Websites for drugs?

[bva]

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Hi,

Could anyone please suggest the websites or journals to answer this question:
How many days that we can use the drug, after we open the seal?

Thanks so much.

 

[patmcd]

What drug?

 

[bva]

What drug?

All the lists of drugs. Any website?

 

[twester]

Drugs expire based on their expiration dates which is based on the lot number (when it was produced). It doesn't really matter whether the seal is broken or not. The shelf-life of all drugs is limited. Chemical compounds degrade at different rates. I don't think there's any database that will answer your question.

Can we know why you're asking this question?

 

[sdn1977]

Well....there is no one particular website. But - there are some "rules of thumb"....

For injectables without preservatives - lidocaine, injectable kcl, most any other injectable without preservative - no more than 24 hours & in some instances - only one shift of use.

For sublingual nitroglycerin - there is no "seal" - btw...on purpose! But..most folks will say 30-60 days after the bottle top has been opened. Some say the ntg should "sting" - but that has been shown not to be true.

For insulin...the vial should be discarded after 30 days of the top of being entered - not the top of the vial being removed.

For bulk bottles of medications - say a bottle of 1000 metformin....you can keep that until the expiration date printed on the bottle - UNLESS you have pre-packaged that into unit dose containers. In that circumstance...individual laws (or rules of use) prevail.

Now......are there exceptions to this??? Absolutely!

Again - what specific drug/compound are you interested in & what is the circumstance???

Pharmacy is nothing if not exceptions!😀

 

[bva]

I'm doing my internship at the hospital. At the hospital, after we open the seal, some drugs we use for 7 days, some drugs we use within 24 hours, and some drugs we use for 1 month.

I've been searching for a while for a journal or website to confirm this practice, but so far still cannot find any particular website. I thought that there is a specific database to answer the question. I'm interested in doing evidence-based practice, so I need the academic resources to confirm.

Thanks so much!!!

 

[DrugDealer]

On a similar note, are there any other drugs, besides tetracycline, that become harmful (instead of just sub-potent) past their expiration date?

 

[sdn1977]

Ok....I think what you're asking about is called the standard of practice for beyond use dating. This will vary & is a fluid subject, so what you read now will change from where I work to perhaps where someone else works. Why??? Because its based on - our standard of practice.

For example, in my institution, we rarely if ever will use a multidose vial outside the hospital (insulin comes to mind as one of the few). However, we don't allow insulin to be used between patients - it can only be used for one single patient & for only 30 days (the pt should be long gone by then) because we have so many pts who use insulin.

So...the obvious thought would be good - use it up- right? Well, no actually.....the greatest risk is having someone introduce something into the vial or having the top of the vial no longer reseal after more than 20-30 sticks. That risk is far, far greater than the expense of the vial.

But....a 20 bed hospital in a small rural town who rarely gets a pt requiring insulin - their standard of practice may be different.

Ok - heres a few references:

http://www.medscape.com/viewarticle/406903_2

American Journal of Health-System Pharmacy - Fulltext: Volume 57(2 ...
JCAHO requires an expiration date to be included on the label of the medication ... with applicable pharmacy laws and regulations and standards of practice. ...
pt.wkhealth.com/pt/re/ajhp/ fulltext.00043627-200001150-00019.htm - Similar pages

http://www.nhianet.org/education/onlineCourses/

http://72.14.253.104/search?q=cache:TqCvk6qAugAJ:www.ascp.com/resources/clinical/upload/ASCP

http://72.14.253.104/search?q=cache:qc2cPzOu1EQJ:www.ascp.com/resources/policy/upload/Gui98

Theres lots & lots more references for beyond use dating. Let me know if this doesn't help.

 

[npage148]

On a similar note, are there any other drugs, besides tetracycline, that become harmful (instead of just sub-potent) past their expiration date?

Aspirin gets pretty nasty when degraded

 

[DrugDealer]

Aspirin gets pretty nasty when degraded

True, it gets vinegary, but I thought you could stick take it. I thought it still worked as a pain releiver, but just lost its cardioprotective effects.

 

[bva]

Ok....I think what you're asking about is called the standard of practice for beyond use dating. This will vary & is a fluid subject, so what you read now will change from where I work to perhaps where someone else works. Why??? Because its based on - our standard of practice.

For example, in my institution, we rarely if ever will use a multidose vial outside the hospital (insulin comes to mind as one of the few). However, we don't allow insulin to be used between patients - it can only be used for one single patient & for only 30 days (the pt should be long gone by then) because we have so many pts who use insulin.

So...the obvious thought would be good - use it up- right? Well, no actually.....the greatest risk is having someone introduce something into the vial or having the top of the vial no longer reseal after more than 20-30 sticks. That risk is far, far greater than the expense of the vial.

But....a 20 bed hospital in a small rural town who rarely gets a pt requiring insulin - their standard of practice may be different.

Ok - heres a few references:

http://www.medscape.com/viewarticle/406903_2

American Journal of Health-System Pharmacy - Fulltext: Volume 57(2 ...
JCAHO requires an expiration date to be included on the label of the medication ... with applicable pharmacy laws and regulations and standards of practice. ...
pt.wkhealth.com/pt/re/ajhp/ fulltext.00043627-200001150-00019.htm - Similar pages

http://www.nhianet.org/education/onlineCourses/

http://72.14.253.104/search?q=cache:TqCvk6qAugAJ:www.ascp.com/resources/clinical/upload/ASCP

http://72.14.253.104/search?q=cache:qc2cPzOu1EQJ:www.ascp.com/resources/policy/upload/Gui98

Theres lots & lots more references for beyond use dating. Let me know if this doesn't help.

THANK YOU SO MUCH!!!!! Million Thanks.

 

[bva]

Another question please...
What is the different between 28 days and 1 month?

Regarding Insulin

I found this website that says "Opened vials, whether or not refrigerated, must be used within 28 days. They must be discarded if not used within 28 days." http://care.diabetesjournals.org/cgi/content/full/26/9/2665

Why can't we use insulin for 30 days?

 

[sdn1977]

Another question please...
What is the different between 28 days and 1 month?

Regarding Insulin

I found this website that says "Opened vials, whether or not refrigerated, must be used within 28 days. They must be discarded if not used within 28 days." http://care.diabetesjournals.org/cgi/content/full/26/9/2665

Why can't we use insulin for 30 days?

You can use insulin for 30, 31, 32 days. But...its easier for some to think of 28 days since it easy to count 4 weeks from Thursday, for example. (Think of bcps - it easier to remember to start every Sunday or take your Fosamax every Wednesday or inject your Enbrel every Friday, etc.....likewise - it easy to remember to open a new insulin vial on the first day of every month - could stretch to 31 days without issue. Somewhat like changing the battery in your smoke alarm every time your clock gets reset on & off daylight saving time - ease of use only).

There is no difference pharmacologically, stability or lability-wise between 28 & 30 days.

 

[bva]

Thank you so much, SDN1977. Million Thanks!!!