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What Antibiotics Become Toxic After Expiration

by Dan Hughes
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What Antibiotics Become Toxic After Expiration

What Antibiotics Become Toxic After Expiration

If you’ve ever taken an antibiotic and it didn’t seem to work as well as expected, or if your doctor prescribed antibiotics for something other than what you were diagnosed with, then you may have wondered how long those pills are supposed to last after they expire? Although some medications become less potent over time, not all antibiotics lose their effectiveness at the same rate — and while expiration dates indicate how long these drugs should be stored before being discarded, this doesn’t necessarily mean that once the date passes, the medication will no longer work. This is because many factors affect how quickly an antibiotic becomes ineffective, including the type (e.g., macrolide), how often you take them, whether you’re infected by bacteria susceptible to the drug, and even where you store the medicine. For example, amoxicillin loses its effectiveness against penicillin-resistant strains of Streptococcus pneumonia faster than methicillin-sensitive Staphylococcus aureus.
Antibiotics are classified according to how long they remain effective in treating certain types of infections; however, even within each class, there’s variation. Some classes don’t require refrigeration, such as cephalosporins, nitroimidazole compounds, sulfonamides and trimethoprim, which are used to treat bacterial infections like giardiasis, trichomoniasis, urinary tract infections, skin infections and ringworm. Others, like fluoroquinolones, clindamycin, erythromycin and doxycycline, need to be kept refrigerated because they contain active ingredients that degrade rapidly when left out. Still others, like azithromycin, clarithromycin, telithromycin and minocycline, are extended release forms that are designed to stay effective longer than typical immediate release versions.
Most people assume that once the “expiry” date on a prescription appears, the medication will no longer work, but this isn’t always true. According to the U.S. Food & Drug Administration (FDA) Center for Biologics Evaluation & Research, about half of all antibiotics go unused simply because patients aren’t aware of their expiration dates. While most antibiotics are safe to use beyond their expiration dates, some can cause side effects, allergies or infection. If you’re taking any kind of antibiotic, you should consult your physician or pharmacist about potential complications related to using past-dated meds. Also, keep in mind that different antibiotics react differently to heat and light, so make sure any medicine you have leftover hasn’t been exposed to either until you know exactly what you’ll be doing with it next.
In general, antibiotics intended for oral consumption shouldn’t be kept past their shelf lives, although there are exceptions to every rule. The FDA recommends throwing away all past-date antibiotics, especially those belonging to the following groups:
Group A: Cotrimoxazole, Dapsone, Erythrocin, Nitrofurantoin, Sulfonamide, Trimethoprim
These medicines should be thrown away as soon as possible because they could potentially harm children who swallow them. Side effects include nausea, vomiting, stomach cramps, diarrhea, dizziness, drowsiness, rash, itching, headache, fever, jaundice, joint pain, swelling around joints, muscle pain, difficulty breathing and chest pain.
Group B: Ampicillin, Augmentin, Cefaclor, Clarithromycin, Clofoxin, Enzyme inhibitors, Metronidazole, Mupirocin, Roxithromycin, Tetracycline, Tinidazole, Vancomycin
As mentioned previously, tetracyclines, such as tetracycline, oxytetracycline and doxycycline, tend to lose potency more slowly than other drugs in this group. However, since many of us ingest tetracyclines via toothpaste, mouthwash and acne treatments, we still recommend discarding them after 30 days to avoid potential side effects. These include rashes, stinging eyes, nausea, abdominal pain, constipation, increased cholesterol levels, hair loss and darkening of teeth.
Group C: Azithromycin, Ciprofloxacin, Danofloxacin, Norfloxacin, Fleroxacil, Levofloxacin, Lomefloxacin, Sparfloxacin, Telithromycin, Zinacef
Most Group C antimicrobials are extended release forms meant to be taken once daily, but some can also be given twice daily. Like tetracyclines, they typically lose their effectiveness much slower than other medicines in this group. Unfortunately, they also tend to break down much quicker once opened, which means you should throw them away right after opening them to prevent contamination. Patients who suffer from liver disease or intestinal blockages are especially vulnerable to serious consequences stemming from consuming expired antibiotics, so doctors advise throwing out any medicine from this group that was prescribed specifically for them. Other signs of deterioration include mold growth, foul odors, cloudy packaging and brownish liquid leaking from the bottle.
The good news is that most antibiotics are harmless when expired, regardless of their classification. But even though antibiotics pose few risks when they’re expired, the best way to ensure you get the full benefit from your prescriptions is to pick up refills early. When you receive your first refill, ask your pharmacy staff to notify you of when the second one will arrive. And remember, if you notice anything unusual about your current prescription, call your physician or local health department immediately.
According to the Centers for Disease Control and Prevention, antibiotic resistance (or antibiotic-resistant organisms) occurs when bacteria evolve immunity to antibiotics. As bacteria continue to develop immunity to antibiotics, treatment options become increasingly limited, and sometimes the only solution is to replace the offending organism altogether.

 

If you’ve ever taken an antibiotic and it didn’t seem to work as well as expected, or if your doctor prescribed antibiotics for something other than what you were diagnosed with, then you may have wondered how long those pills are supposed to last after they expire? Although some medications become less potent over time, not all antibiotics lose their effectiveness at the same rate — and while expiration dates indicate how long these drugs should be stored before being discarded, this doesn’t necessarily mean that once the date passes, the medication will no longer work. This is because many factors affect how quickly an antibiotic becomes ineffective, including the type (e.g., macrolide), how often you take them, whether you’re infected by bacteria susceptible to the drug, and even where you store the medicine. For example, amoxicillin loses its effectiveness against penicillin-resistant strains of Streptococcus pneumonia faster than methicillin-sensitive Staphylococcus aureus.
Antibiotics are classified according to how long they remain effective in treating certain types of infections; however, even within each class, there’s variation. Some classes don’t require refrigeration, such as cephalosporins, nitroimidazole compounds, sulfonamides and trimethoprim, which are used to treat bacterial infections like giardiasis, trichomoniasis, urinary tract infections, skin infections and ringworm. Others, like fluoroquinolones, clindamycin, erythromycin and doxycycline, need to be kept refrigerated because they contain active ingredients that degrade rapidly when left out. Still others, like azithromycin, clarithromycin, telithromycin and minocycline, are extended release forms that are designed to stay effective longer than typical immediate release versions.
Most people assume that once the “expiry” date on a prescription appears, the medication will no longer work, but this isn’t always true. According to the U.S. Food & Drug Administration (FDA) Center for Biologics Evaluation & Research, about half of all antibiotics go unused simply because patients aren’t aware of their expiration dates. While most antibiotics are safe to use beyond their expiration dates, some can cause side effects, allergies or infection. If you’re taking any kind of antibiotic, you should consult your physician or pharmacist about potential complications related to using past-dated meds. Also, keep in mind that different antibiotics react differently to heat and light, so make sure any medicine you have leftover hasn’t been exposed to either until you know exactly what you’ll be doing with it next.
In general, antibiotics intended for oral consumption shouldn’t be kept past their shelf lives, although there are exceptions to every rule. The FDA recommends throwing away all past-date antibiotics, especially those belonging to the following groups:
Group A: Cotrimoxazole, Dapsone, Erythrocin, Nitrofurantoin, Sulfonamide, Trimethoprim
These medicines should be thrown away as soon as possible because they could potentially harm children who swallow them. Side effects include nausea, vomiting, stomach cramps, diarrhea, dizziness, drowsiness, rash, itching, headache, fever, jaundice, joint pain, swelling around joints, muscle pain, difficulty breathing and chest pain.
Group B: Ampicillin, Augmentin, Cefaclor, Clarithromycin, Clofoxin, Enzyme inhibitors, Metronidazole, Mupirocin, Roxithromycin, Tetracycline, Tinidazole, Vancomycin
As mentioned previously, tetracyclines, such as tetracycline, oxytetracycline and doxycycline, tend to lose potency more slowly than other drugs in this group. However, since many of us ingest tetracyclines via toothpaste, mouthwash and acne treatments, we still recommend discarding them after 30 days to avoid potential side effects. These include rashes, stinging eyes, nausea, abdominal pain, constipation, increased cholesterol levels, hair loss and darkening of teeth.
Group C: Azithromycin, Ciprofloxacin, Danofloxacin, Norfloxacin, Fleroxacil, Levofloxacin, Lomefloxacin, Sparfloxacin, Telithromycin, Zinacef
Most Group C antimicrobials are extended release forms meant to be taken once daily, but some can also be given twice daily. Like tetracyclines, they typically lose their effectiveness much slower than other medicines in this group. Unfortunately, they also tend to break down much quicker once opened, which means you should throw them away right after opening them to prevent contamination. Patients who suffer from liver disease or intestinal blockages are especially vulnerable to serious consequences stemming from consuming expired antibiotics, so doctors advise throwing out any medicine from this group that was prescribed specifically for them. Other signs of deterioration include mold growth, foul odors, cloudy packaging and brownish liquid leaking from the bottle.
The good news is that most antibiotics are harmless when expired, regardless of their classification. But even though antibiotics pose few risks when they’re expired, the best way to ensure you get the full benefit from your prescriptions is to pick up refills early. When you receive your first refill, ask your pharmacy staff to notify you of when the second one will arrive. And remember, if you notice anything unusual about your current prescription, call your physician or local health department immediately.
According to the Centers for Disease Control and Prevention, antibiotic resistance (or antibiotic-resistant organisms) occurs when bacteria evolve immunity to antibiotics. As bacteria continue to develop immunity to antibiotics, treatment options become increasingly limited, and sometimes the only solution is to replace the offending organism altogether.

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