[e-drug] Can expired drug still be used? (5)

e-drug
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E-DRUG: Can expired drug still be used? (5)
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Dear E-drug Users,

To leave the issue of whether an expired item is fit for use or not to the discretion of technical, informed people is always good: People who appreciate the chemistry of the pharmaceutical under consideration...

Generalizing that you can use expired solid dose forms like tablets, six months or one year from the date of expiry isn't exactly right. It is indeed not only misleading, but is dangerous to society. Let us take two extremes.

First consider nitroglycerin, an ester, when it expires, following long periods of exposure to the environment, it will be expired, truly. Why should you use such? On the other hand, you may have stock of well-stored nitroglycerin and you have a patient who is in agony and needs it and there is neither any in stock nor is there money to import some. Why don't you use the expired one?

Second in Uganda, in a major hospital, we had suxamethonium that expired, several months before the expiry date on the container. The package of this medicine, used in general anesthesia, had been stored in a warehouse that was close to an active autoclave for a few months, and therefore expired ahead of the expiry date.
And during theatre operation, the drug delivered false hope. Surgeons thought pharmacists where not helping them because they picked suxamethonium that was hardly useful from the hospital warehouse...

From these two extremes, once expired it is to be discarded, and get new items. After technical consideration of the chemistry of the chemical in question, and when there is nothing to use--for a number of reasons--an expired item may be better than nothing. But use your professionals before making an informed decision as some times expired items could be exactly dangerous. How about manufacturers making statements in product inserts to the effect of whether it is safe to use their products once expired?

George Kibumba, MPS(Uganda).
Msc. Student,
Pharmaceutical Services and Medicines Control,
University of Bradford,
Flat A3, Room 1, Wardley House,
Little Horton Lane, Bradford,
West Yorkshire, BD5 0AE
E-mail: kibumba@yahoo.com

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E-DRUG: Can expired drug still be used? (6)
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Dear E-drug Users,

The comments on the topic are interesting. Could
someone please tell us what should be followed when a
drug expires. Should the drug be discarded/destroyed
or should it be kept for a little while waiting for
any emergency it may be useful for?

Some medical officer once landed into in trouble when
he tried to assist a patient using an expired drug
when he had no alternative. The problem was that the
patient's relatives discovered that their loved one
was given expired drugs and it became a serious issue
when the patient was not helped by the drug.

It may be nice sometimes to inform stakeholders about
the action one intends to take with regard to expired
medicines.

Geoffrey Ngwira B.Pharm
Y.B. Pharmaceuticals
P.O. Box 5938
Limbe
Malawi

[Expired drugs should in principle no longer be used; so in principle they should be removed from the stock and destroyed or sent back to the manufacturer/wholesaler for safe disposal.
Keeping them for emergencies should only be considered as a last resort; this should only happen if there are no fresh, "non-expired" drugs in the store. Patients have the right to know they can only get no drug or an expired one, and should take an informed decision with the health worker. To avoid routine dispensing, it might be safer to have expired drugs for "emergencies" stored in a different location, away from the normal pharmacy.
In some countries it is illegal to stock or dispense expired drugs.
WB]
  
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