Medication expiration

[cbrons]

How long past the listed expiration date do most drugs in pill or capsule form last? (Not talking about antibiotics here).

At the risk of sounding stupid, Does freezing them work? Keeping them refrigerated?

May seem like odd questions, but when I have an excess of sample 30 and 15-day supplies of various drugs to give to low or no-income patients and they are approaching expiration, I wonder how to stretch their usability out if possible.

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[zelman]

How long past the listed expiration date do most drugs in pill or capsule form last? (Not talking about antibiotics here).

At the risk of sounding stupid, Does freezing them work? Keeping them refrigerated?

May seem like odd questions, but when I have an excess of sample 30 and 15-day supplies of various drugs to give to low or no-income patients and they are approaching expiration, I wonder how to stretch their usability out if possible.

Varies by drug. Usually you don't need special storage to extend the shelf life. You DO need to pay a lab to test a sample from the lot, and then you can calculate the new expiration date for that lot.

 

[sosoo]

in retail setting, lets say a drug expires in 2 months. However when u fill it for a patient, u remove the pills from original bottle, the expiration (discard after date) is extended to 1 year... the patient can take it far beyond the original 2 month expiration.

 

[bacillus1]

in retail setting, lets say a drug expires in 2 months. However when u fill it for a patient, u remove the pills from original bottle, the expiration (discard after date) is extended to 1 year... the patient can take it far beyond the original 2 month expiration.

Not true...you have to update the expiration date on the label to reflect the original bottle's expiration date if it's less than a year.

 

[zelman]

in retail setting, lets say a drug expires in 2 months. However when u fill it for a patient, u remove the pills from original bottle, the expiration (discard after date) is extended to 1 year... the patient can take it far beyond the original 2 month expiration.

Oh dear lord. You can't possibly think this is true, right?

 

[confettiflyer]

We would do +2-3 years past expiration for PO medications (less if we had ample supply) and +6 months for inhalers. This was at an impromptu homeless clinic in North Philadelphia with ziplock bags, handwritten labels, and a medical students galore.

Our formulary was pretty much "whatever we happen to have at the moment"

 

[Abby Atwood]

in retail setting, lets say a drug expires in 2 months. However when u fill it for a patient, u remove the pills from original bottle, the expiration (discard after date) is extended to 1 year... the patient can take it far beyond the original 2 month expiration.

You are required to write the expiration date on the bottle if it is less than one year from the dispense date. Having worked retail, I know that this doesn't always happen. In most settings, it would be up to technicians and interns filling medications to remember this step. Without training, it's often forgotten. Expiration date never increases when you repackage; it can only decrease.

 

[uicgrad]

Sosoo,

I can't believe you believe what you posted. What pharmacy school did you go to?

 

[Lnsean]

in retail setting, lets say a drug expires in 2 months. However when u fill it for a patient, u remove the pills from original bottle, the expiration (discard after date) is extended to 1 year... the patient can take it far beyond the original 2 month expiration.

this is crazy...simply removing a pill from a container does not all of a sudden extend its integrity and shelf life. In NJ, pills in amber vials are allowed to have a 1 year shelf life from the date on the label---these are return-to-stock where the original manufacturer bottles have already been thrown away and so the assumption is 1 year.

 

[CetiAlphaFive]

in retail setting, lets say a drug expires in 2 months. However when u fill it for a patient, u remove the pills from original bottle, the expiration (discard after date) is extended to 1 year... the patient can take it far beyond the original 2 month expiration.

Wow. No, that is not how that works.

How could you possibly even reach that conclusion?

 

[CetiAlphaFive]

How long past the listed expiration date do most drugs in pill or capsule form last? (Not talking about antibiotics here).
At the risk of sounding stupid, Does freezing them work? Keeping them refrigerated?
May seem like odd questions, but when I have an excess of sample 30 and 15-day supplies of various drugs to give to low or no-income patients and they are approaching expiration, I wonder how to stretch their usability out if possible.

Well, the majority of PO meds are degraded via oxidation or light exposure.

So, if you sealed your samples in dark containers filled with an inert gas, you'd probably extend the shelf life quite a bit.

However, you should remember that you're probably hurting your STAR rating by giving out samples. Maybe. I mean could be.

 

[Mao263]

in retail setting, lets say a drug expires in 2 months. However when u fill it for a patient, u remove the pills from original bottle, the expiration (discard after date) is extended to 1 year... the patient can take it far beyond the original 2 month expiration.

Omg.... I was wondering why every time I take medication it's exactly the year expiration

 

[Abby Atwood]

Omg.... I was wondering why every time I take medication it's exactly the year expiration

Expiration after a year is a legal requirement for repackaged drugs. As soon as the drug is placed in an amber vial, the expiration date is reduced to a maximum of one year from the date of repackaging. If your drug is a common drug like most statins, antibiotics, antihypertensives, or thyroid medications it is likely that the drug would have expired sometime in 2019 if it had been kept in its original container and it was stored properly. If the expiration date on the original container is less than a year from the date filled, the expiration date needs to be noted on the label.

The fact that your pharmacy is telling you the medication expires in a year does not necessarily mean anything nefarious is going on. They are required to say that, and I would be far more concerned if they were giving you exact dates that were more than a year away (e.g. 02/28/2019). If you have questions or concerns, ask your pharmacist how they handle expiration dates.

 

[SmallCapPharma]

in retail setting, lets say a drug expires in 2 months. However when u fill it for a patient, u remove the pills from original bottle, the expiration (discard after date) is extended to 1 year... the patient can take it far beyond the original 2 month expiration.

LMAO



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[Mao263]

Expiration after a year is a legal requirement for repackaged drugs. As soon as the drug is placed in an amber vial, the expiration date is reduced to a maximum of one year from the date of repackaging. If your drug is a common drug like most statins, antibiotics, antihypertensives, or thyroid medications it is likely that the drug would have expired sometime in 2019 if it had been kept in its original container and it was stored properly. If the expiration date on the original container is less than a year from the date filled, the expiration date needs to be noted on the label.

The fact that your pharmacy is telling you the medication expires in a year does not necessarily mean anything nefarious is going on. They are required to say that, and I would be far more concerned if they were giving you exact dates that were more than a year away (e.g. 02/28/2019). If you have questions or concerns, ask your pharmacist how they handle expiration dates.

Thank you! I just got scared thinking that I might be taking expired med

 

[zelman]

this is crazy...simply removing a pill from a container does not all of a sudden extend its integrity and shelf life. In NJ, pills in amber vials are allowed to have a 1 year shelf life from the date on the label---these are return-to-stock where the original manufacturer bottles have already been thrown away and so the assumption is 1 year.

To be more precise, it's the earlier of either one year or the actual expiration date (which should have been updated on the amber vial when the Rx was initially filled).

 

[sosoo]

for those who doesn't believe me, simply volunteer a day at cvs. fill a prescription from a bottle that will expire in 2 months. then look at the automatically printed label. (and no you cannot manually change it). the discard date / expiration date is extended to 1 year.

 

[CetiAlphaFive]

for those who doesn't believe me, simply volunteer a day at cvs. fill a prescription from a bottle that will expire in 2 months. then look at the automatically printed label. (and no you cannot manually change it). the discard date / expiration date is extended to 1 year.

Let me spell it out for you:

Yes. We understand your pharmacy system will default the expiration date to 1 year from the date of dispensing.

That's because the computer in front of you lives in cyber space. It has no way of knowing what the lot number or expiration date of the bottle in your hand is.

You, as the pharmacist, must ensure that the expiration date is changed to show the actual expiration date on the bottle if it's less than 1 year away.
CVS' system does allow for editing of the expiration date.
I've done it.


Please hear me very clearly:
If you are artificially extending expiration dates, you are breaking the law.
Every prescription you dispense where you do this is a mis-fill.

It's mind numbing that you lack the critical thinking to understand this

 

[Mao263]

for those who doesn't believe me, simply volunteer a day at cvs. fill a prescription from a bottle that will expire in 2 months. then look at the automatically printed label. (and no you cannot manually change it). the discard date / expiration date is extended to 1 year.

I am gonna call my parents to stop going to cvs.
Also I volunteere in the hospital and pharmacist do write manually expiration date

 

[Dred Pirate]

for those who doesn't believe me, simply volunteer a day at cvs. fill a prescription from a bottle that will expire in 2 months. then look at the automatically printed label. (and no you cannot manually change it). the discard date / expiration date is extended to 1 year.

second what the others said - the computer doesn't get to make up an expiration date. moving the pills doesn't automatically change science. please use critical thinking skills

 

[LoveWillSaveTheDay]

for those who doesn't believe me, simply volunteer a day at cvs. fill a prescription from a bottle that will expire in 2 months. then look at the automatically printed label. (and no you cannot manually change it). the discard date / expiration date is extended to 1 year.

Maybe no one has shown you how to correct the expiration date in the cvs system. The same thing happens at Kroger if I don't manually change it in the system. if I somehow go too fast or forget to enter in the expiration date in the system I just physically scratch out the computer generated date on the label and write the ex date. If no one shows you how, just simply write the correct date on the label.

You wouldn't drink expired milk, even if you poured it in a new glass, I hope. And no one should take an expired, man made compound....

 

[CetiAlphaFive]

You wouldn't drink expired milk, even if you poured it in a new glass, I hope. And no one should take an expired, man made compound....

Hahahahahah
[ / thread ]

 

[gwarm01]

You wouldn't drink expired milk, even if you poured it in a new glass, I hope.

Oh, you have no idea how far I'll go..

 

[sosoo]

in all the cvs i work, the techs line up the baskets, and i never seen a single pharmacist change the date for each script or handwrite the date. how can they? they only verify. they did not pull the drugs to look at the expiration on the bottle. not 1 pharmacist at Cvs looks at the bottle's expiration and change the date. if u believe otherwise, you're not working at cvs.

 

[LoveWillSaveTheDay]

in all the cvs i work, the techs line up the baskets, and i never seen a single pharmacist change the date for each script or handwrite the date. how can they? they only verify. they did not pull the drugs to look at the expiration on the bottle. not 1 pharmacist at Cvs looks at the bottle's expiration and change the date. if u believe otherwise, you're not working at cvs.

Same at Kroger. You technically have to train your techs to fix the date when they count the prescriptions since you have no way of knowing the expiration, but that's on amber vials only. If they use the stock bottles or keep the med in the original container, you should always double check their work to make sure the expiration date on the stock matches the expiration date on the label if it expires within a year. If it's not correct, then you should hand it back to the tech to fix or scratch it out yourself. If you team doesn't check the dates and just goes by the computer, then you should probably have a huddle so you all can be on one page.

I think what was wrong with what you originally said is that you made it seem like you believed that the drug itself is still good after the expiration date.

P.S. If a med isn't working because it's expired and a customer complains, the tech isn't the one who will be in trouble, it's you. So definitely check

 

[sosoo]

I think what was wrong with what you originally said is that you made it seem like you believed that the drug itself is still good after the expiration date.
P.S. If a med isn't working because it's expired and a customer complains, the tech isn't the one who will be in trouble, it's you. So definitely check

under certain conditions (in military), the drug is still good long after expiration. however in retail, if a med isn't working b/c its expired, the customer won't know the expiration. the labeling is automatic for 1 year expiration, even if the original bottle expires in 2 months. we will not be in trouble b/c the cvs labeling is automatic.

 

[Niosh]

under certain conditions (in military), the drug is still good long after expiration. however in retail, if a med isn't working b/c its expired, the customer won't know the expiration. the labeling is automatic for 1 year expiration, even if the original bottle expires in 2 months. we will not be in trouble b/c the cvs labeling is automatic.

So is this adulteration or misbranding?
On one hand, it wasn't expired at the time of dispensing, so I'd lean on misbranding. But on the other hand there will be a time when it is expired but is labelled as though it is not, so it would then be adulterated?

 

[sosoo]

i would say its mislabeling. the drug content is the same when repackaging to an amber vial, so its not adulterated.

 

[CetiAlphaFive]

in all the cvs i work, the techs line up the baskets, and i never seen a single pharmacist change the date for each script or handwrite the date. how can they? they only verify. they did not pull the drugs to look at the expiration on the bottle. not 1 pharmacist at Cvs looks at the bottle's expiration and change the date. if u believe otherwise, you're not working at cvs.

under certain conditions (in military), the drug is still good long after expiration. however in retail, if a med isn't working b/c its expired, the customer won't know the expiration. the labeling is automatic for 1 year expiration, even if the original bottle expires in 2 months. we will not be in trouble b/c the cvs labeling is automatic.

You have got to be kidding.
Where is your integrity?

Do you understand the meaning of the words "direct supervision"???
Once you walk into the pharmacy, you are responsible for everything your techs do or don't do.
They don't change the exp. date? Your fault.
They don't tell you to counsel the patient? Your fault.

I hope you do end up moving to Texas and apply to my pharmacy, so I can do this with your resume:

 

[Niosh]

i would say its mislabeling. the drug content is the same when repackaging to an amber vial, so its not adulterated.

I dunno, I think you should ask your board of pharmacy what they think.

 

[LoveWillSaveTheDay]

under certain conditions (in military), the drug is still good long after expiration. however in retail, if a med isn't working b/c its expired, the customer won't know the expiration. the labeling is automatic for 1 year expiration, even if the original bottle expires in 2 months. we will not be in trouble b/c the cvs labeling is automatic.

You most definitely will be. Do you think cvs is going to take the fault for a technical difficulty when all you (or your tech) have to do is simply scratch out the automated date with a pen and put the correct expiration date? The customer may not know better, but you do.

You have a certain level of education that neither the computer nor 95% of the people in cvs, including the store manager, has. You know it's expiring before the automatic year date, just write it on the label if your system won't let you correct it. Otherwise you or your staff are knowingly 'mislabeling' prescriptions. If you don't believe us, just ask your coworkers....

 

[CetiAlphaFive]

You most definitely will be. Do you think cvs is going to take the fault for a technical difficulty when all you (or your tech) have to do is simply scratch out the automated date with a pen and put the correct expiration date? The customer may not know better, but you do.

You have a certain level of education that neither the computer nor 95% of the people in cvs, including the store manager, has. You know it's expiring before the automatic year date, just write it on the label if your system won't let you correct it. Otherwise you or your staff are knowingly 'mislabeling' prescriptions. If you don't believe us, just ask your coworkers....

Or better yet, she should tell her Rx Supervisor and District Manager what she's been doing

 

[Dred Pirate]

in all the cvs i work, the techs line up the baskets, and i never seen a single pharmacist change the date for each script or handwrite the date. how can they? they only verify. they did not pull the drugs to look at the expiration on the bottle. not 1 pharmacist at Cvs looks at the bottle's expiration and change the date. if u believe otherwise, you're not working at cvs.

i moonlighted there and i changed them

 

[RxPreceptor]

This has been an issue at CVS for quite some time. You would think that they would build a safety net into this issue by say prompting the technician at production to manually type in the expiration date but corporate updates seem to be more focused on measuring metrics like whether the patient would like to receive text messages. There is an option to change expiration date but the problem is still that it should manually have to be typed in with credentials (I should note that this is how vaccines prompt the person at production; lot # and expiration date are manually entered with credentials; I am not sure why the IT people can not do this for all meds).

There is the same issue with data entry for hard copy scripts filling in the date of issue (pisses me off every time I count out a control substance only to have to call the patient and tell them his/her Rx is no longer valid).

Or better yet, encrypt the expiration date into the barcode info like some automation systems do.

 

[sosoo]

This has been an issue at CVS for quite some time. You would think that they would build a safety net into this issue by say prompting the technician at production to manually type in the expiration date but corporate updates seem to be more focused on measuring metrics like whether the patient would like to receive text messages. There is an option to change expiration date but the problem is still that it should manually have to be typed in with credentials (I should note that this is how vaccines prompt the person at production; lot # and expiration date are manually entered with credentials; I am not sure why the IT people can not do this for all meds).

There is the same issue with data entry for hard copy scripts filling in the date of issue (pisses me off every time I count out a control substance only to have to call the patient and tell them his/her Rx is no longer valid).

Or better yet, encrypt the expiration date into the barcode info like some automation systems do.

yea this is a widespread issue at cvs that no one really care to think about. the techs pull the original bottles, count the pills, n put it back on the shelf. the system labeling is automatic for 1 year and everyone just go with the flow. even if the bottle expires in 2 months, or 1 month, it will still be changed to 1 year.. and off the bag to the waiting bin.

 

[farmadiazepine]

Oh dear lord. You can't possibly think this is true, right?

lollll

 

[Dred Pirate]

yea this is a widespread issue at cvs that no one really care to think about. the techs pull the original bottles, count the pills, n put it back on the shelf. the system labeling is automatic for 1 year and everyone just go with the flow. even if the bottle expires in 2 months, or 1 month, it will still be changed to 1 year.. and off the bag to the waiting bin.

that is why you tell the techs to leave the bottle in the pyxis - so you as the pharmacist can verify and change it. If you know it is an issue - you are 100% liable and at fault for the error

 

[sosoo]

that is why you tell the techs to leave the bottle in the pyxis - so you as the pharmacist can verify and change it. If you know it is an issue - you are 100% liable and at fault for the error

how can i tell all the techs at all the cvs? this is happening everywhere.

 

[CetiAlphaFive]

how can i tell all the techs at all the cvs? this is happening everywhere.

That's a contradiction.

You've stated three mutually exclusive things in this thread:
1.) The pharmacist never sees the bottle.
2.) The pharmacist sees it but there's no way to change it.
3.) It's a company wide problem that no one can fix.
EDIT: 4.) you originally stated that changing bottle extends the expiry date.


I used to do it all the time at my CVS.

Back when I was an RPh there, it was under "Additional info" in the production screen.
Not hard.

 

[Mao263]

that is why you tell the techs to leave the bottle in the pyxis - so you as the pharmacist can verify and change it. If you know it is an issue - you are 100% liable and at fault for the error

One day when I started volunteering in the hospital pharmacy, I prepared 1 pill antibiotic from the bottle (usually they are prepacked, but not that day). Pharmacist yelled at me that I didn't put original bottle to show him.

 

[Dred Pirate]

how can i tell all the techs at all the cvs? this is happening everywhere.

simple - you are the pharmacist - you are in charge at the store you are working in. From your posts (no disrespect intended) but you do not seem to be the most assertive person. When you show up for your shift (are you a floater or do you have your own store?) - you state you want to see the bottles in the basket - explain to them why (you need to verify expiration dates). When the baskets get to you and you don't have the stock bottle, you send it back and ask nicely. (it will happen). After multiple times you need to be assertive and repeat why. They will probably roll their eyes at you, but explain, it is against the law to not have the correct expiration dates on the bottle.

If you consistently have problems, you follow company policy and write them up.

I can gauntness that if you call your state board of pharmacy and they find deficiencies - it will be your license they go after, not CVS not the techs.

 

[wagrxm2000]

Just read this thread and wow why is this an issue at cvs? There's a place to change the date at Walgreens. Its not that hard.

 

[owlegrad]

Just read this thread and wow why is this an issue at cvs? There's a place to change the date at Walgreens. Its not that hard.

There is at CVS as well. Do you think most techs do or that most pharmacists check/care?

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[SmallCapPharma]

You press E for Edit and there is a field that says "drug expiration date". You change that then it goes in QP then print it. Takes an extra 5 sec and YOU need to train your techs.


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[moose10]

In most pharmacies, as staff do inventory/expiration checks they should mark or sticker all short-dated medication stock bottles. Train techs to leave any stock bottles with a mark or sticker in the bin along with the counted vial, then verification RPh changes the date if needed. Easy peezy. I do see sosoo's point in that many, many pharmacies the verification RPh does NOT see the stock bottle used to count the prescription out, and from what I've seen that depends on the pharmacists comfort level with technicians and the volume of the store. Too much volume=not enough time to check a detail like that. Of course, the best practice is to check stock bottles.

Also, tightly controlling inventory should go a long way in making sure most medications do not sit on the shelf long enough to even come close to expiration date.

Back to OP, sometimes manufacturers have extended stability data they might be willing to share if you contact them. Or you could go to package insert or original stability studies if they were published anywhere. If you share what medications you have samples of maybe we could find an intern to do some extra research 😛

 

[wagrxm2000]

There is at CVS as well. Do you think most techs do or that most pharmacists check/care?

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You may not but I do.

 

[owlegrad]

You may not but I do.

I didn't ask you if you did it and I wasn't inviting any of your comments on how I practice. It doesn't apply to me as I work in long-term care and we put everything into bubble packs with expiration dates. The expiration dates are checked as part of the rph process so I know we're not sending out any expired meds. It's not in any way comparable to how pills are packaged in retail.

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[CetiAlphaFive]

I didn't ask you if you did it and I wasn't inviting any of your comments on how I practice. It doesn't apply to me as I work in long-term care and we put everything into bubble packs with expiration dates. The expiration dates are checked as part of the rph process so I know we're not sending out any expired meds. It's not in any way comparable to how pills are packaged in retail.
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Allow me to provide a little insight on how it should be done correctly.

Retail is a lot like Back of house restaurant work.
You need to do your prep before dinner rush hits.

Someone should be checking dates on a regular basis. We do it once a month.
Stuff that has an expiry date of less than a year gets a big 1 through 12 written on its face, preferably in red sharpie, so that anyone touching it is alerted to the fact that it's expiring soon. Some places put colorful stickers on the faces of bottles, but I think these are less reliable.
Oldest bottles should always be facing the front.

It's easy to see which techs are the doofuses when you're floating. Put them at Drive thru the whole day and make your life easier.

See a tech doing something they shouldn't? Chew them out. Easy Lemon Squeezy.

 

[owlegrad]

Allow me to provide a little insight on how it should be done correctly.

Retail is a lot like Back of house restaurant work.
You need to do your prep before dinner rush hits.

Someone should be checking dates on a regular basis. We do it once a month.
Stuff that has an expiry date of less than a year gets a big 1 through 12 written on its face, preferably in red sharpie, so that anyone touching it is alerted to the fact that it's expiring soon. Some places put colorful stickers on the faces of bottles, but I think these are less reliable.
Oldest bottles should always be facing the front.

It's easy to see which techs are the doofuses when you're floating. Put them at Drive thru the whole day and make your life easier.

See a tech doing something they shouldn't? Chew them out. Easy Lemon Squeezy.

One of the few smart things I ever heard a DM-type person say was, "You should be working twice as hard when no one is at the counter". His point being that there is actually more work to do when there are no customers around. A tough message to get across to techs (and pharmacists) but very true. There is so much much that can be done to prepare for the rush vs just waiting for it to come and then complaining...

 

[sosoo]

again volunteer a day at a busy cvs and see if anyone is doing it. from my observation its not being done at any cvs i've come across. whatever date is automatically printed is bagged up and sold. i've yet to see one person looking at the expiration on the original bottle and edit and re-print the label. if the bottle expires in 2 months and the script is for 90 days, not a problem. the customer will only know the date that's automatically printed. that's just the way it is. one day a customer brought in the original bottle for Viread. and because it comes in original packaging, they were able to point out the expiration date on it that expires in 2 months. they got frantic and wanted a refund. thats a common story happening at cvs. if u actually work for this company and don't believe it, then you're either in denial or clueless.