Would You Ingest This (medicine edition)

August 21, 2024 6:05 PM

Expired promethazine + codeine cough syrup -- do I dare?

I am having horrible cough for days now. It is so bad it is interfering with my sleep. I have been doing all the stuff I usually do for a cough, but it's unrelenting, so I decided to bring in the big guns so I can get some sleep. I asked my doctor for a prescription for promethazine with codeine cough syrup -- I've had it prescribed before and it has worked well for me. As I learned when the doctor tried to send the scrip to the pharmacy, the medicine is something like discontinued -- at least no pharmacy I called (and I called a dozen, including liquid compound pharmacies) will fill it or compound it.

I do have a mostly bottle of it from a few years ago -- expiry date 2021. If it were a pill I would not hesitate, I know that army study about how medicines are good for 20-30 years after their expiration dates. But I am a little more confused about whether a liquid medicine 3 years out of date would be effective and safe. Given how miserable I am, and that apparently this medicine is impossible to find now, I very much would like the answer to both to be "yes."

So I turn to AskMe -- would you take it? If you are a doctor, YANMD but I would be interested in your opinion (yes, I know the official stance is all expired medicine is bad). I got maybe 3 hours of sleep last night, and tonight looks to be a repeat of that.

posted by virve to Health & Fitness (13 answers total)

It probably won't hurt you but it might not be very effective. Drugs in liquid suspension aren't very stable, I'm sure that's what the expiry date is about more than anything else.

I have been doing all the stuff I usually do for a cough

Unclear if you've tried over the counter cough suppressants? I don't know what you usually do.

My personal best remedy for an unquittable cough is what I call a Kentucky Robitussin: tablespoon of honey in a shot of bourbon. You'll want to sip it. (Probably a real bad idea to knock one back while you're also chugging expired codeine, so...one or the other please be smart.)
posted by phunniemee at 6:23 PM on August 21 [1 favorite]

Response by poster: Clarifying for phunniemee and anyone else who might think in the same direction: I am not able to take any drugs with DM, as Dextromethorphan has a really bad interaction with a medicine I take on a daily basis (that I learned about the hard way, by taking DayQuil before I was aware there would be an issue). That leaves me with very limited over-the-counter options for cough relief (basically Buckley's, the "it tastes terrible and it works" medicine -- which...it does work somewhat but not well enough or for long enough for me to fall asleep)...But also please let's avoid giving me other remedies for coughing, and focus on the expiration date question and WWYD.
posted by virve at 6:38 PM on August 21

WWYD

(me personally I'd take the old drugs)
posted by phunniemee at 6:43 PM on August 21 [2 favorites]

I'm certainly no doctor, but I'd try it. I don't think it'll poison you; I think the bad outcome would simply be that it doesn't do anything.
posted by BlahLaLa at 6:49 PM on August 21 [1 favorite]

yeah, go ahead and give it a shot. It probably won't work, but it also won't harm you.

(yes, I know the official stance is all expired medicine is bad)

FWIW I've never taken that stance. I'm still taking OTC allergy pills from a bottle with a 2022 expiration date, and they're working just fine. I can't even remember the last time we bought a new bottle of ibuprofen.
posted by pdb at 7:58 PM on August 21 [1 favorite]

I would eat it...uhm.. I would try it. I agree that the risk is that it is not effective not that you will curl up and be very sick from it.

Seriously, I would probably wash it down with a beer as the warnings always say that alcohol can intensify the affects of codeine. But, I am not you and not suggesting you do it. Just a thought.
posted by JohnnyGunn at 9:09 PM on August 21 [1 favorite]

my experience with codeine-based cough syrup is that codeine, which suppresses the cough, in liquid form rapidly loses strength after the expiration date.

This is in contrast to some other medications which retain efficacy well after expiration. Liquid codeine is not one of these.
posted by zippy at 9:23 PM on August 21 [1 favorite]

Yes, I'd take it. I'm in the camp that won't hurt, might help, and if it doesn't work, toss it.
posted by BlueHorse at 10:44 PM on August 21

Pharmacists are pretty good at answering questions like this. I’d give a call to a pharmacist at one of the drugstores you tried to get the prescription filled to ask them about your past expiration date cough syrup.
posted by sciencegeek at 2:22 AM on August 22

Can you get prescribed promethazine and codeine separately, as pills, and just take those?


Yes, I'd try it and see if it helped.
posted by Elysum at 3:26 AM on August 22

yes, I know the official stance is all expired medicine is bad

This is not what expiration dates signify. The expiration date simply means that the company has spent the money to do life or storage testing out to a certain time in the future (a couple of years, usually). Beyond that, there is no data to back up any claims that the manufacturer makes about the effectiveness of the product. It's not like the drugs expire on the 31st, and on the 1st of the next month it turns into poison.
posted by backseatpilot at 7:55 AM on August 22 [1 favorite]

The US military did studies on medicines expiring and, short version: you're fine.

The only ones not to take are old liquid antibiotics, old insulin, and old nitroglicerine, and you shouldn't be taking antibiotics that weren't recently prescribed anyway.
posted by The corpse in the library at 11:21 AM on August 22

I just googled "cough syrup without dextromethorphan" and there are alternatives like OTC Guaifenesin. If you're near a pharmacy go talk to the pharmacist about DM-free cough remedies.
posted by mareli at 3:30 PM on August 22