Most of the time the drug handles time well but the excipient degrades. This makes it very hard to control how those drugs will work. It opens so many variables.
It is like not using the seat belt could save your life if you are thrown away of the car at some specific circumstances, like happened to a person I know. But they are there because it works better most of the time as engineers could design safety with less variables.
My father had an emergency immune problem(that we have already identified as it is recursive) and the only required drugs in house were expired for some years. He took those before we bought the new ones and the old ones were like 1/3 potency of the new ones.
Given that most of the price of drugs come from intellectual property and patents and each pill cost dollar cents to make, I don't see the urgency of taking expired drugs.
If Hospitals trow away expired drugs then it is a good reason to take into account in the global negotiation process, and I bet they already do in countries that buy drugs in bulk.
A lot of cost of drugs comes from R&D, quality control etc. The chemical synthesis itself generally isn't that expensive. And expired pills would be a quite unpredictable precursor, which isn't very desirable in the pharma industry (or anywhere else for that matter). In other words, I doubt you could make much of a profit (if any) from purifying non-decomposed chemicals from pills.
Drugs in pill form don't really expire, they just lose efficacy.
And if stored well it takes a long time.
I cant find it right now but someone found some pills that had been stored like 50 years in sealed containers and testing for the activr ingredient showed they were still like 80% or more good.
> allow replaceable cartridges for the auto-injector
I think the risk of reusing injection equipment is chance of infection. Also a more reasonable solution to the wastage is to do a long term study to extend the expiry date. The drug manufacturer don't do a long study because of the lost time plus potential extra sales.
Most chemical processes happen faster with a higher temperature. Some drugs decay into harmful substances (e.g. Aspirin).
Other factors, such as humidity or UV, may play a part as well.
Rather than testing every permutation of storage conditions over time, manufacturers put a safety margin. Individual consumers aren't in a position to remember exactly how they treated any given container of pills. Even if the manufacturer knew how a given sequence of storage practices affected their drug, nobody would be the wiser.
I'm sure this is an easy question to answer, but it was bugging me during the whole article.
What's preventing a pill that releases a dose immediately and one after 6 hours? Or something like a diabetic pump that dispenses medication continuously? Surely such systems have the potential to be safer and more effective for patients?
I am still for single use, but if it is unused and the medicine expires people throw away the entire thing. The reason for replacement every 18 months is that the medicine expires, if you could just replace the medicine if you didn't use it you may see cost savings. However, I am just spitballing here and it is likely that there are reasons why this cannot come to fruition which I have not considered thoroughly.
I used to work in QA for a major drug company where we'd store the drugs for years at different temperatures and humidity, and every 3/6/12/18/24/48/60 months we'd test them in spectrometers, as well as testing for clumping in powders, colour changes, etc. One of our jobs was to make sure they didn't turn into anything nasty, but it was mainly making sure they stayed stable.
For all day-to-day drugs it's really a precaution rather than anything else. Usually they just become a little less effective by becoming less concentrated, but most of the ones I worked with even the 50/80(?) ones were still fine years later (stored at 50 degrees celsius, 80% humidity (I think? Was 20 years ago)). We had a special warm room where all the samples were kept.
Good point, I hadn't thought of that. "Back in my day," there were no time release medicines that I'm aware of. When caring for kids of my own, the kiddie medicines were mostly liquids.
It's just poor design to allow for good-faith. It's too easy for a bad actor to artificially create "leftover" doses to give to friends and family. Just don't allow doctor discretion and organize better for the next day, problem solved.
Nitroglycerin has a fairly short half life and doesn't love being exposed to air. Aspirin like any drug has a shelf life but not an unusually short one. Masks etc are going to have an expiration but unless the package is damaged are likely fine. Airways being invasive require closer management. Tetracycline is one of the few drugs that I am aware of that most practitioners will not use past expiration because of reports in the literature that old tetracycline caused kidney damage.
There are well defined SOPs in healthcare for when a sealed kit is opened. It is taken out of service, restocked, QCd, and returned to service. There was no mention of O2 administration in this article but the oxygen kit also requires routine checks and maintenance.
don't some medicines have a time delay release mechanism that this would defeat? getting that much of a dose of some medicines all at once wouldn't be ideal I'd think. caveat emptor and all that.
Protein-based drugs, such as oxytocin or insulin, are likely to be consumed and recycled into component amino acids.
Most molecules left out in the environment will eventually be oxidized, have an important bond cleaved by UV light with enough energy, or undergo thermal decomposition.
As sunlight, dissolved oxygen concentration, and temperature can vary wildly just by moving a few meters away, and the chemicals themselves have different stability, it is very difficult to predict how long a pill that was flushed down the toilet will persist in the environment.
Generally speaking, certain drugs are only useful because they take longer to degrade inside the body. It wouldn't do you much good to get an injection of a drug if your body's proteases chop it up to uselessness in the first ten minutes, or if it zooms right to the liver and gets methylated, or whatever it is the body does to clear foreign chemicals. In those cases, microbes will also have a hard time turning them into something else.
It's really sad, but the automation for this is a pharmacy that creates custom plastic sealed single-dosing packets. Some people, most older people, are on THAT many meds and just need to take the next one off the roll.
It is like not using the seat belt could save your life if you are thrown away of the car at some specific circumstances, like happened to a person I know. But they are there because it works better most of the time as engineers could design safety with less variables.
My father had an emergency immune problem(that we have already identified as it is recursive) and the only required drugs in house were expired for some years. He took those before we bought the new ones and the old ones were like 1/3 potency of the new ones.
Given that most of the price of drugs come from intellectual property and patents and each pill cost dollar cents to make, I don't see the urgency of taking expired drugs.
If Hospitals trow away expired drugs then it is a good reason to take into account in the global negotiation process, and I bet they already do in countries that buy drugs in bulk.
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