How to correctly store medications

Medicines that have expired (past the ‘use by’ or ‘expiry’ date) can be less effective, or even unsafe to take. This is due to a change in their chemical composition or a decrease in their dosage. Other medicines, when expired, can be at risk of bacterial growth. This applies to prescription drugs, supplements and over-the-counter treatments.

Heat, direct sunlight, humidity and cold are some common factors that can have a negative impact on your treatments.

Below are some example medicines and how they are affected if stored incorrectly or have gone past their expiration date.

	Hormonal contraception Medicines like hormonal contraception can lose their effectiveness if stored at very high or low temperatures over longer periods of time. This is because heat can change the molecular structure of the medication, with components being broken down and reducing efficacy.
	Antibiotics Antibiotics, like most medicines, can become less effective if exposed to heat over a longer period of time. Ineffective antibiotic treatments could fail to treat infections, causing more serious illnesses as well as antibiotic resistance. Antibiotics, particularly in liquid form for oral administration, are vulnerable to bacterial contamination. This is due to non-sterile compounds. It is therefore important to store these exactly as instructed.
	Nitrates Hot and humid environments can cause the active ingredient in nitrates, such as Nitroglycerin, to be degraded. Patients who rely on this treatment may experience serious consequences, as they are used to treat episodes of chest pain (angina).
	Eye drops Using medicines such as eye drops that have expired can lead to irritation, inflammation and even infections. This is due to the chemical compounds changing or becoming less potent over time. Although typically containing preservatives, eye drops are also susceptible to bacterial contamination (if opened).

Always read your dispensing label and patient information leaflet about special requirements for medication storage. Medicines should always be stored out of sight and reach of children or pets. Prescription medications should only be consumed by those they have been prescribed to for everyone’s wellness and medication safety. Over-the-counter medications and herbal remedies should ideally also not be shared, this is to avoid cross-contamination and prevent bacterial growth.

Most tablets, pills and capsules should be stored at room temperature, which is usually up to 25*C. Furthermore, the storage place should not be humid or exposed to direct sunlight. Here are some do’s and don’ts for perfecting your storage of medication:

• Do find a location for safe storage. This should be somewhere out of sight and reach from children and pets
• Do store your tablets in a cool dry place, such as a kitchen cabinet or shelf (not near water or heat) or a dresser drawer in the bedroom
• If using a special storage box, you should take care to ensure it is the recommended temperature and does not get humid. A specially designed medicine cabinet could be a solution
• Do not expose your treatments to direct sunlight
• Do not store your tablets above 25*C for a prolonged period of time
• Do not store your treatments in locations such as your car, on your person or in a bathroom cabinet (steam from hot showers increase humidity)
• Do not send your medicine in your checked luggage (they can be exposed to extreme low temperatures or get lost

Typical treatments that should be stored at room temperature:

• Contraception including, the combined pill, the mini pill, NuvaRing, Evra Patch and Sayana Press
• Erectile dysfunction treatments, such as Viagra
• Antibiotics such as azithromycin in tablet form
• Medical tapes and patches, including Scopoderm and Fludroxycortide Tape
• Some refrigerated treatments can be stored like this for up to 30 days once opened and in use (such as insulin and Saxenda pens)

Typical treatments that should be stored in refrigeration:

• Insulin
• New, unopened Saxenda pens. Do not freeze
• Botox
• Vaccines
• Some treatments in tablet form, e.g. Ritanovir

All medicine should come with a patient information leaflet (PIL). This leaflet has information about your treatment and how it should be stored. Always refer to the PIL for instructions on how to store. Never freeze treatments, unless specifically stated.

Treatments, if left in less than optimal conditions, might still be effective up to a short amount of time. Typically, if medicine has gone bad due to imperfect storage, it will have some visible signs.

If your medicine has been exposed to extreme temperatures, been left in a humid environment or had direct sunlight over a prolonged period, it has likely been compromised. If you are worried about this, especially if you are treating serious medical conditions such as high blood pressure, or taking contraception, you should speak to your doctor about renewing your prescription.

It’s also advisable to only have a 3-month (rather than 6) stock of treatment at any given time. This is to minimise the length of time the medicine is stored.

The most obvious answer here is to check the expiry or use-by date of the medicine. If it has gone off, it should not be consumed. As mentioned previously, how you store the medicine can also make the medicine expire before any of these dates. The following is what you should look out for:

• The expiry date usually means that the medicine should not be taken after the end of the month printed on the pack or label.
• The use by date usually means you should only consume the medicine before the month printed on the pack or label.
• Instructions by pharmacist may differ from the expiry or use by dates but should be followed. A pharmacist may instruct you to discard the remains of a medicine after 14 days of opening.
• Change of colour to your medicines may be a product of medicine that has been stored incorrectly. If you notice a difference, you should not take your medicine.
• Different texture can mean liquids turning gel-like (thicker solutions), tablets that are softer or harder than normal, or tablets sticking together. Do not use any of these.

To summarise, if your medicine pack suggests your treatment is out of date, you should not use it. Medicine that is still in date but looks, tastes or smells different to when you first started taking it may have also gone off. Talk to your doctor or pharmacist for advice. Some medicine may still be safe to take, but its efficacy could be reduced.

It is also worth noting that not all medicine will give you a visual sign that their effects have been reduced. If you are worried that your medicine’s quality has been compromised, you should speak to a healthcare professional.

However convenient and tempting it might be to take a tablet you have lying around that has gone off rather than buying a new pack, you should consider the potential risks you could expose yourself to, and dispose of it instead.

Ideally, medicines should be disposed of at a pharmacy.

Medicine should not be flushed down the toilet or drain, as this could contaminate the water supply and end up in drinking water.

Taking left-over or expired medicine to the pharmacy might seem like a lot of work, so the United States’ Food and Drug Administration (FDA) has some alternative safe methods of disposal that you can do at home.

	1Take the unused medicines out of its original medicine bottle and packaging
	2Blend the medicine with an undesirable substance, such as coffee grounds or kitty litter
	3Add the mixture to a concealable container, such as an empty jar or a plastic bag
	4Remove or cover up your personal details on the original packaging
	5Dispose of the empty medicine container and the concealed mixture with your household rubbish

Although you should travel with your medicines in your carry-on luggage rather than checked luggage, medicine can safely be shipped short distances. Medications ordered from euroClinix will always be packed in a way so that the temperature is optimal, even during transit. Your medicine will be delivered quickly with discretion and your safety in mind.

Always read the PIL to ensure that you know how to store it once you receive it.