Over-the-Counter Drugs: Expiration Dates, Safe Storage and Proper Disposal

Last year's cold remedies, allergy sprays and crusted-over bottles of calamine lotion – it's easy for over-the-counter drugs to pile up past their expiration date. But when containers look funky and products spill out of your medicine cabinet, it's time to toss them. Here's how to safely and effectively store your OTC drugs – and when (and how) to get rid of them.

For starters, over-the-counter drugs don't belong on the counter – that is, not on your kitchen counter. It's just too easy for kids – or pets – to reach medications, vitamins and supplements kept there for convenience. If you must keep medications in the kitchen, store them in a higher, less-visible location, like the cabinet over your fridge, advises Colleen Creighton, director of the CHPA Educational Foundation, part of the Consumer Healthcare Products Association.

"With children it's out of sight as well as out of reach so they can't be enticed by medicines," Creighton says. Toddlers can be determined, creative climbers, she notes, using laundry baskets as stools, or pulling out kitchen shelves, stepping into them and making their way upward onto counters.

Kids overdose on OTC medication types "across the board," Creighton says. Some products, however, are particularly concerning for the CHPA, a nonprofit that educates consumers on the safe and proper use of OTC meds and dietary supplements. One is acetaminophen – the active ingredient in Tylenol that's also contained in other medications – because it can cause permanent liver damage in children who ingest too much.

Accidental drug overdose is an ongoing U.S. public health issue tracked by the Centers for Disease Control and Prevention. "About 10 years ago, the CDC noticed an uptick in the number of children going to the emergency room," Creighton says. "They noticed that children were getting into their grandparents' medication and into their parents' medication. Or in some cases it was an older sibling."

Safe medication storage doesn't stop at home. Say you use a small case to hold your medicines while traveling. "Maybe you zip it up and you forget – you're busy," Creighton says. "You check [into] the hotel and start to unpack the medications in your suitcase. Your toddler is wandering around and can easily get into it." Have a locked container available for travel and store it well out of reach.

The knowyourotcs.org website offers more advice on OTC medication storage and drug safety. Tips include locking medicine cabinets as an extra precaution, keeping medications in their original child-resistant containers, relocking safety caps on medicine bottles after each use, never keeping medicines in purses or coat pockets and advising houseguests – like grandparents – to avoid that as well.

Keeping OTC products past their prime also means medications might be less effective when sick kids need them most, Creighton says. "We ask consumers that at least once a year, preferably twice a year, close to flu or allergy season, know what's in your medicine cabinet and on your shelves and make sure nothing's expired," she says.

Ideally, OTC medications should be kept in a cool, dry location away from direct light. A brightly lit bathroom where family members take steaming showers doesn't pass muster, says Norman Tomaka, the media liaison for the American Pharmacists Association and a clinical consultant pharmacist in Melbourne, Florida.

"If there's one good myth that you can get rid of, it's that the medicine cabinet should be in a bathroom," Tomaka says. "It's probably the worst place for medication. It's probably OK for perfume and maybe some cosmetic items that you're going to use enough in a small period of time, but certainly not medications of any sort. Prescription, nonprescription – it's bad."

Exposure to sunlight, bare lightbulbs or neon light can reduce medication potency, Tomaka says. It's best to store drug products at temperatures below 77 degrees, but no colder than 59 or 60 degrees, he adds. "We're relatively sure that the 60 percent humidity mark is the maximum for most drug products when storing for an extended period of time," he adds. With that in mind, he notes, you can store unopened OTC products with more confidence.

Expiration dates are scientifically based on when manufacturers can guarantee the full effectiveness, purity and safety of an OTC or prescription drug in a closed container, Tomaka explains. However, he adds, "It doesn't mean that everything is junk after that date." For example, the U.S. Department of Defense has its Shelf Life Extension Program, in partnership with the Food and Drug Administration, in place to reduce waste of certain stockpiled prescription drugs that have been shown to last beyond their expiration date. A 2012 study in JAMA Internal Medicine looked at the stability of a cache of long-expired prescription drugs discovered in their original, unopened containers. Most retained at least 90 percent of their potency, some up to four decades past their expiration dates, tests revealed.

In your home, however, it's sometimes best to get rid of open OTC medications even before their expiration date passes. Depending on the type of medication, these factors figure into how long they should be kept:

• Liquid medications: Store medicines as tightly closed as possible. Some liquid OTC cough syrups and pain relievers contain a small amount of food preservative, Tomaka says, which has been shown to keep them effective up to the expiration date on the bottle. However, he says, once you open the bottle and expose it to air – and possibly insert a little plunger or syringe to measure out a dose of the product – the opportunity for mold or bacteria contamination arises. With liquid antacids, he says, "There's a reason that crusty cap doesn't look really good. It's better to dispose of that product."

• Tubes of ointment: Many people believe that because the active ingredient in an ointment or cream is an antibiotic, it can't be contaminated. While the chances are low, Tomaka says, antibiotic gels like Neosporin shouldn't stay in your medicine cabinet forever. Air reduces potency, he says, and you want reliable, mold-free medication to apply to a fresh gash on your hand. He prefers to use a tube of antibiotic that's been opened within a year, even if it has a five-year expiration date.

• Nasal sprays: Wipe the container's tip with a clean tissue after each use. Nose sprays may contain natural or gas propellants that can sometimes lead to contamination of the active ingredient if kept beyond the expiration date, Tomaka says.

The same precautions for disposing of unneeded prescription medications apply to OTC drugs, too. The FDA suggests mixing medications with an unpalatable substance such as used coffee grinds, kitty litter or dirt. Next, place the mixture in a sealed plastic bag and throw it your household trash. Disposing of drugs with care keeps them out of the water supply and out of the wrong hands. Although less potent than prescription drugs, some OTC products like cough medicines have the potential for abuse.

You can also take advantage of drug take-back days. They're not just for controlled or habit-forming substances, Tomaka says, but for any drugs you want to remove from your environment. Many county locations, such as fire stations or county chambers, have drug-take back containers, Tomaka says. Contact your local authorities for more information.