Taking expired medication is generally not recommended. However, in some cases, taking expired antibiotics may not cause harm. Antibiotics work by preventing bacteria from multiplying or killing bacteria. Their potency and effectiveness tend to decrease over time after the expiration date. The expired antibiotics may not work as well to treat an infection, but are unlikely to be toxic or dangerous in most cases. However, it depends on how long the antibiotics have been expired, how they were stored, and the type of antibiotic.
What are antibiotics?
Antibiotics are medicines used to treat bacterial infections. They work by either killing bacteria or preventing them from multiplying and growing. Antibiotics are used to treat a variety of common bacterial infections, including strep throat, sinus infections, ear infections, pneumonia, urinary tract infections, skin infections, etc.
Some common types of antibiotic liquids include:
- Amoxicillin – used to treat infections like bronchitis, pneumonia, ear infections, strep throat
- Azithromycin – used for respiratory infections, skin infections, strep throat
- Cephalexin – treats infections of the throat, skin, ears
- Ciprofloxacin – treats respiratory and urinary tract infections
- Clindamycin -used for lung, skin, blood infections
Antibiotics come in various forms like tablets, capsules, liquid suspensions, topical creams, etc. Liquid antibiotic suspensions are commonly prescribed for children who have difficulty swallowing pills. The liquid form also allows for precise dosing based on the child’s weight.
Do antibiotics expire?
Yes, antibiotics do expire and have an expiration date printed on the bottle. The expiration date ensures that the medicine maintains its potency and effectiveness up to that date.
The active ingredients in antibiotics break down over time with exposure to heat, humidity, and light. This affects their potency. Manufacturers thoroughly test the antibiotics’ stability and establish an expiration date accordingly.
The expiry date guarantees that the antibiotic will retain its full strength and efficacy up to the listed date, as long as it is stored correctly.
What happens when you take expired antibiotics?
Taking expired antibiotics may lead to the following scenarios:
Reduced effectiveness
After the expiration date, antibiotics start losing their potency and efficacy steadily. Expired antibiotics may not work as well to treat the infection.
The decreased concentration of active ingredients in expired antibiotics can mean that a higher dose may be required to have the same effect as a normal dose of non-expired antibiotics.
Unwanted side effects
As antibiotics degrade over time, they can undergo chemical changes in their composition. This can lead to increased toxicity and additional side effects when expired antibiotics are taken.
Some common side effects of taking expired antibiotics include nausea, vomiting, diarrhea, dizziness, headaches, rashes, etc.
Treatment failure
Taking an expired antibiotic carries a higher risk that the bacterial infection will not be fully treated and resolved.
The suboptimal levels of active drug could mean that while some bacteria are killed, others survive and continue to multiply. This can lead to persisting or recurrent infection requiring additional antibiotic treatment.
In severe infections like pneumonia, taking an expired antibiotic can lead to dangerous consequences like systemic spread of infection, hospitalization, or sepsis.
Antibiotic resistance
Taking expired antibiotics encourages antibiotic resistance in bacteria. When bacteria are exposed to low doses of antibiotics, it pushes them to develop mutations to help them survive.
These antibiotic-resistant bacteria are harder to kill, and over time, can proliferate in the body and environment. Expired antibiotics fuel this process and contribute to the global health threat of antibiotic resistance.
Adverse interactions
The chemical changes in expired antibiotics could potentially react with other medicines or substances in unexpected ways. This may result in unanticipated adverse interactions and effects.
Consulting a doctor or pharmacist before taking an expired antibiotic, especially when on other prescribed medications, can help assess and prevent complications.
How long are antibiotics good for after the expiration date?
There is no standard timeframe for how long antibiotics remain effective after their listed expiration date. It depends on the specific drug, storage conditions, and how far past the expiration date it is.
According to medical experts:
- Amoxicillin liquid may start losing potency around 6-12 months past its expiration.
- Other penicillins and cephalosporins may start degrading about 1 year after expiration.
- Tetracyclines like doxycycline may be effective for about 2 years after expiration.
- Macrolides like azithromycin tend to be stable for around 2-3 years past listed expiry.
- Fluoroquinolones like ciprofloxacin are generally stable for 2-4 years beyond their expiration date.
Proper storage helps maintain the antibiotic’s strength for longer. Keeping them in their original packaging, away from excess heat, moisture, and sunlight can prolong their shelf life. But, the efficacy steadily drops off over time and is not guaranteed beyond the manufacturer’s expiry date.
Is it safe to use expired antibiotic liquids?
Using expired antibiotics is generally not recommended and carries risks:
- May not treat the infection effectively
- Higher chance of side effects and adverse reactions
- Promotes antibiotic resistance
- Can interact with other medications
However, in certain emergency scenarios, taking an expired antibiotic may be warranted:
- No other alternative antibiotics are available
- A serious infection requires urgent treatment
- The antibiotic expired fairly recently (within 1 year)
- Proper dosage and duration is followed
For milder infections, it is advisable to consult a doctor and get an updated prescription rather than take an expired antibiotic. Do not increase dosage or duration without medical guidance.
Monitor closely for any issues when taking an expired antibiotic and seek medical care if symptoms worsen or don’t improve.
What precautions should you take when taking expired antibiotics?
If you must take an expired antibiotic, these precautions can help reduce risks:
- Check if it was stored properly away from heat, humidity and sunlight.
- Inspect that the color and consistency of the liquid looks normal without sediment or haziness.
- Start with a standard dose. Don’t increase dose or duration without doctor’s approval.
- Never use for viral infections like cold, flu, or COVID-19 – antibiotics are ineffective for viruses.
- Take the full course as directed, don’t stop midway even if you feel better.
- Be alert to any unusual side effects like rashes, dizziness, severe diarrhea, etc.
- Avoid mixing with other medicines without consulting doctor about interactions.
- Consult doctor if symptoms don’t improve within 2-3 days of starting treatment.
Taking additional precautions can help mitigate risks when using expired antibiotics. However, it is best to avoid using expired antibiotics if possible and get a fresh prescription whenever feasible.
How can you tell if antibiotic liquid has gone bad?
Here are some signs that may indicate antibiotic liquid suspension has gone bad and should not be taken:
- Passed expiration date by over 1 year
- Discoloration – significantly darker, has sediment, particles floating
- Cloudy appearance instead of clear transparent liquid
- Separation of liquid – oil droplets, layering effect
- Crystallization – gritty texture, grainy deposit at bottom
- Foul smell
- Bottle or cap appears swollen or warped
- Formula is thicker and syrupy
- Foaming or bubbling when shaken
Always do a visual inspection before taking antibiotic liquid. Check for any changes from its normal appearance, consistency, smell, etc. When in doubt, seek medical advice before using medication that seems degraded.
Can expired antibiotics make you sick?
Expired antibiotics are unlikely to directly cause illness in most people. They become less potent over time but do not usually turn toxic or poisonous.
However, some people may experience side effects like nausea, diarrhea, vomiting after taking degraded antibiotics. Those with allergies or sensitivities have a higher risk of reactions to altered drug compounds in expired antibiotics.
The greater risk is from not properly treating the original infection when taking antibiotics that lack effectiveness due to expiration. Severe infections not fully resolved can progress and make you sick.
Bacterial illness that persists or recurs after taking an expired antibiotic can lead to complications that make you sick. Seek prompt medical care if your infection is not improving within a couple days of starting expired antibiotics.
When should you not take expired antibiotics?
Avoid taking expired antibiotics in these cases:
- Mild infections that are not an emergency – Get a new prescription
- Viral infections unresponsive to antibiotics – Like colds, flu, most sore throats
- Allergies or sensitivities to antibiotic ingredients
- Taking other medications that may interact
- Pregnant or breastfeeding mothers
- Infants under 2 months old
- Longer than 1 year past expiration date
- Stored improperly in heat/humidity for extended time
- Discolored, separated, or strange smelling formula
It is best to avoid using expired antibiotics if possible, especially in at-risk groups like infants, pregnant/nursing women, and those on multiple medications. Check with a pharmacist about risks before taking expired antibiotics.
How should you dispose of expired antibiotic liquids?
To safely dispose of expired antibiotic liquids:
- Take to approved medication take-back programs if available in your area. Many pharmacies host them.
- Mix with unappealing substance like dirt, cat litter, coffee grounds in a sealed bag or container.
- Remove label with personal information before disposal.
- Do not crush tablets or capsules – dispose intact.
- Do not flush down toilet or drain unless specifically instructed.
- Where possible, opt for eco-friendly or high-temperature incineration disposal.
Proper disposal of expired antibiotics helps prevent contamination of water supplies and accidental ingestion risks. Discreetly discarding labels also protects personal health information.
Can expired antibiotics still work?
Expired antibiotics may still retain some effectiveness, but it diminishes over time past the labelled expiry date. How long they remain potent depends on:
- Storage conditions – Refrigeration prolongs potency
- Antibiotic type – Some classes degrade slower than others
- Dosage – Higher doses offset lowered drug concentrations
- Infection location – More serious infections need full potency
- Patient factors – Underlying health issues may need fully potent antibiotics
While expired antibiotics could potentially still work to some degree, it is generally risky to rely on them for treatment, especially for serious infections. Their ability to successfully kill bacteria and resolve infections becomes less reliable over time. Getting a fresh prescription is the safest option.
Conclusion
Taking expired liquid antibiotics poses some risks as their effectiveness declines over time after the labeled expiration date. They may not fully treat the infection, fuel antibiotic resistance, and cause additional side effects. However, in certain emergency cases, using recently expired antibiotics may be warranted with added precautions. Whenever possible, it is prudent to avoid using expired antibiotics and get updated prescriptions under medical guidance for best treatment results and safety. Proper storage, inspection, dosing, and disposal help mitigate risks when expired antibiotics must be used. Consult a pharmacist or doctor if you have questions about taking antibiotics past their expiration.