How long are antibiotic pills good for?
October 10, 2022 11:12 PM Subscribe
I had a prescription for doxycycline (low dose - 100 mg) to take as needed (following treatment schedule: 2x/day for 2 days then 1x/day for 2 weeks) for rosacea flare-ups. I refilled it right before everything shut down at the start of the pandemic (in late March, 2020), as a just-in-case sort of thing (I had needed it the previous fall, wasn't sure how long the shutdown would last and if it would be stressful enough to trigger another flare-up). I haven't had to use it since, but am having a rosacea flare-up now. Complicating factor: my family doctor retired, the practice she was at didn't reassign her clients to other doctors, so I've been without a family doctor for a bit; and local walk-in clinics are hard to access. I'll keep trying the walk-in clinic option and YANMD, but you might know something about the pharmaco-chemistry involved: can I take this two-and-a-half year old antibiotic, or will it have likely lost enough of its effectiveness that that would be un- or counter-productive?
Bottom line: maybe not a good idea.
From what I recall when I last looked into this, many medication expiration dates have little science behind them, and many of the medications retain potency long after their expirations (literally decades in some cases).
Some, however, do not. And you are unlikely to find good research for any particular drug's longevity.
With one possible exception, medications don't seem to change into anything harmful when they age, although some preparations (mostly liquid meds) may become contaminated with bacteria.
CAUTION: the one common medication that (maybe) has become harmful when expired is tetracycline, an antibiotic in the same class as your doxycycline. This article states that the problem has never been seen with doxycycline, though. And I seem to recall that even the problem with outdated tetracycline was beginning to be questioned.
Still, unless you're willing to be a guinea pig or a data point, this is one med where you might want to take the expiration date somewhat seriously.
posted by wjm at 1:08 AM on October 11, 2022
From what I recall when I last looked into this, many medication expiration dates have little science behind them, and many of the medications retain potency long after their expirations (literally decades in some cases).
Some, however, do not. And you are unlikely to find good research for any particular drug's longevity.
With one possible exception, medications don't seem to change into anything harmful when they age, although some preparations (mostly liquid meds) may become contaminated with bacteria.
CAUTION: the one common medication that (maybe) has become harmful when expired is tetracycline, an antibiotic in the same class as your doxycycline. This article states that the problem has never been seen with doxycycline, though. And I seem to recall that even the problem with outdated tetracycline was beginning to be questioned.
Still, unless you're willing to be a guinea pig or a data point, this is one med where you might want to take the expiration date somewhat seriously.
posted by wjm at 1:08 AM on October 11, 2022
I would take it no problem. Most veterinary drugs are chemically identical to human drugs (doxy is) and my veterinary doxy has a 4 year shelf life.
posted by DarlingBri at 4:32 AM on October 11, 2022 [2 favorites]
posted by DarlingBri at 4:32 AM on October 11, 2022 [2 favorites]
My concern would be - is that even the most effective treatment any more, several years out?
posted by tiny frying pan at 5:07 AM on October 11, 2022
posted by tiny frying pan at 5:07 AM on October 11, 2022
Call your pharmacy, the pharmacist will have good working knowledge of which drugs you can ignore the expiration date of.
posted by Bottlecap at 7:10 AM on October 11, 2022 [4 favorites]
posted by Bottlecap at 7:10 AM on October 11, 2022 [4 favorites]
2nding call the issuing pharmacy. Pharmacists are specialists who can likely give a better answer than a physician.
posted by theora55 at 8:04 AM on October 11, 2022 [1 favorite]
posted by theora55 at 8:04 AM on October 11, 2022 [1 favorite]
I think you have gotten good conservative advice above. Specifically, call a pharmacist.
By way of reference of my standpoint, I am not a doctor, not a pharmacist, have no knowledge of drug interaction, do not use Dr. Google, and have been to over 150 Grateful Dead shows before 1995 (I may or may not have been willing to take "medications" of questionable province).
Turns out that just 2 weeks ago, I self diagnosed an infection in my mouth, I think it was under a capped tooth. It also turns out that I had a full protocol of Amoxicillin prescribed to another family member 3 years ago. I followed and took that protocol. Worked fine for me. It also turns out I had to go to urgent care for another matter 3 days into taking the Amocx, and while there I 'fessed up about the antibiotic self diagnosis thing. The doctor shrugged. Said something along the lines of glad it worked.
I would take them. If they are not working after some days, then go to a doctor who can prescribe newer pills or different pills. YMMV.
posted by JohnnyGunn at 11:05 AM on October 11, 2022
By way of reference of my standpoint, I am not a doctor, not a pharmacist, have no knowledge of drug interaction, do not use Dr. Google, and have been to over 150 Grateful Dead shows before 1995 (I may or may not have been willing to take "medications" of questionable province).
Turns out that just 2 weeks ago, I self diagnosed an infection in my mouth, I think it was under a capped tooth. It also turns out that I had a full protocol of Amoxicillin prescribed to another family member 3 years ago. I followed and took that protocol. Worked fine for me. It also turns out I had to go to urgent care for another matter 3 days into taking the Amocx, and while there I 'fessed up about the antibiotic self diagnosis thing. The doctor shrugged. Said something along the lines of glad it worked.
I would take them. If they are not working after some days, then go to a doctor who can prescribe newer pills or different pills. YMMV.
posted by JohnnyGunn at 11:05 AM on October 11, 2022
That is how you create antibiotic resistant strains of bacteria. Don't take antibiotics that aren't fully effective because they've expired.
posted by Bottlecap at 4:36 PM on October 11, 2022
posted by Bottlecap at 4:36 PM on October 11, 2022
No, do not fuck with this. Antibiotics are not the same as many other types of drugs and have expirations that aren't jist about diminished potency.
posted by aspersioncast at 5:10 PM on October 11, 2022
posted by aspersioncast at 5:10 PM on October 11, 2022
Does your insurance offer a telehealth service? I've gotten antibiotics prescriptions a few times from my insurance's telehealth doctors. That would be a way to get a new prescription without having to deal with the walk-in clinic.
posted by Jacqueline at 7:46 PM on October 11, 2022
posted by Jacqueline at 7:46 PM on October 11, 2022
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posted by BobTheScientist at 11:23 PM on October 10, 2022 [1 favorite]