March is a month when spring cleaning often comes to mind. Traditionally, this is time to make our homes spic and span, organize our garages (or wardrobes) and prepare for a new season. Of course, it would be nice if we had some weather to at least signal the coming of a warmer season... but I digress. As we spring forward this weekend, we may also wish to zone in on spring cleaning in one commonly overlooked area -- our medicine cabinets.
What's in your medicine cabinet? You may already be thinking about some over-the-counter pain relievers, unused prescriptions or that daily multivitamin that was never really used daily -- items that may have long expired.
I often receive questions from patients wondering about what to do with expired products. There are some key tips to keep in mind.
First, the expiry date for a prescription medication is the time until which we are assured the product maintains its potency, purity and absorbability.
Of course, this is assuming it was stored as per the manufacturer's directions. So we should not only be considering what is in the medicine cabinet, but also where it is located. I recommend avoiding areas with high moisture or temperature fluctuations. A surprise to many, this actually means not in bathroom cabinets.
Anyone who's seen the Seinfeld episode on a guest snooping in the medicine cabinet, only to find a fungus cream, now has two reasons to change its location. The ideal storage site should have a cool, consistent temperature away from direct sunlight. And of course away from curious children and the prying eyes of others.
After the expiry date we cannot be certain the medication is safe to use. Each active ingredient has a unique shelf life. As time progresses, some ingredients degrade and may become inactive. Depending on the type of medication, this inconsistent dosing may have serious therapeutic consequences. For example, your blood pressure might not be controlled. We must also be aware of another potential outcome: The product can even become toxic, resulting in unanticipated side-effects from the breakdown metabolites of the expired drug.
So before you decide to pop that expired prescription pill, you might want to give your pharmacist a call. After all, March is Pharmacist Awareness Month. An excellent resource for health information and a medication expert, a pharmacist can even help you do a bit more spring cleaning by way of a med review.
This is a good time to consider whether your medications, both prescription and over-the-counter, are optimally balanced for you. A pharmacist can conduct a personalized review with you to ensure there are no interactions, that you have the best medications and doses for your personal health needs and that there are no other issues to consider, such as drug-induced nutrient depletions.
In my practice, I do quite in-depth health reviews in addition to medication reviews, and we are often able to identify therapeutic issues that have been overlooked, and in many cases, reduce unneeded prescriptions, saving money and stress.
If you end up needing to discard any expired products, your pharmacy can assist you with that as well, free of charge, through the Manitoba Medications Return Program (MMRP). There are many participating pharmacies that accept your used and expired products so they can be disposed of safely and confidentially.
So this weekend, if you spring forward into some spring cleaning, remember your pharmacist is a great resource. Now that you've learned about the Manitoba Medications Return Program, you'll never want to think about flushing a medication unsafely down the toilet again. For the many Winnipeggers now dealing with frozen pipes, though, it is sad to think you couldn't, even if you wanted to.
Tara Maltman-Just is the executive clinician and licensed pharmacist at Vitality Integrative Medicine in Winnipeg.