Efficacy of drugs is actually a super surprising reality. If you look at most drugs, they usually have an expiration of no more than a couple of years. But truly our government doesn’t want you to know, that the Efficacy of drugs is actually decades longer than the printed expiration.
Efficacy of drugs
When do drugs really expire? Which ones take decades to degrade? Why does the US government use secret expiration dates for pharmaceutical stockpiles — but make pharmacies & hospitals discard perfectly potent meds? I went down a wild rabbit hole for us.
In 2012, Dr. Lee Cantrell, a Cali pharmacist-toxicologist, found a box of drugs that had been stashed away on a shelf for decades. He wondered if any of the meds were still effective Most people stop at wonder — the scientifically-minded amongst us find a way to get an answer about the true efficacy of drugs. Dr. Cantrell hit up a UC lab for some liquid chromatography & mass spectrometry. They analyzed various meds that had expired 28 – 40 years prior. It was a very cool study.
Study synopsis
The average % of active ingredient still present compared to decades-old label:
- Acetaminophen (AKA Paramecetol) — 100% remaining
- Hydrocodone — 100%
- Caffeine — 100%
- Methaqualone — 100%
- Codeine — 95%
- Phenobarbital — 94%
- Amphetamine — 49%
- Aspirin — 1%
The implications of these findings received press coverage a few times over the years — but public discussion always quickly dissipates. What incentive does big pharma have to extend expiration dates!?
Imagine how much money pharma would lose if pharmacies, hospitals, & patients were to STOP routinely trashing & replacing large quantities of Rx & OTC meds What would it take for the pharma-funded FDA to tell pharma to take that kind of monetary hit?
But the reality is, for decades, the US federal government has been quietly studying the true shelf-life of medications They stockpile pharmaceuticals around the world for the military, as well as for “emergency preparedness” programs like the Strategic
National Stockpile
Rather than throw out stockpiled drugs on assigned expiration dates, the government tests them The Shelf Life Extension Program (SLEP) began in 1985 – a joint venture of DoD & FDA. State & local governments are not permitted to participate (despite having their own stockpiles).
When SLEP finds that a drug is still useful, they extend the expiration date for their stockpiles — but not for us consumers In fact, they have a strict policy to never share drug testing results or extension decisions. Yes, they are gatekeeping the Efficacy of drugs, in this case. Crazy!
Around 20 years back, the AMA called SLEP out. In turn, SLEP released a single lone paper revealing a bit of what they know about the true shelf-life of carefully-stored pharmaceuticals This disclosure, however, flew under the radar. Very few know of it. You are about to be in the few. SLEP divulged that they were able to extend the expiration date for 88% of 122 stockpiled drugs tested over a 20+ year period They examined & reexamined potency, pH, ability to dissolve, water content, impurities, etc Some meds tested “still good” since the program’’s inception.
Drugs which never failed testing
The tables in this SLEP paper are a bit tedious to digest, but I dug through them, to compile us some lists. In their carefully-stored government stockpiles, the following meds NEVER failed the Efficacy of drugs testing
Acetaminophen, pseudoephedrine (capsules), and Amoxicillin sodium (tablets).
Which drugs did SLEP find failed expiration testing more often than passed? There were only 10:
- Albuterol (inhalant)
- Diphenhydramine HCI (spray)
- Epinephrine
- Lidocaine HCI (solution)
- Ergotamine tartrate
- Caffeine (tablets)
- Isoproterenol HCI (solution)
Regarding epinephrine… Dr. Cantrell recently tested 40 EpiPens, 1 – 50 months past expiration All devices still contained 80%+ of their labeled concentration. About half contained 90%+ I would definitely use an expired EpiPen if I were going into anaphylaxis & it was all I had.
What about insulin & nitroglycerin? It wasn’t included in the SLEP study. Perhaps they didn’t want to waste resources testing meds already widely known to degrade But in an emergency, I would use those expired, too (& call for help!).
Quite interestingly, SLEP tested 4 drugs MUCH more often than they did any others:
- Pyridostigmine bromide (nerve agent prophylaxis)
- Atropine sulfate (nerve agent antidote)
- Pralidoxime chloride (nerve agent antidote)
- Ciprofloxacin (broad-spectrum antibiotic that is used to treat Pneumonia, the Plague, Anthrax, and Typhoid Fever)
What did SLEP find out about antidepressant stability? Well, They didn’t report examining them at all Is this omission an indirect admission from the government? Perhaps antidepressants really aren’t important for our military & public health?
You may be wondering, Say a med truly does expire & becomes less effective or ineffective — does it ever turn TOXIC? Toxicity was almost unheard of “Once upon a time”. However, I learned expired tetracycline can potentially degrade into a dangerous compound & cause kidney problems. This is one drug which expires pretty quickly after it’s expiration and should be thrown out.
Common Sense
Common sense will tell us that expired liquid meds & ointments may eventually grow bacteria &/or mold Expired biologics like immunotherapies & vaccines may also pose increased risk as molecules denature / aggregate (according to… my brain) — potential for immune rxns & etc.
Common sense will also tell us:
- Meds that need a “propellant”, like an inhaler, may fail to dispense over time
- Gelatin capsules will eventually break down
- Hard tablet pills will last the longest.
Right now, almost all pharma meds expire within 1-3 years “officially”. So what’s the deal with this seemingly arbitrary selection of inaccurate, quick expiration dates? When pharma submits a drug application to the FDA, they are required to assign an expiration date & include stability. But what about the SLEP research? Why hasn’t it led to the FDA instructing pharma to extend expiration dates? That would be too logical SLEP uses their data to extend expiration in their stockpiles only.
Extensions for “the rest of us” come from pharma’s testing data, not SLEP’s. This will generally only happen if pharma can’t keep up with demand in an ~emergency~
Examples: EpiPens in 2019 + Tamiflu per 2010 Swine Flu « COVID vaccines during the marketing of a pandemic
But most of time, pharma can easily meet demand & perpetually supply new batches and make new sales The result? Hospitals, pharmacies, & patients collectively spend billions of dollars per year replacing perfectly potent, safe, useful drugs — prescription & over-the-counter.
Drug Exports
Did you know, it’s illegal to export expired drugs — so donating them to countries in crisis isn’t permitted. The WHO even issued an instruction manual on how to dispose of drug donations, including those “near expiry date”. There have been documented instances in which the unavailability of certain antibiotics led to the prescribing of broader-spectrum ones — which, in turn, led to increased antibiotic-resistant strains appearing in hospitals & communities.
Disastrous & unnecessary
So, should the incoming FDA revisit the Efficacy of drugs and their real expiration dates? Our tax dollars have already funded decades-long research on this matter SLEP has many of the drug-stability answers we need. Pharma prefers they continue to keep those answers to themselves.
As a prepper, if you are interested in stockpiling some meds including antibiotics, we can now provide that service. For example, I just re-upped my stockpile of amoxicillin.
Let us know in the comments what you think about this policy and the Efficacy of drugs along with their expiration.
