SATELLIFE

A Recent Conversation in the Essential Drugs Discussion Group

From: "Dr. Noorizan Abdul Aziz" <>
To: <>
Date: Tue, 21 Sep 2004 15:07:13 +0800
Subject: [e-drug] Can expired drug still can be used?
E-DRUG: Can expired drug still can be used?
------
Dear e-drug colleagues,
I came across a case of pre-packed drugs dated 9/2004 at the pharmacy. Then my students asked whether the drug can still be used for the patient. The students thought it could be used until the end of September but the pharmacist said it can be used up 1-2 months from the stated expired date and for IV medications could be used longer then that. She said she obtained the information from the manufacturer. But my comment to my students (not in front of the pharmacist) that this medication should be used the latest at mid-of Sept. I advise my students not to used expired medication because we are not sure about the efficacy and it also possible it may change to other compound which may pose a danger to the patient.
Please do share and get comments from our colleagues on this issue.
Thank you,
Noorizan Abd.Aziz M.Sc(radiopharmacy) ,Pharm.D.
Discipline of Clinical Pharmacy,
School of Pharmacy,
Universiti Sains Malaysia.
11800,Pulau Pinang Malaysia
[Moderator’s comment: The expiry date is the last day at which the manufacturer can be sure that the drug is OK. In principle the drugs should not be used after that date (end September, rather than mid September). If a pharmacist gets permission from the manufacturer that the drugs can be used after the expiry date, the manufacturer should have evidence (eg longer stability studies) to back up the new expiry date.
Obviously the drugs won’t become suddenly toxic on 1 October, but one should maintain this principle of expiry dates unless in emergencies. The use of expired drugs is then at the risk of the health worker using it, and the patient should know this. In some countries using expired drugs is illegal. It may be better to improve drug supply management and get fresh drugs rather than spending time trying to prolong their lifespan?
Wilbert Bannenberg]
______

Response

Date: Thu, 23 Sep 2004 11:18:11 +0100 (BST)
From: "robert chana" <>
Subject: RE: [e-drug] Can expired drug still be used? (11)
To: Essential Drugs in English <>
E-DRUG: Can expired drug still be used? (11)
------
[Thanks to all E-druggers for a frank discussion. I think we can close it for now! Please try another interesting subject! E-drug is there for you! WB]
Dear All,
I would like to mention that the use of expired drugs should be discouraged for in my opinion it falls under Misuse of drugs and so does not meet the pharmacists obligation to protect Public Health.
The patient on the other hand receives expired drugs at the same cost as he would have received the drug had it not expired. This means that the patient has been robbed of his/her money value.
It is very dangerous to talk about using expired drugs in areas where there is abuse/misuse of "good drugs". In areas where pharmacoepidiemology, pharmacovigilance is a dream it is not even advisable to mention the use of expired drugs.
Determining whether the drug maintains its potency aftre expiry is even more difficult than testing the quality of newly fabricated pharmaceuticals yet most countries in the developing would do not do the simple quality assurance tests before accepting the drugs into their market for use.
Conditions that might have been use by quality assurance agencies could have satisfied international standards for packaging etc but who has ever bothered to know whether the packaging material from company X meets the standard for humidity, temperature, and supports/protects for friability.
I would opinion that expired products are expired products and are dangerous to the society and might be use only when a substitute can not be found and only when the benefit of treating the patient with such clearly out weighs the risk of taking the drug.
As we generally know that 10% of the potency is lost by the expiry date and also is now known especially for antibacterial agents that this per centage is taken care of by the companies, how would we dose an expired insulin or an expired Nifedipin Sustained Release capsule?
Regards to all,
Chana Chapchet Robert B.Pharm
Pharmacist
Presbyterian Church In Cameroon
Synod Office
Buea, Cameroon

______