medication expiration dates
Testing was done by FDA for DOD: FDA shelf life extension program.
https://slep.dmsbfda.army.mil/slep/s...r_JAN_2006.doc
They are very secretive about the specific drugs tested and the results but some info leaks out in this document.
Quote:
It is important to note that products tested under this program are maintained under tightly managed, controlled conditions at a limited number of locations. Extrapolation of these data to drugs stored by others would be inappropriate. Storage conditions may vary widely across the population and SLEP data are not generalizable unless storage conditions are identical and verifiable. Even within the SLEP, products known to have been stored under adverse conditions (i.e., high temperature or low temperatures) by SLEP Participates are excluded from the program, unless they are marked and tested separately from “normal” stocks.
Individual prescriptions, i.e. those which have been stored by individuals or opened are not considered. Many drugs are disqualified from testing because they are likely to fail and the number of drugs being tested has reduced to 13. And these extensions are based on testing actual samples from each of the drug lots and do not apply to other lots of the same drug stored in a different warehouse. SLEP does not apply to small lot sizes in local pharmacies; in addition, drugs there may be repackaged from open bottles or dispensing machines and exposed to air and thus is no longer in the unopened shelf life phase. Also, the program primarily applies to exotic drugs (such as antidotes for biological warfare agents) that do not have value in the commercial market and cannot be returned for credit (what happens to those commercially marketable drugs when they are returned?).
Problem drugs:
- Any liquid
- Any biologic (i.e. vaccines)
- Epinephrine.
- Tetracycline - old tetracyline had toxic effects (has since been reformulated)
- water purification tablets
- mefloquine hydrochloride (anti-malarial)
Expiration dates are typically 2-3 years or 1 year or less after prescribed/repackaged/opened. FDA issues warnings to consumers not to use expired drugs.
Stuff in your bug out bag or first aid kit in the car is particularly liable to degrade due to temperature extremes.
One concern is that the pill bottles the drugs are repackaged into can admit air/oxygen/humidity. Air tight containers rarely are actually air tight - the seals breath with changes in air pressure and the plastic is permeable. And consumers frequently store in humid rooms such as bathroom or kitchen. Many do not have air conditioning.
On the other hand, if you have drugs in their original unopened containers (not pharmacy containers) sealed in a #10 can with an oxygen absorber and desicant and temperature controled storage, this data might give some hints as to its lifetime.
20% of drugs tested were not granted extension. Some drugs didn't even make it to their expiration date. In general, toxicity is not an issue:
http://www.endtimesreport.com/Prescr...longevity.html
Quote:
Only one report known to the medical community linked an old drug to human toxicity. A 1963 Journal of the American Medical Association article said degraded tetracycline caused kidney damage. Even this study, though, has been challenged by other scientists. Mr. Flaherty says the Shelf Life program encountered no toxicity with tetracycline and typically found batches effective for more than two years beyond their expiration dates.
It appears that, under the particular storage conditions of the specific lots of drugs tested by SLEP, they passed if there was a 95% confidence that the drugs retained 90% of their effectiveness.
http://www.dsls.usra.edu/grandrounds/20091027/khan.pdf
General USP storage temperatures for medicines which don't require refrigeration are are 25C +5/-10 (i.e. 15-30C). Some sites say below 25C. Refrigerated meds 2C to 8C. Each 10 celsius degree increase in temperature would probably translate to halving the life of the product. Reducing the temperature may increase life comparably, but there is little info about low temperature storage. Some drugs can be damaged by temperatures at or below freezing. Domestic fridges can inadvertently freeze contents.
A UK study showed that in all doctors offices and pharmacies, drugs were stored at incorrect temperatures:
http://www.rsm.ac.uk/media/pr157.php
Temperatures in doctors bags in cars reached 49.5C/121F (could be worse in parts of the US); constant exposure to these temps could reduce the life of the drugs by about 83% vs 25C. A small microwave oven sized 8 bottle wine cooler might be worth considering if you want to store a bunch of expensive meds for a long time.
Table of non-refrigerated storage durations for medications requiring refrigeration based on manufacturer data (free registration required):
http://www.medscape.com/viewarticle/562416_print
Example results (room temperature): typical vaccines 72hours, insulin 14-30 days (depending on specific variety), penicillin G 7 days at 77F or 1 day at 104F, Saquinavir soft gelatin capsules 90days. Some explicitly stated durations were lifetime cummulative exposure.
Video: Top 5 Antibiotics for SHTF storage:
http://www.youtube.com/watch?v=DOfthwm_v3E
Suggests using calvetsupply.com (no prescription required, labeled for fish use). You can get for a lot less from shopmedvet.com but you would need a license on file (or perhaps a prescription).
Potassium Iodide tablets (to protect thyroid against ingested radioactive iodine) are good indefinitely when properly stored but they do become more difficult to dissolve and may need to be crushed:
http://www.nrc.gov/about-nrc/emerg-p...de/ki-faq.html
Aside: WHO list of essential medicines (long):
http://en.wikipedia.org/wiki/WHO_Mod...tial_Medicines