Understanding Medication Expiration Dates: Rx Update: Virtual Hospital

Rx Update: November 2003 (Updated February 2004)

Understanding Medication Expiration Dates

Joan Murhammer, R.Ph., Mary Ross, R.Ph., M.B.A., Kevin Bebout, R.Ph.
Peer Review Status: Internally Reviewed

Understanding medication expiration dates is an important part of patient care. Expiration dates may relate to loss of potency and/or sterility. In other cases, a drug may break down into other, harmful substances. As medications age, the potency decreases. In the case of sterile drugs, seals may deteriorate, allowing bacteria to enter. Some medications are good until the date given by the manufacturer; for others, the expiration date changes based on how the medication is stored or when it is reconstituted. Drugs that are reconstituted may need to be used immediately, or they may expire in several hours or days. It is important to mark the date and time that the container is opened for medications that do not receive the manufacturer's expiration date once the product is used, so that it can be discarded if it is not used before its maximum time use period. It is important to use good aseptic technique when accessing multiple-dose vials. The rubber diaphragm of the vial should be cleansed with alcohol before inserting the needle, a sterile device should be used each time, and touch contamination of the device must be avoided before penetrating the rubber diaphragm. Products should be carefully inspected before use for turbidity, leaks, cracks, and evidence of particulate matter. The medication should be discarded if suspected or visual contamination occurs (i.e., solution turns hazy). When giving a patient a medication, it is important to always double check the expiration date and discard the product if the expiration date has been reached. This will help ensure that the patient receives safe and appropriate drug therapy.

Table 1 summarizes UIHC policy for assigning expiration dates to drug doses prepared or products used on patient care units. Table 2 summarizes the UIHC policy for IV hang times and tubing changes.

Table 1: Assignment of Expiration Dates to Drug Doses Prepared Or Products Used on Patient Care Units

Medication Product Category
Expiration Date/
Maximum Time Period for Use

Products for parenteral administration prepared/compounded on PCU (e.g., syringe)
24 hours

IV solutions prepared/compounded on PCU (e.g., IV bag)
24 hours

Intravenous fat emulsion

Manufacturer's bottle

Syringe

24 hours
12 hours

Sterile irrigating and topical solutions
24 hours

Ampuls
Use immediately, discard excess

Single-dose vials
Use immediately, discard excess

Multiple-dose vials (containing a bacteriostatic preservative*)
Manufacturer's expiration date

Multiple dose vials of heparin flush, bacteriostatic 0.9% sodium chloride, bacteriostatic sterile water, and lidocaine (1% and 2% with or without epinephrine)
Manufacturer's expiration date

Unit dose oral solids, liquids, and suppositories in manufacturer's original packaging
Manufacturer's expiration date

Floorstock containers of oral solids and oral liquids in bulk bottles
Manufacturer's expiration date

Floorstock topical medications such as ointments, ophthalmics, etc.
30 days after opening

Patient-specific bulk containers of oral liquids, ophthalmics, topicals, etc.
Manufacturer's expiration date

Floorstock topical antiseptic liquids such as alcohol, hydrogen peroxide, and povidone-iodine solution
Manufacturer's expiration date

* Bacteriostatic preservatives include phenol, chlorobutanol, benzyl alcohol, and methylparaben/propylparaben combinations.

Table 2: IV Hang Times and Tubing Changes¹

Medication Therapy
Maximum Time Period

Continuous IV Therapy

Tubing
Solution Bag/Syringe
96 hours
96 hours^#

Intermittent IV Therapy

Tubing
Solution Bag/Syringe
24 hours
24 hours

^#The bag/syringe can be hung for up to 96 hours or in the time frame that the additives expire, whichever comes first. Medications that are prepared by Pharmacy and have a longer expiration date or products that are commercially available (e.g., D51/2NS with 20 mEq KCl/l, morphine PCA syringes) can be hung for up to 96 hours.

¹Nursing Policy 07.030 Administration of IV Therapy.

If you have any questions about the expiration date of a medication, call the Drug Information Center (6-2600) or the pharmacy serving your patient care area. For complete guidelines for the assignment of expiration dates for drugs products used on patient care units, go to http://www.vh.org/formulary/Hand/drugexpirationdates.html.

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Table 1: Assignment of Expiration Dates to Drug Doses Prepared Or Products Used on Patient Care Units
Medication Product Category	Expiration Date/ Maximum Time Period for Use
Products for parenteral administration prepared/compounded on PCU (e.g., syringe)	24 hours
IV solutions prepared/compounded on PCU (e.g., IV bag)	24 hours
Intravenous fat emulsion Manufacturer's bottle Syringe	24 hours 12 hours
Sterile irrigating and topical solutions	24 hours
Ampuls	Use immediately, discard excess
Single-dose vials	Use immediately, discard excess
Multiple-dose vials (containing a bacteriostatic preservative*)	Manufacturer's expiration date
Multiple dose vials of heparin flush, bacteriostatic 0.9% sodium chloride, bacteriostatic sterile water, and lidocaine (1% and 2% with or without epinephrine)	Manufacturer's expiration date
Unit dose oral solids, liquids, and suppositories in manufacturer's original packaging	Manufacturer's expiration date
Floorstock containers of oral solids and oral liquids in bulk bottles	Manufacturer's expiration date
Floorstock topical medications such as ointments, ophthalmics, etc.	30 days after opening
Patient-specific bulk containers of oral liquids, ophthalmics, topicals, etc.	Manufacturer's expiration date
Floorstock topical antiseptic liquids such as alcohol, hydrogen peroxide, and povidone-iodine solution	Manufacturer's expiration date
* Bacteriostatic preservatives include phenol, chlorobutanol, benzyl alcohol, and methylparaben/propylparaben combinations.

Table 2: IV Hang Times and Tubing Changes¹
Medication Therapy	Maximum Time Period
Continuous IV Therapy
Tubing Solution Bag/Syringe	96 hours 96 hours^#
Intermittent IV Therapy
Tubing Solution Bag/Syringe	24 hours 24 hours
^#The bag/syringe can be hung for up to 96 hours or in the time frame that the additives expire, whichever comes first. Medications that are prepared by Pharmacy and have a longer expiration date or products that are commercially available (e.g., D51/2NS with 20 mEq KCl/l, morphine PCA syringes) can be hung for up to 96 hours.