Is the cracking of the pill's syrup spoiled?
Can the granules be edible
if they become
damp and agglomerate?
Do not use the medicine if these eight conditions occur
"Doctor, can my medicine be used after 2 hours in the trunk?"
"Pharmacist, I forgot to store my medicine in the refrigerator. Is it still effective?"
"Doctor, the surface of my pill has become damp and sticky. Is it broken?"
...
We will always receive similar consultation calls from time to time.
Indeed, improper storage of medicines may result in reduced efficacy or even increased adverse reactions. Today, pharmacists will explain how to simply identify spoiled medicines, store medicines reasonably, and how to deal with expired medicines.
In these eight cases, the medicine cannot be used before it expires
What kind of medicine can no longer be used?
First of all, we have to make it clear that expired drugs cannot be used regardless of their appearance.
The validity period of a drug refers to the period during which a drug can maintain acceptable quality under specified storage conditions.
If the expiration date is exceeded, the active ingredients in the medicine may be degraded or decomposed to produce other impurities, which may cause the medicine to fail to achieve the target efficacy or produce adverse reactions.
So, must the medicines within the expiry date be fine?
Don't be careless, you cannot continue to use it if the following appearance changes occur.
Because, if the medicine is not stored in accordance with the prescribed conditions, it may be affected by temperature, light, air (oxygen), humidity and moisture, etc., which may cause physical or chemical changes visible to the naked eye, such as deliquescent, desiccation, or solution clarity.
The surface of the normal tablet is dry and bright. If the surface of the tablet has mottling, discoloration, cracking, adhesion, or special smell on the surface of the tablet, it means that the drug has deteriorated and can no longer be used.
The normal capsule shell of the capsule is hard and smooth. If the shell becomes soft, deformed, sticky, or the powder leaks out, it means that the medicine can no longer be used.
The granules of normal granules are loose and dry, and are easy to roll. If they become damp and agglomerate or stick together, it means that they have deteriorated.
Syrups, mixtures, and tinctures are usually clear and transparent. If there is a small amount of precipitation, it can be mixed after shaking; if there is a large amount of precipitation, lumps or rancidity, bad smell, mildew, swelling Abnormal phenomena such as bags indicate that the medicine has deteriorated.
Powder injection Normal powder injection powder is fine and loose after shaking, and clear and transparent after dissolution; if it is not shaken, it becomes turbid and contains foreign matter after dissolution, indicating that the medicine has deteriorated.
Normal water injection should be a clear and transparent liquid. If the liquid changes color, becomes turbid, or precipitates, crystals, flocculates, or even the color of the same batch number is inconsistent, it indicates that the drug has deteriorated.
Ointment, suppository If the ointment or suppository appears moldy, smelly, water-oil layering, or crystals or particles appear, it means that it has deteriorated; but if the suppository has softened, don't worry too much, and you can continue to use it after refrigerating.
Eye drops and ear drops are usually recommended to be used up as soon as possible within one month after opening. If there are crystallization, turbidity, flocculation, discoloration, etc., they cannot be used.
These four factors
Let medicines go bad quietly
Can medicines with normal appearance be used normally?
Most drugs will show abnormalities visible to the naked eye after deterioration, but it does not mean that the drugs can be used normally within the expiration date when the appearance is normal.
In one case, the drug insert clearly stipulates the length of time that the drug can be stored under certain conditions, and it cannot be used even if it does not change the appearance of the time under the limited storage conditions.
For example, the Chinese Pharmacopoeia clearly stipulates the use period of the three dosage forms of ophthalmic preparations, ear preparations, and nasal preparations, that is, they can be used for up to 4 weeks after activation. The specification shall prevail.
Another situation is that if the medicines within the validity period are not stored in accordance with the conditions stipulated in the instructions, it is difficult to guarantee the quality of the medicines even within the validity period.
Because improper storage conditions can cause chemical reactions such as hydrolysis, oxidation, and photodegradation of the drug, the active ingredients degrade or produce invisible impurities, reduce the efficacy of the drug and even cause adverse reactions. The common influencing factors and mechanisms are as follows:
Too high temperature will accelerate the rate of deterioration of medicines, leading to direct failure and deterioration of certain medicines; if the temperature is too low, liquid preparations will appear crystals or delamination, and injections such as water injections will also be damaged by freezing.
Common refrigerated medicines include biological products, blood products and antibiotics.
Air (oxygen) After the medicine is removed from the package, it will slowly oxidize under the action of oxygen in the air, which not only reduces the efficacy, but may also cause discoloration or precipitation.
Humidity and high humidity can easily lead to damp hydrolysis of medicines and accelerate the degradation of medicines.
Drugs that are prone to hydrolysis include digoxin, clindamycin, azathioprine and cisplatin.
Light can stimulate the oxidation reaction and accelerate the photodecomposition of the drug.
Certain drugs are photosensitized, such as sodium nitroprusside, hydrocortisone, vitamin A, etc., need to be stored in the dark; some drugs can produce phototoxicity after photodegradation, such as furosemide, acetazolamide, etc.
Learn
This is the right answer for medicine storage
Going back to the question at the beginning, when we encounter similar problems at the beginning of our daily life, how to solve them?
Firstly determine whether the drug is within the validity period, and then compare it with the "property" in the drug insert through the eyes and nose to determine whether the drug is abnormal, if there is an abnormality, you cannot continue to use it; if you cannot judge, you should read the drug carefully In the “storage” column of the instructions, once the storage conditions are not met or the expiration date is exceeded, it is recommended to stop using it even if there is no visible change.
In order to avoid the above situation, you should read the instructions carefully after purchasing the medicine and store the medicine in accordance with the "storage" conditions.
Common drug storage conditions and requirements are as follows:
Room temperature: 10 to 30°C
Shady place: <20℃< p="">
Cool and dark place: avoid light and temperature <20℃< p="">
Cold place: 2℃ to 10℃
Avoid light: avoid direct sunlight
So, how to deal with expired medicines?
If the medicine is found to have exceeded the expiration date or the appearance of the medicine has changed at home, it cannot continue to be used or discarded at will.
Because the active ingredients in some medicines decompose or are contaminated by bacteria, harmful ingredients may be produced; some anti-cancer drugs are inherently toxic, and if they are discarded randomly, they may pollute the environment and cause harm to other people.
Therefore, if there are expired drugs at home, they can be dealt with in the following three ways:
Expired drug collection box If the community or nearby hospital is equipped with an expired drug collection box, the expired drugs at home can be sorted out and handed over to the community or hospital for unified collection and disposal.
Hazardous trash cans Currently, some areas have implemented garbage classification, and expired medicines can be put into hazardous trash cans.
If you do not find a drug collection point, you can do it yourself at home.
Ordinary tablets need to be fully soaked with water. Capsules need to be opened to dissolve the content particles, and then pour them into the toilet to flush away; for sprays, avoid contact with open flames, and completely empty the content before discarding the bottles; antibiotics, antitumor drugs, and certain drugs. Some special medicines should be consulted with doctors and pharmacists, and try to avoid handling them by yourself.
Text/Li Qianqian (Beijing Chest Hospital)
Pharmacist Tips
Expired drugs should not be used and be recycled regularly;
When using the medicine again after opening the package, pay attention to whether there is any deterioration and the expiration date;
Read the instructions carefully and store in strict accordance with the storage conditions;
Household medicine cabinets should be placed in a cool and ventilated place.