this post was submitted on 19 Oct 2024
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Good to know about tetracycline, but drugs don't magically become useless after an arbitrary expiry date.
Most prescription medicines are still quite effective after the expiration date. Various studies have shown they're still effective even decades after the expiration date.
https://pmc.ncbi.nlm.nih.gov/articles/PMC7040264/
As someone who works in medicine, I would just caution you to take that with a grain of salt, especially since they repeatedly mention the storage of said medications. Not all pill bottles are airtight, and if you keep them somewhere that isn't always less than 75 degrees Fahrenheit or so, I wouldn't trust them more than a year past the expiration date. Note also, when they say "cool, dark place" that is not accounting for freezing temperatures which can also mess with the medications.
All this to say: if you have emergency medications, cycle them out with new ones as often as possible, and store them in airtight containers in a climate controlled area of your house.
This strikes me as a classic early-med-student response. Your appear to be missing the point of the study and the broader research behind drug expiration. The journal touches on storage conditions twice, but largely in the context of resource-limited areas. The researchers, with advanced degrees and extensive knowledge in medication degradation by the way, have supported their claims with evidence from multiple studies. For example, a review by Lyon et al. (2006) and the Shelf-Life Extension Program (SLEP) studies echo similar conclusions. There are also additional peer-reviewed articles that come to the same conclusions.
Blister packs, like those my medication is in, provide an airtight seal, so your blanket advice on storage is off the mark. Even if they weren't in blister packs, the article and sources note that degradation is generally minimal, even if stored in a non air-tight-sealed container. Additionally, guessing a random one-year rule ignores peer-reviewed science. For someone in medical school, it would be better for you to focus on understanding the research and deferring to it when appropriate rather than stretching to offer input on irrelevant conditions. I appreciated your point on tetracycline and noted it, but beyond that, your comment seems more about proving you know something than contributing to this specific conversation.
The article you listed reads more like preliminary research more than anything else, and aside from medical school, I have done research into drug expiration on my own given that I have multiple complex health problems and I need to know how long I can count on my medication being effective if I needed to stockpile it. My background education in organic and general chemistry tell me that the two biggest concerns are humidity and temperature. You can also get information from the drug manufacturers about storage recommendations and cautions about efficacy following improper storage. If humidity or extreme temperatures (like where I live in Minnesota) come into play, the guidelines get a lot more fuzzy.
Also noted in there, a concern with antibiotics in particular is, that while they will retain some efficacy, the diminished effects over time can lead to more problems with resistance, and that can become important in a single individual depending on their colonization status and how often they end up needing to use the antibiotics.
Don't get me wrong, keeping a stockpile of medications is important (I'm trying to build up a buffer that I cycle out for some of my more critical medications) but it has to be done with cognizance and awareness of the pitfalls of such a practice. Personally, I would not trust my life to medication that has been expired for more than about 3 years if it is at all avoidable which is why I cycle my stockpile each time I get a refill. (i.e. putting the new meds in the storage container and taking the ones that were in there so that the storage is never more than a couple months old) I'm on a couple medications that stopping them suddenly for even a few days has the potential to put me in the hospital if not end up being lethal depending on the severity of the withdrawal.
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Also, I have a very strong suspicion that the medication you have on hand is Azithromycin (because very few medications come in blister packs), so here's a list of infections that a Z-pak is good for:
If it's not on this list (like pretty much any gram negative, anaerobic, or gram positive with resistant features like MRSA, among others) I wouldn't count on the Z-pak actually being useful.
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