Home' Trinidad and Tobago Guardian : February 7th 2017 Contents A24 body & soul
guardian.co.tt Tuesday, February 7, 2017
When old medicine goes bad
Most of us have reached for a painkiller, at one
time or another, only to discover the date on
the label shows it has expired. But what does an
"expiration" date on medicine really mean? Is it
dangerous if you take it anyway? Less effective?
It turns out that date stamped on the label actually
means a lot. It's based on scientific evidence gathered
by the manufacturer showing how long the drug's
potency lasts. Companies expose their medications
to different environments, different temperatures and
humidity levels to see just how long it takes for the
medication to degrade to the point that its effective-
ness is compromised.
The general rule, says pharmacist Mike Fossler
with the American College of Clinical Pharmacol-
ogy, is that once a drug is degraded by ten per cent
it has reached "the end of its useful life." If you take
it months or even years past the expiration date, it's
unlikely to do you any harm, he says; it just might
not do you much good.
That may not be a big deal if you're treating a head-
ache, but if you're fighting a bacterial infection with
antibiotics like amoxicillin or ciprofloxacin, for ex-
ample, using less than fully potent drugs could fail
to treat the infection and lead to more serious illness.
Pharmacist Mohamed Jalloh, a spokesman for the
American Pharmacists Association, says there's an
even bigger reason not to rely on old drugs: antibi-
otic resistance. When you inadvertently "under-
dose" yourself by taking antibiotics that aren't full
strength, he says, you run the risk that the bacteria
you're battling will figure out not only how to defeat
this weakened drug, but other antibiotics, too.
At least 23,000 people each year in the US die from
infections that have become resistant to antibiot-
ics, according to the Centers for Disease Control and
"If your medicine has expired, don't use it," con-
curs Ilisa Bernstein, deputy director of the office of
compliance in the Food and Drug Administration's
Center for Drug Evaluation and Research.
That goes for over-the-counter drugs, as well as
prescription meds. Check the expiration date before
even buying those pain relievers or allergy tablets,
some pharmacists advise --- the same way you check
your milk. Buy the one with the date that's furthest
away. "Once the expiration date has passed," Bernstein
says, "there is no guarantee that the medicine will be
safe and effective."
Of course, even new drugs can quickly lose potency
if they're not stored properly. Get those pills out of the
bathroom "medicine cabinet" now, pharmacists say.
The steam from your shower or shave kills pills fast.
"Medicines like the kind of environment that people
like --- a little dry and not too hot or cold," Fossler says.
And, of course, don't take medication to the beach
or leave it in a hot car. Like humidity, heat degrades
a medicine's active ingredients.
Some medications are more vulnerable than others,
so check the label.
Insulin, certain immunotherapy drugs, and some
children's pain relievers and cold remedies require
refrigeration and protection from light.
And compared to capsules and tablets, "liquids are
not as highly preserved," says Barbara Kochanowski,
Our collective failure to reverse
inequality is at the heart of a global
malaise, from populism to climate
change, argue experts in The BMJ
Profs Kate Pickett and Richard
Wilkinson at the University of York,
say societies with bigger income dif-
ferences tend to have poorer physical
and mental health, more illicit drug
use and more obesity. More unequal
societies are also marked by more vio-
lence, weaker community life and less
Other global risks stemming from
inequality range from "fiscal crises"
to "profound social instability"
creasing polarisation of societies"
and "increasing national sentiment"
and even "changing climate" and a
"degrading environment" because of
the ways in which inequality drives
consumerism and over-consumption,
Yet, despite decades of research
showing that we need to tackle the
structural determinants of health if
we want to reduce health inequalities,
this has not happened and health in-
equalities have not diminished, they
write. "In many cities in the UK and
USA, for example, we continue to see
life expectancy gaps of five to ten years
and occasionally of 15 to 20 years be-
tween the richest and poorest areas."
They believe that the long-term
failure, even of ostensibly progressive
governments, to tackle these glaring
injustices is perhaps one of the rea-
sons why public opinion has swung
so strongly away from the established
And they warn that the public's
sense of being left behind "will only
be exacerbated by the negative health
effects of austerity, which are starting
to emerge in our health statistics."
They point out that during the last
generation, economic growth ceased
to improve health, happiness and the
quality of life in rich countries. "Now,
more than ever, we need an inspiring
vision of a future capable of creating
more equal societies that increase sus-
tainable well-being for all of us and
for the planet," they conclude. (BMJ)
Medicines which have
expired may not do you
a scientist with the Consumer Healthcare Products
Association. Anytime you see a change in the col-
our, odour or consistency of a drug---such as a cream
turning into a runny solution---consider it a red flag,
Kochanowski says, and consult your pharmacist. It's
probably time to toss that medication. (NPR)
Rising inequalities to blame for
many of world's ills, say experts
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