You Are Not My Chemist, But... (old medicine question)
March 27, 2013 1:21 PM   Subscribe

I've got an opened tube of hydrocortisone cream (hydrocortisone at 2.5%). It's expiration date is from 2008 (over 5 years old, for any future searchers). Still safe/effective to use it?

Is there any reason to believe that this cream won't still be effective? In a closed tube, is the HC somehow deteriorating? Or the supporting elements perhaps becoming rancid somehow?

I am, of course, applying this to my butt, so there's no real need for the cream to be food grade. On the other hand, I *am* applying directly to my butt. So there IS a need for it not to be, say, corrosive. Or botulistic.

(Yes, I know I should get some new cream, but HC at 2.5% requires a prescription here in the States).
posted by Cardinal Fang! to Health & Fitness (11 answers total)
General advice is to just try and see if it works. I'm not a doctor, but I have been using expired steroid cream on myself for a while and it works fine. I don't think there's any way it will have turned corrosive or harmful.
posted by thewumpusisdead at 1:31 PM on March 27, 2013

You should stop into or call your local retail pharmacy and ask.
posted by discopolo at 1:34 PM on March 27, 2013

It should be fine. Try it and see.
posted by Thorzdad at 1:45 PM on March 27, 2013

It's unlikely to be harmful unless it actively smells bad or something. I'm assuming you didn't squeeze it directly onto your butt last time. Like, you didn't wipe the tip of the tube across your bum to get the medicine out, hopefully? Ideally you'd apply the cream from the tube onto a clean cotton swab or something similar, and then use your finger or the swab to apply the cream to the skin. I think most people just use their fingers though, which can definitely introduce bacteria into the tube.

That said, I doubt it's going to work very well. Most hydrocortisone cream I've seen has a pretty short shelf life, like if I buy a tube at a well-traveled drugstore and the expiration date is about 1 year away. Increasing that time frame up to 5 years past the original expiration makes me think you might get more benefit out of a new tube of OTC cream even if the label states a lower percentage.
posted by vytae at 1:53 PM on March 27, 2013

It is very likely to still be effective.
posted by procrastination at 2:06 PM on March 27, 2013

Procrastination, both links require a Medscape login. Can you paste the abstracts or give us a summary?
posted by vytae at 2:13 PM on March 27, 2013

I am a pharmacist. I do not know the exact degradation pattern of hydrocortisone but it is very likely that it would not be helpful to you.

There are too many variables to predict how much concentration of hydrocortisone actually remains in your cream: you said it was opened (how long ago, has it been open since you got it in the first place), storage, humidity, temperature fluctuations, potential bacteria from the environment of having used the tube before and then closing the cap for many years, etc.

You're really better off just buying the 1% OTC stuff that is still sealed and fresh. (And/Or seeing a physician about getting a new prescription for the 2.5% stuff)
posted by watch out for turtles at 5:30 PM on March 27, 2013

Oh, sorry! I posted from my university office, and we must get Medscape through the U. I am home now by will try and update tomorrow. The gist was that 90+% of medicines were shown to be good after about 5 years past exploration. The dates are apparently very conservative.
posted by procrastination at 6:01 PM on March 27, 2013

Why not test it somewhere like the inside of your elbow? The skin there is sensitive but not a mucous membrane so it wouldn't be particularly damaging if you have a reaction.
posted by radioamy at 7:55 PM on March 27, 2013

The practice varies widely, but your physician may be willing to call in a prescription if this is a recurrence of an old problem they have seen. The OTC strength may also be adequate. I would try both of those before 5 year expired stuff unless I was in despirate poverty.
posted by a robot made out of meat at 6:29 AM on March 28, 2013

I am back at work, and while there are no abstracts to quote, here is what the Medscape articles say:
One of the largest studies ever conducted that supports the above points about "expired drug" labeling was done by the US military 15 years ago, according to a feature story in the Wall Street Journal (March 29, 2000), reported by Laurie P. Cohen. The military was sitting on a $1 billion stockpile of drugs and facing the daunting process of destroying and replacing its supply every 2 to 3 years, so it began a testing program to see if it could extend the life of its inventory. The testing, conducted by the US Food and Drug Administration (FDA), ultimately covered more than 100 drugs, prescription and over-the-counter. The results showed that about 90% of them were safe and effective as far as 15 years past their original expiration date.
posted by procrastination at 9:50 AM on March 28, 2013

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