Which medications become toxic after expiration?

Key takeaways

• Taking medication past its expiration date can be dangerous because the drug’s composition may change, potentially leading to bacterial growth or reduced effectiveness.
• Certain expired medications, such as some antibiotics, insulin, eye drops, epinephrine, and heart medications, carry specific risks, including kidney damage, reduced blood sugar regulation, eye infections, and ineffective treatment of allergic reactions or chest pain.
• If you’ve taken expired medication, monitor for any adverse reactions and consult a healthcare professional or poison control center for guidance.

Overview

The expiration date of a medication is the date at which the drug starts to break down or lose its full effect. 

Although some people say that most medications are safe to use after expiration, the Food and Drug Administration (FDA) recommends not taking medications past their expiration date. 

This is because certain medications can become toxic after expiration, making them harmful if you consume them.

Need a diagnosis or prescription quickly? Optum Perks offers personalized on-demand care in as little as 15 minutes. For $29, answer a few questions online and receive a diagnosis and treatment plan from a US-licensed healthcare professional. Get started here.

Why do some medications become toxic after expiration?

It can be dangerous to take certain medications after their expiration date. This is because some drugs can break down after a certain time, meaning they won’t have their original composition.

When a drug degrades, it might become more vulnerable to the growth of toxic substances like bacteria. Those bacteria can cause illness and infection if you take the expired medication. 

Expiration dating of medications is a law that was introduced by the FDA. Every medication distributed in the United States must have an expiration date listed. This is to ensure that every medication sold meets set standards for purity, strength, and quality.

A medication expiration date containing a month and a year shows that you should not take it after the end of the month given on the date. If a specific date is mentioned, which includes the day and month (for example, October 17, 2025), you should not take the medication after this date.

Other medications are not safe to take after they expire because of their decreased effect or breakdown, not necessarily because they become toxic.

Though taking these drugs may not cause you direct harm, their effect will be diminished, meaning they can’t effectively treat the condition you’re taking them for. This is particularly important when it comes to medications for conditions like heart disease and diabetes. 

What medications may become toxic after their expiration date? 

Several medications have been found to be unsafe when taken after their expiration date. They include:

Some antibiotics

Some antibiotics are unsafe to take after expiration because they lose their strength (potency), and taking them can lead to antibiotic resistance.

It can be harmful to take certain antibiotics like tetracycline (Doxycycline) after their expiration date. Research from 2019 found that taking tetracycline past its expiration date led to kidney damage in some people. 

Insulin

When insulin breaks down, its structure changes. This results in a lower effectiveness in reducing blood sugar.

For people with diabetes, taking expired insulin is dangerous because it can’t lower sugar levels as effectively as it should. This could also lead to serious and life threatening complications like diabetic ketoacidosis.

A 2023 case study describes someone who developed acute erythrodermic psoriasis (in which a rash develops all over the body) after taking insulin glargine (Lantus) 3 months past its expiration date. That said, more research is needed on the link between taking expired insulin and developing a serious rash. 

Eye drops

Eye drops can become contaminated after their expiration date. This means that they’re no longer sterile and can develop germs and bacteria. This can lead to eye infections and other conditions.

A 2022 case study found that expired eye drops may result in toxic epithelial keratopathy, an eye disease that can cause corneal pain and reduced vision.

Epinephrine

Epinephrine (EpiPen) is a lifesaving medication used to treat severe allergic reactions. After its expiration date, the EpiPen may not be as effective in treating urgent allergic reactions. This can be dangerous if you have an allergic reaction.  

Heart medication 

Nitroglycerin (Nitrostat) is a medication used to treat chest pain (angina). Angina happens when part of the heart doesn’t get enough blood.

According to a 2018 study, nitroglycerin is not a stable medication, meaning it will break down over time. This will cause its effectiveness to reduce significantly. Its effectiveness depends on several factors, such as temperature, storage, and carrying practices.

Taking expired nitroglycerin isn’t safe because it may not work to address chest pain and, in urgent cases, can fail to stop a heart attack. 

Other medications

Other medications and supplements you should not take after their expiration date include:

• birth control pills
• vitamins
• supplements
• herbal remedies

If you need help covering the cost of medications, the free Optum Perks Discount Card could help you save up to 80% on prescription drugs. Plus, you can now get them delivered to your home in as little as 3 days. Search for your medication here.

Online care for medication refills

It can be dangerous to take medications past their expiration date. If your medications have expired, getting refills of a new prescription quickly is important so your treatment plan isn’t disrupted.

Online care services, including Optum Perks Online Care, may make getting treatment easier. With these services, you can submit an online form answering a few questions about your symptoms, and a US-licensed healthcare professional will respond soon after to prescribe a treatment plan.

What are the risks of taking expired medication?

Both the FDA and the Centers for Disease Control and Prevention (CDC) warn against taking expired medication and recommend the safe disposal of medication that’s past its expiration date. 

If you take an expired medication, you may have a risk of:

• getting an infection or illness from bacteria that grew in the expired medication
• developing a resistance to antibiotics
• worsening the condition that the medication is intended to treat
• developing a serious health condition, such as kidney damage

What should you do if you have taken expired medication?

The best practice is to look at the expiration date of medications when you buy them and before you take them. Also, avoid taking the label off your medications or placing them in another container.

Keep in mind that it’s important to store your medications in a cool and dry place to ensure their full effectiveness. For safety, it’s also important to keep them away from children. 

If you realize that you’ve taken expired medication, you can follow these steps:

• If you experience nausea, vomiting, difficulty breathing, rashes, and convulsions, call 911 or go to your nearest emergency care center.
• A lot of medications won’t cause you harm if you’ve taken them after their expiration date. But it’s worth being cautious and contacting a healthcare professional if you’ve taken an expired drug. 
• Visit the poison control center’s online guidance tool or call 800-222-1222.

Summary

The general recommendation is to not take medications that have expired. Some medications can become toxic after their expiration date, due to contamination from bacteria or from a chemical breakdown. This can lead to harmful effects, such as:

• illness
• worsened symptoms
• serious health conditions like kidney damage

If you’ve realized you’ve taken an expired medication, seek medical help immediately.

Download the free Optum Perks Discount Card to save up to 80% on many prescription medications. Plus, you can now get them delivered to your home in as little as 3 days. Search for your medication here.