Hi All

I need some advice, I am repacking/stocking my FAK and I have last years dose of antibiotics which according to the label are expired, but haven't touched them or nothing.

Anyways, my question is, would someone consider them still good to use?
I plan on replacing the ones in my PKS with them, or would that be a no no. Also as I am younger, I don't know how many prescriptions my physician will be willing to give me considering they are for "kits".
If they should be thrown out, is there a safe/proper way?

Any input would be great?

Vader

Hi Vader,

Antibiotics such as Vibramycin, Vibramycin 50, Vibramycin -D have a reasonable shelf life of around 4 years if stored below 25 C.

http://emc.medicines.org.uk/emc/assets/c/html/DisplayDoc.asp?DocumentID=1475#SHELF_LIFE

So I guess it depends on which antibiotic you have in your PSK.

If your doctor originally wrote the prescription for these for your kit, take them back to him when you next ask for a new prescription (to show him that they have indeed not been used, sold, whatever).

Jim

Also, there are so many people medications for chronic conditions (over 50% of Americans take medication for depression, anxiety, diabetes, high blood pressure, etc etc) and some of this passes through the urine. There seems to be so much of the stuff entering the environment from all these millions of pople that it is having an effect on many living things in the ecosystem we depend upon to survive.

what's really fishy about that EPA story is the statement that light degrades antibiotics. If that's true, then why is it still in the water? Hmm.... (OK, maybe groundwater).

I'm guilty of tossing pills in the toilet, but I usually do it in the morning as I leave the house, so they're dissolved by the evening when I use it again. Occasionally I'll toss them in the trash, which probably doesn't help either. Probably the "best" way to dispose is incineration.

They are no longer effective and they loose whatever makes them work. But then there is a trace amount in ground water. If this is true how watered down is the amount of the pills are in the water? Next to nothing, much less I’m sure then what it would be in your body from taking the pills. And yet we are told they loose their potency?


Something doesn’t make sense here, either they are not potent and taking them is not going to do you any good and thus it would also make sense that they would not be strong enough to be in the water.


Or they are still good long after their pull date.

If antibiotics are anything like pain pills, they are effective for many years past the pull date

Izzy, I'm clarifying a few things in the kindest spirit of knowledge sharing...It's just important that accurate info is presented here on this board. I'm sure you'd agree with that.



The oral antibiotics in my pharmacy: A) Are not produced in amber vials, but usually white opaque bottles. We dispense them in amber vials because *some* medications are light sensitive, and it's easier if they are all amber for those cases B)Will have expiration dates ranging from 2-3 YEARS. We will send back any that have an expiration date less than 1 year.

The PDR is a compendium of product information published by the pharmaceutical companies. Although somewhat useful, it doesn't always tell the whole story; only what the FDA has ruled that company is allowed to tell. Much better references are Facts and Comparisons or Micromedex. Heck, even Epocrates is decent for some basic knowledge. BTW, PDRs are often given away free...that might tell you something. Epocrates is free too, but it's actually quite good for a brief summary of Rx information.



Strong trace...? Unless one believes in homeopathy...then the less there is of a substance, the more powerful it is. Back in the real world... The term "trace" indicates minuscule amounts. The amounts in that latest EPA scare were exactly that, trace. The main thing the EPA was concerned about was the fish being altered by the presence of some of the compounds. Fish (and amphibians!) are far more sensitive to things in the water than us mammals. The EPA went out of their way to emphasize that this does not represent a danger to humans. Funny how that didn't make it to the headline...

Current recommendations are still to flush them down the toilet.

Good job on the "finish your antibiotic" discussion! Ditto! The worst way to build up an emergency supply of antibiotics would be to not finish the prescription and keep that as your supply.



Your instincts are well-founded. This service is available in select locations as a kiosk. People dump their used meds in and they take it to get incinerated. (Makes you wonder how many drug addicts will be kiosk-diving thinking their junk is in there!) I think it's pretty sparse, however; most clinics will just tell you to flush it if you call for this service.



They can't prescribe controlled substances (Lortab, Morphine) for themselves. That's the only thing the DEA regulates. They can prescribe antibiotics for themselves or family members. (Prescribing for himself is usually frowned upon, though not illegal) Absolutely nothing unethical about prescribing antibiotics for travel outside the country. It is quite routine to prescribe antibiotics to deal with the possibility of traveler's diarrhea. One issue a prescriber might debate is whether the person can "self-diagnose" a bacterial infection. There are women who know they have a yeast infection (believe me, they know!) and most docs I work with will just call it in for established patients without seeing them (if it's the 2nd time for the yeast infection) But it's a case by case basis; every prescriber has his/her comfort zone for such things.

I will join the haranguing against that National Geographic Adventurer for encouraging people to "get a lot of antibiotics before ever traveling." The prescriber should only prescribe those antibiotics and/or immunize according to well-established guidelines (See Sanford's guide). It would be foolish for people to try to get "lots of" antibiotics to "self-diagnose" a condition in another country.

My final take on storing antibiotics for BOB use is that it is probably unnecessary for most situations that are not catastrophic and long-lived. However, if you travel to 3rd world countries, it would be a good idea. Get your shots, too!

Thanks for the good info.

I will probably keep the expired antibiotics as a back up, considering they have always been protected from the sun and all.
I appreciate the help thanks guys

Replacing these antibiotics is better than to use those. Antibiotics may or may not have side effects on your health but also we are not sure 100% that it will not affect your health badly.

I was ticked off yesterday with ********* pharmacy yesterday because I had gotten another prescription for the medications that I have to take (for the rest of my life because of some yoyo who wasn't suppose to be driving decided to drive that day and ruin my life) but that's a different story---sorry ranting. Anyway I was trying to get a 90 day stockpile in case of emergencies when they denied me of any more refills until my medications gets lower. The medication is not an antibiotic or barbiturate like Oxycontin etc... I was told with the new system they have, I have to be within a few days of the medication to expire before allowed any more medication. Do I need to get a doctor to write me a little love note that allows me to stockpile a 90 day supply or am I stuck on a controlled system that I need to find other means...

Falcon, I think these older threads will give you some ideas. Try this , this, and this.

Considering how many of us rely on one or more prescription meds long term, I think this is an important topic and we've had some good discussion about it in the past.

Thank you for the links Arney, I wasn't aware of the 80% rule, now it gives me some ideas what needs to be done. Thanks again.

I would advocate that people avoid carrying any antibiotics. Most of them are at least mildly toxic and allergies are not uncommon. Selection of the right antibiotic for a condition is not a simple choice and dosing is problematic.

Most people who carry them have no idea what the right dose is, and given the right dose most of them don't carry enough to complete a proper course of treatment. Half a dose or half the proper time is a grand way to make sure any infection becomes resistant to the antibiotic you half-use.

A stock of antibiotics can make sense if you are spending a long time in a very remote location. They can save the day if you're 500 miles and two weeks from anywhere. But 99% of the people don't qualify and are not far enough out long enough for antibiotics to be any benefit.

Given that a PSK is going to be limited to a short-time, typically two to five days, but always less than ten days, there is no need for antibiotics.

Count me in with the "do not carry" group, with the exception of a dozen single use packs of neosporin in my FAK.

Antibiotics may be potent years beyond the expiration date. I worked in the drug industry and a vp of quality control was in the office next to me. He told me one day that expiration dates on drug bottles had nothing to do with when the medicine was no longer potent. All the FDA wanted to know was the medicine was effective up to that date. What drug companies wanted to do was push the product through the system and a long effective date was contrary to that desire. (Tetracycline may be one exception and an antibiotic that should not be taken after the expiration date.) For what it's worth here's one link to a Wall St Journal story:

http://www.endtimesreport.com/Prescription_longevity.html

Tim W.

Most drugs, including MOST antibiotics remain effective past their expiration date. There is a potiential loss of potency depending on storage conditions ( especially temp and possibly humidity{depending on packaging}) as well as the passage of time. HOWEVER TETRACYLINE clearly develops toxicity when used past expiration.

+1. When tetracycline expires, throw it out! Modern (aka post 1980) manufacturing makes that family of antibiotics generally safe past the expiration date, but don't risk it with that one.

Art, you said it better than I could.

Big ditto!

Even us allied health care professionals can get in trouble when we think we know as much as the doctor does.

I've been shocked at finding out that a few pharmacists self-treat with rx meds without a physician's prescription because they "know as much as he/she does." Not only is that ill-advised, it's also illegal.

One thing the practice of pharmacy has taught me is to respect medications. They are not candy, folks. Let the prescriber be the one to make the judgment call. (That's what he/she pays those exorbitant malpractice fees for!)

Boy, nothing like correcting yourself. Current recommendations are NOT to flush your meds, but to take them to those aforementioned kiosks. Ask your pharmacist where to find them. In our state, we have some at police stations. My apologies to the fish and amphibians that were harmed by my outdated info!

Actually, the current recommended treatment for Traveler's Diarrhea (TD) is immodium and anywhere from one dose to three days of a fluoroquinolone antibiotic......ie Cipro or Levaquin. Self treatment is the standard of care too.

I was on a mission trip to China and the morning were to leave, TD hit. The thought of being on a plane for 22+ hours with diarrhea is unthinkable.

I loaded up on immodium and took a single dose of Cipro. I was good the entire trip home.

And the odds are you would have been fine with Imodium alone. And even then you hold off on the Imodium until you have symptoms. Ironically one of the common side effects of using Cipro is diarrhea.

It also has to be noted that Cipro does not speed acclimation to local bacterial flora and, in effect, you are reversing exposure and slowing natural acclimation. If you are exposed, get diarrhea, and take Cipro you may need to take more every time you are exposed. Avoid taking Cipro and stick to Imodium and your body will adjust over time and the local bacteria won't make you sick.

Of course the short-term visitor doesn't necessarily have that sort of time. The first course of action is to avoid the local flora by avoiding the water and contaminated foods. If you start to show symptoms take Imodium and treat the symptoms.

The use of antibiotics as a prophylactic, before infection, can backfire on you. Cipro doesn't differentiate between beneficial bacteria that serve and protect you and harmful bacteria. Killing off your friendly bacteria can leave you open to nasty varieties of bacteria, like clostridium difficile, to take root and cause long-term problems.