A fresh start to the new year should include a clean sweep of your medicine cabinet, says Stevie Veach, a clinical professor in the University of Iowa College of Pharmacy. Expiration dates on your prescription and over-the-counter medications indicate how long a drug will remain stable and active, and properly storing or disposing of expired or unused drugs can prevent abuse and misuse.

Veach offers her expertise on what to watch for when clearing out your medicine cabinet, explains the potential risks of outdated medications, and provides suggestions for safely disposing of medication that has overstayed its welcome.

Why is it important to remove old prescriptions from your home?

Disposing of unused medications in your home can prevent accidental exposure or overdose to a medication by an adult, child, or pet. Data from those who have intentionally diverted medications for misuse or abuse shows that some gain access to these medications through the homes of their friends and family. Finally, keeping unused medications in your home can lead to a chance that the medication could be taken improperly and result in a dosing error, duplication of medication, or even drug interaction with something else taken by the individual.

How much attention should be paid to a medication’s expiration date?

The expiration date on a medication is the latest date by which the product can be legally sold by a retailer (for over-the-counter medications) or dispensed from a pharmacy (for prescription medicines). The expiration date is determined by manufacturers through stability testing and provides confidence that the drug will remain stable and active until that date as long as it is stored properly. Some drugs may remain active and stable for weeks, months, or even years beyond this printed expiration date, but that time frame can be difficult to determine without further testing.

A primary reason for expiration dates on drugs is that the potency of the drug may be diminished over time. Lifesaving medications, such as nitroglycerin for heart attacks or epinephrine for severe allergic reactions, should always be replaced once their expiration date has been reached. Insulins or inhalers for lung diseases may also fall into this category. Taking an old medication that has lost its potency may delay proper treatment of disease or infections and lead to worse outcomes.

How is a medication’s shelf-life affected by how and where drugs are stored?

Some medications can grow bacteria once they have been initially opened; therefore, the expiration date may be different than what is stamped on the bottle—this may include eye drops or vials of injectable medications. Storage temperatures can also affect the stability and expiration date of a medication. Some refrigerated medications, such as insulins or other injectables, are only viable for a shortened period once they reach room temperature. Temperature extremes, such as freezing or high temperatures, can change the stability of a medication as well.

When should we dispose of old prescriptions?

Any prescription medication that is no longer being used should be properly disposed of. Unused medications in your home may lead to accidental exposure or overdoses by children or pets. Additionally, unused prescription medications open the risk of diversion and illegal selling or consumption, especially in the case of pain, anxiety, or sleep-related medications. When in doubt, check with your pharmacist about when and how to properly dispose of unused or expired medications.

How do I properly dispose of old prescriptions?

Many pharmacies will take back unused prescription and over-the-counter medications, but you may have to ask at the pharmacy counter, and they may not be able to accept controlled substances. Some pharmacies also have a medication disposal box, which may look like a large mail drop box in their lobby or public area. Some police departments may also have receptacles for drug disposal. You can check the Drug Enforcement Administration’s (DEA’s) website for a list of places to dispose of unused controlled substances by searching for your city and state.

Twice annually in April and October, the DEA partners with local law enforcement to hold Drug Take Back Day. Look for announcements about these dates in your community.

Can I dispose of outdated medications at home?

Medication disposal packets or systems, such as Deterra or DisposeRx, offer an in-home medication disposal option. These products make the medication no longer viable for someone to use. Once the medication has been deactivated with the disposal packet/system, they can be safely disposed of in the regular trash. These packets or disposal systems can be purchased over the counter. Some pharmacies may be able to supply these packets for free to residents of the state of Iowa through a grant from the Iowa Board of Pharmacy and Iowa Department of Public Health.

If the above options are not available to you, the Food and Drug Administration recommends that medications can be disposed of in the household trash by first mixing the medication with an “unpalatable substance” such as dirt, kitty litter, or used coffee grounds and then sealing the mixture in a plastic bag or container and disposing of it in your trash receptacle. Because of the risk of drug diversion is high for some types of medications, the FDA has created a list of medications that can be flushed down the toilet to prevent misuse, but this list is limited to only about a dozen of medication types.