Abstract
Every drug manufacturer is legally bound to display the date of expiry on all pharmaceutical products. Excluding certain medicines such as nitroglycerin, insulin, epinephrine, and tetracycline, most medicines stored under reasonable conditions retain at least 70–80% of their original potency for at least 1–2 years after the expiration date, even after the container has been opened. The drug is likely to lose some potency after the expiration date, but it is not clear how much potency is lost over a certain period of time past expiration dates. Placing medication in a cool place, such as a refrigerator, will help it remain potent for many years. Even though both the American Medical Association and the Food and Drug Administration do not recommend the dosing of expired pharmaceuticals at this time, discussion of the issue is warranted in order to understand the potential behind some expired drugs. This review article studies the financial implications and reason for stock piling of unused and expired pharmaceuticals, health hazards, common and ideal ways of disposal of unused and expiry medications and the way forward.
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References
Török I. Does medicine lose its value near the expiration date?. Acta Pharm Hung 2001; 71:213–214.
Culbertson NT. What can be done with expired pharmaceuticals? .A review of literature as it pertains to special operations forces medics. J Spec Oper Med 2011; 11:1–6.
Sandford-Smith J. Outdated drugs may be useful. BMJ 2003; 326:51.
Vogler S, de Rooij RHPF. Medication wasted – contents and costs of medicines ending up in household garbage. Res Social Adm Pharm 2018; 14:1140–1146.
Clark M, Embrey M. Pharmaceutical donations. MDS-3: managing access to medicines and health technologies. Arlington: Management Sciences for Health; 2012. 15.1–15.3.
Hogerzeil HV, Couper MR, Gray R. Guidelines for drug donations. BMJ 1997; 314:737–740.
van der Heide B, Schouten E. Assortment of drugs causes more problems than it solves. BMJ 1995; 311:684.
Nakyanzi JK, Kitutu FE, Oria H, Kamba PF. Expiry of medicines in supply outlets in Uganda. Bull World Health Organ 2010; 88:154–158.
Ruhoy IS, Daughton CG. Beyond the medicine cabinet: an analysis of where and why medications accumulate. Environ Int 2008; 34:1157–1169.
Castiglioni S, Bagnati R, Fanelli R, Pomati F, Calamari D, Zuccato E. Removal of pharmaceuticals in sewage treatment plants in Italy. Environ Sci Technol 2006; 40:357–363.
Wu M, Atchley D, Greer L, Janssen S, Rosenberg D, Sass J. Dosed without prescription: preventing pharmaceutical contamination of our nation’s drinking water. Natural Resources Defense Council White Paper 2009 1–60.
Oaks JL, Gilbert M, Virani MZ, Watson RT, Meteyer CU, Rideout BA, et al. Diclofenac residues as the cause of vulture population decline in Pakistan. Nature 2004; 427:630–633.
Boehringer S. What’s the best way to dispose of medications. Pharm Lett 2004; 20:4.
Costanzo SD, Murby J, Bates J. Ecosystem response to antibiotics entering the aquatic environment. Mar Pollut Bull 2005; 51:218–223.
Tong AY, Peake BM, Braund R. Disposal practices for unused medications around the world. Environ Int 2011; 37:292–298.
Hwang B-D. Storage and disposal of unused medications for housewives in the Busan Metropolitan City. Korean J Health Serv Manag 2013; 7:69–79.
Abahussain EA, Ball DE. Disposal of unwanted medicines from households in Kuwait. Pharm World Sci 2007; 29:368–373.
Azad MAK, Ansary MRH, Akhter MA, Al-Mamun SM, Uddin M. Disposal practice for unused medications amongthe students of the International Islamic UniversityMalaysia. J Appl Pharm Sci 2012; 2:11.
Persson M, Sabelström E, Gunnarsson B. Handling of unused prescription drugs – knowledge, behaviour and attitude among Swedish people. Environ Int 2009; 35:771–774.
Albaroodi KAI. Pharmacists’ knowledge regarding drug disposal in karbala. Pharmacy (Basel). 2019; 7:57. Published 2019 Jun 10. doi:10.3390/ pharmacy7020057
Glassmeyer ST, Hinchey EK, Boehme SE, Daughton CG, Ruhoy IS, Conerly O, et al. Disposal practices for unwanted residential medications in the United States. Environ Int 2009; 35:566–572.
Returning unused and expired medications in British Columbia. Health Products Stewardship Association. Available at: http://www.healthsteward.ca/returns/british-columbia. [Accessed 28 September 2016].
Macarthur D. Any old drugs? Two schemes for the disposal of unwanted medicines in Europe. Pharm J 2000; 264:223–224.
Bashaar M, Thawani V, Hassali MA, Saleem F. Disposal practices of unused and expired pharmaceuticals among general public in Kabul [published correction appears in BMC Public Health. 2017 Mar 6;17 (1):231]. BMC Public Health 2017; 17:45. Published 2017 Jan 7. doi:10.1186/s12889-016-3975-z
Bashaar M, Thawani V, Hassali MA, Saleem F. Disposal practices of unused and expired pharmaceuticals among general public in Kabul [published correction appears in BMC Public Health. 2017 Mar 6;17 (1):231]. BMC Public Health 2017; 17:45. Published 2017 Jan 7. doi:10.1186/s12889-016-3975-z
Smith CA. Managing pharmaceutical waste. J Pharm Soc Wis 2002; 5:17–22.
Shah A, Parmar S, Kumkishan A, Mehta A. Knowledge, Attitude and Practice (KAP) survey regarding the safe use of medicines in rural area of Gujurat. Adv Trop Med Pub Health 2011; 1:66–70.
Chien H-Y., Ko J-J., Chen Y-C., Weng S-H., Yang W-C., Chang Y-C. Liu H-P. Study of medication waste in Taiwan. J Exp Clin Med 2013; 5:69–72.
West LM, Diack L, Cordina M, Stewart D. A cross-sectional survey of the Maltese general public on medication wastage. Int J Clin Pharm 2016; 38:261–270.
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Sarla, G.S. Efficacy and disposal of drugs after the expiry date. Egypt J Intern Med 31, 431–434 (2019). https://doi.org/10.4103/ejim.ejim_110_19
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DOI: https://doi.org/10.4103/ejim.ejim_110_19