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Dr. Coates is a veterinarian based in the other “Sunshine State” – that's Colorado to the rest of you – where she lives and plays with a varied range of animals. She shares her professional and personal experiences, Monday through Friday, here on petMD's blog, the Fully Vetted. Log in for your daily dose of her insight and wisdom.

 

How Good is That 'Expired' Drug in Your Pet's Medicine Cabinet?

June 22, 2010 / (7) comments


Yesterday's Morning Edition on NPR featured Joanne Silberner's report on human drugs and their expiration dates. Though I'd never heard of this law, it seems pharmacists are required to attach a one-year expiration date to all of the drugs they dispense.

And — get this — they're legally enjoined to do so regardless of the manufacturer's expiration dates. Which means the same is true for veterinarians, seeing as we're required to comply with pharmacy laws, too.

Apart from feeling pretty stupid for not knowing of this basic law (it's an FDA regulation), I had this immediate, visceral reaction to this information: That's just wrong! After all, the drug manufacturers are required to test the safety and efficacy of their drugs under warm, humid environments (read: bathroom) for years beyond their manufacturing date. So why then does the FDA feel justified in placing limits where they previously did not exist?

Here's what the pharmacy profession (staunch supporter of the regulation) argues: Because we don't test drugs at the time of dispensing, we don't know whether they're still as good as the manufacturers say they are. Read between the lines: We don't want to be legally responsible. Read between the lines some more: Limiting the expiration date is an easily defensible way to encourage more drug sales.

But if you're like me, you look up the manufacturer's expiration dates and you follow those instead of the pharmacy's. For myself and my own family, that is. Turns out that my veterinary hospital employer follows the pharmacy rules. The expiration date is always one year out unless the manufacturer's expiration date precedes it. This being the law and all that. (Good thing I'm not in charge, seeing as I'm occasionally ignorant of basic rules.)

But it's not fair! you might argue. It's not exactly consumer friendly to arbitrarily set higher bars on some products — especially when they are so transparently yielding bigger bottom lines for those who lobby in their favor. Fishy smelling, right? I think so, anyway.

Which is why I took a look at a local hospital's Rx labels (from a patient who had been transferred that morning). I'd recalled they were even more restrictive than a year. Turns out I was right. And an employee who'd worked at yet another hospital reported the same about her previous employer's policy.

Why? For two reasons, the former employee explained: 1. Because people probably store animal medications even more carelessly than their own, and 2. Because this way people are less likely to stop their drugs and start them up again whenever they please.

OK, so I'll concede to the second point. But then, there are plenty of times I'll ask an owner to stop a med and start it again. So why make them come in again for a "fresh" round? That's wasteful! It's wrong! And it's not consumer friendly.

So what do I recommend YOU to do? I recommend that you follow your veterinarian's instructions. But I also recommend that you ask for the manufacturer's expiration date on meds that might need to be administered again in the future. Why waste?

Still, there's one caveat. As the NPR report finally concluded, there's no need to trifle with meds that potentially offer immediate, life-saving benefits. Epi-pens (epinephrine injections for anaphylaxis), for example. But then, I've only ever prescribed Epi-pens for three patients. Yep. Sometimes I think the pharmacy industry protests too much on their own behalf. That's my take, anyway. You're free to offer your own below.


Dr. Patty Khuly



Pic of the day: "Messed up" by
maggiejumps

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COMMENTS (7)
1
by on 06/22/2010 06:46am

the one year expiration wouldn't be so bad if you didn't need an office visit for a refill. Seeing that one follows the other my conspiracy theory for the day is that the vets pushed the pharma industry to change the rules HAHA

2
Expiration dates
by on 06/22/2010 07:26am

About a year ago I read a study by the Army that tested meds stored since the '60's in the old bomb shelters. Most of the meds (including antibiotics) were still safe and remained potent after all those years in storage. I store all meds, my own and my pets', in a cool, dry, dark area (i.e. NOT in the bathroom medicine cabinet). I don't hesitate to use them if it's within a reasonable time past the expiration date (but certainly not 40-50 years)!! I suspect it's partly a result of collusion between the FDA and drug manufacturers and partly due to our oh-so-litigious society that expirations are so short. If it's within 6-12 months of expiration, I would think that most meds should be effective and safe to use, provided they are properly stored.

3
expiration dates
by on 06/22/2010 08:36am

Pharmaceutical companies don't even do thorough testing for side effects...or if they do, they do not publicize them. Look at the trouble Pfizer is in with the FDA! I think I'd just as soon err on the side of caution and say that a year is a nice round number for expiration dates. It does put money in everyone but the drug user's hands but that seems to be the case in a lot of areas.

4
Wrong.
by on 06/22/2010 09:11am

@Kayteenm;

Your assertion that the pharmeceutical industry "...don't even do thorough testing for side effects..." is provably, emphatically wrong. Libelous, in fact. If you'd bother actually *reading* any Clinical Study Report or, more specifically, any New or Supplemental Drug Applicacation, for ANY drug submitted in the US, Canada, Japan, Europe or anywhere else that doesn't simply rubber-stamp the approvals from one of those previously-mentioned entities, you'd see how incredibly, ridiculously ignorant your statement is.

Do side effects get missed? You betcha. Pharmaceuticals act in the most complex of all possible environments known to man - Living biology. NO computer even remotely imagined can adequately simulate that environment. NO studies can ever hope to capture 100% of all effects. There are NO absolute guarantees - Biology is so complex, so variable, that all *anyone* can do is their very best. Sometimes, the "very best" falls short. But certainly NOT from lack of trying!

5
Expiration dates
by on 06/22/2010 11:14am

I have a client who is a pharmaceutical repackager - they provide unit doses to clinics so they can dispense to their patients without having to handle the packaging, labeling etc. and aspects that require a pharmacist on hand. I know from work with them that any repackaged drugs can must have an expiration of 1 year or less (less if the Mfg. expiration is less than a year). When I have had dogs on long term maintenance meds I always ask my vet to write the RX for a full bottle since if the pharmacy simply puts the directions label on an unopened bottle the expiration remains the same as the Mfg. states on the bottle. I still have a bottle of metronidazole from my Berner who died in February 2008 and it does not expire until 2011.

6
Surprised!!??
by on 06/22/2010 12:44pm

The pharmaceutical industry in cooperation with the FDA putting laws and procedures in place that may increase the revenue of the drug companies????

Let me put on my shocked face.

7
epinephrine
by on 06/22/2010 04:39pm

Meh. If the epi is clear, not brown, it's okay to use and will be potent. Date is meaningless.

Now that's MY epi, for me, in case I'm stung by a bee. I'm not buying a new pen every year, much less three new ones to have strategically stationed around.

I'm not saying anyone else should do anything other than obediently go shell out for a new epi pen every year and enrich the drug companies.

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About fully vetted

Patty Khuly, VMD, MBA

Photo of Dr Khuly

Dr. Khuly is a former petMD blogger and small animal veterinarian in Miami, Florida, where she practices medicine at Sunset Animal Clinic and serves on the board of the South Florida Veterinary Medical Association. She is a graduate of Wellesley College, the University of Pennsylvania School of Veterinary Medicine, and The Wharton School of Business.

As a significant sideline, she writes...a lot. She authors pet health columns for USA Today, The Miami Herald and Vetstreet. She also writes a popular monthly column for Veterinary Practice News and serves as regular contributor to Veterinary Economics, The Bark, and the Veterinary News Network.

Dr. Khuly lives in South Miami with her brood of hens, goats, dogs, cats...and humans.

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