Photo of a pill packs in various colors piled on top of each other

“Can I still take that?”: Expert insights on cleaning out your medicine cabinet

From over-the-counter pain relievers to orange prescription pill bottles, chances are your bathroom shelves carry their fair share of medications. But when’s the last time you sorted through them?

Photo of Tawna L. Mangosh
Tawna L. Mangosh

Beyond serving as cabinet clutter, medications that are expired or no longer needed pose safety concerns—whether that be accidental ingestion by a child or pet, or changes in chemical composition that render the drugs ineffective or dangerous. National Clean Out Your Medicine Cabinet Day takes place each spring to challenge us to keep tabs on our medications and, beyond that, to dispose of them properly. 

To gain a better understanding of expiration dates and proper disposal practices, The Daily spoke with Tawna L. Mangosh, a pharmacist, assistant professor in the Department of Pharmacology and director of the Translational Pharmaceutical Science Program at Case Western Reserve University School of Medicine.

Read on to learn Mangosh’s insights.

Understanding expiration dates

The dates printed on each prescription package or pill bottle in your medicine cabinet aren’t just meant as suggestions. As Mangosh explained, they are “an assurance from the manufacturer that the labeled potency or level of effectiveness of that drug will last until that date.”

Manufacturers determine these dates using stability testing—a process assessing shelf-lives under different storage conditions—but results can vary widely depending on a number of factors.

“Once a drug is removed from the manufacturer packaging and placed in a pill bottle, for example, the manufacturer’s expiration date may no longer be valid and the pharmacy will designate a new ‘beyond-use date,’” said Mangosh. “Another obvious example would be drugs that require refrigeration versus those that can be stored at room temperature.”

If you’ve encountered a pill bottle with an illegible expiration date or found loose pills at the bottom of your desk drawer, for instance, Mangosh offers a clear rule of thumb: “Err on the side of caution and do not take the medication.” 

Factoring in drug recalls 

Beyond identifying medications that have passed their expiration dates, regularly cleaning out your medicine cabinet can help ensure you’re aware of drug recalls. In one example as a retail pharmacist, Mangosh recalls counseling a patient who shared they’d been taking heartburn medication that they purchased on Amazon.

“This was just after ranitidine, which is an over-the-counter agent commonly used for heartburn, was recalled by the Food and Drug Administration (FDA) for concerns regarding the increasing levels of NMDA in the medication over time even when stored under normal conditions,” she said. 

Sure enough, the patient went home and discovered they were taking ranitidine—and  expressed gratitude to Mangosh for informing them of the recall. 

“While not an expired medication per se, recalls require a very similar course of action to ensure patient safety,” Mangosh said. 

Properly disposing of medications 

Once you’ve gathered medications that are expired, recalled or simply no longer needed, the next step is not to toss them directly in the trash. This practice not only risks improper ingestion by others such as small children or pets, but can cause environmental harm as medications could seep into our soil and waterways.

Instead, according to Mangosh, you should seek out drug take back locations.

“Many local pharmacies and law enforcement programs either have authorized drug take back programs or can direct you if you drop by or reach out via phone,” she explained. 

Another possibility is to flush the drugs down the toilet, but this option should be limited to (1) drugs such as opioids that are sought after for their misuse potential, or (2) those that can result in death from one dose if taken inappropriately. The FDA maintains a “flush list” of medications that qualify for this approach.

In the event you are not able to locate a drug take back location and the medication in question is not on the FDA’s flush list, there are other options.

“The FDA recommends mixing expired medications with unappealing substances like coffee grounds, for instance, in a sealable bag or container before throwing them in the trash (again to deter ingestion),” said Mangosh. “But always make sure to remove personal information from medication bottles before tossing them or dropping off at take back locations.”