions.
- Put the sealed bag in your household waste, not in recycling.
Do not pour medicines into the toilet, sink or river. Antibiotics and hormones in water are an environmental problem, and the Bagmati already has enough to deal with. Needles and syringes should go in a hard plastic bottle with the cap screwed on, then to a health facility if they accept sharps.
Stop the pile from building up
Go through your medicine box twice a year, maybe before Dashain and before the monsoon. Throw out what has expired, write down what you need to replace, and keep only what you actually use. It is also a good moment to check how you store things, which we cover in our post on storing medicines through the monsoon.
This article is general information, not medical advice. Talk to your doctor or pharmacist about your own medicines and health.
