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    Good Practice Guidance 4. Expiry Dates For Medication

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    Agnieszka Waligóra
    This document provides guidance on medication expiry dates for care home staff, prescribers, and pharmacists. It defines expiry dates and outlines key points for storage such as keeping medications in original containers, cool and dry places, and being vigilant of expiry dates. Using expired medications can cause harmful effects. The guidance provides medication expiry timeframes and exceptions. It concludes with tips for each group to avoid medication waste and ensure proper use of expiry dates.

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    Good Practice Guidance 4. Expiry Dates For Medication

    Uploaded by

    Agnieszka Waligóra
    845 views5 pages
    This document provides guidance on medication expiry dates for care home staff, prescribers, and pharmacists. It defines expiry dates and outlines key points for storage such as keeping medications in original containers, cool and dry places, and being vigilant of expiry dates. Using expired medications can cause harmful effects. The guidance provides medication expiry timeframes and exceptions. It concludes with tips for each group to avoid medication waste and ensure proper use of expiry dates.

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    04. Good Practice Guidance 4. Expiry Dates for Medication

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    This document provides guidance on medication expiry dates for care home staff, prescribers, and pharmacists. It defines expiry dates and outlines key points for storage such as keeping medications in original containers, cool and dry places, and being vigilant of expiry dates. Using expired medications can cause harmful effects. The guidance provides medication expiry timeframes and exceptions. It concludes with tips for each group to avoid medication waste and ensure proper use of expiry dates.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    845 views5 pages

    Good Practice Guidance 4. Expiry Dates For Medication

    Uploaded by

    Agnieszka Waligóra
    This document provides guidance on medication expiry dates for care home staff, prescribers, and pharmacists. It defines expiry dates and outlines key points for storage such as keeping medications in original containers, cool and dry places, and being vigilant of expiry dates. Using expired medications can cause harmful effects. The guidance provides medication expiry timeframes and exceptions. It concludes with tips for each group to avoid medication waste and ensure proper use of expiry dates.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
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    The document outlines best practices for storing and handling medications, including guidelines for expiry dates and how different factors can impact shelf life.

    Medications should be kept in their original containers, in a cool dry place away from light unless otherwise specified. Key dates like the date opened should be recorded. Expired medications should not be used.

    Factors like temperature, moisture, light and how the medication is packaged can all impact the chemical stability and potential contamination risk, shortening the effective expiry date.

    Good Practice Guidance 4: Expiry Dates for Medication

    Adapted from previous NHS Berkshire East guidance, Expiry Date Guidelines for Medication (2010).
    This guidance is primarily for care home staff but also mentions good practice tips for prescribers and
    community pharmacists.
    Definition:
    The expiry date is the point in time when a pharmaceutical product is no longer within an acceptable
    condition to be considered effective. The medication reaches the end of its shelf life.
    Depending on the product, the expiry date may be set as a fixed time:
    after manufacture
    after dispensing
    after opening of the manufacturers container.

    The shelf life of products is determined by either the breakdown of the active drug or by risk of
    contamination. Not all drugs deteriorate at the same rate.
    Key points for basic storage guidelines
    Keep all medication in the original container in which they were dispensed.
    Keep medicines in their original outer packaging, to protect from sunlight.
    All medicines should be stored in a cool (below 250C) dry place unless refrigeration is required
    (between 20C and 80C).
    The expiry date of products can change once opened.
    Record the date opened and the calculated expiry on the medicine package/label.
    Be vigilant with product expiry dates.
    Store as recommended by the manufacturer.
    Use disposable gloves per patient when applying creams or ointments
    Medication should be user specific and sharing of medicines including creams and ointments is
    prohibited.
    Effects of using expired stock
    The active drug could become chemically unstable
    The effectiveness of the drug may change
    The break down products of the drug may be toxic and harmful to the patient
    Increased risk of contamination

    Examples of different wording of expiry dates:

    Wording on packaging
    Best before January 2012
    Use before end January 2012
    Use by January 2012
    Discard after January 2012
    Expires January 2012
    Use within one month of opening
    Discard 7 days after opening

    Definition
    Discard 31/12/2011
    Discard 31/01/2012
    Discard 31/12/2011
    Discard 31/01/2012
    Discard 31/01/2012
    Self explanatory (ideally every 28 days)
    Self explanatory

    Author: Sundus Bilal, Care Home Prescribing Support Pharmacist Issue date: Dec 2012
    Page 2
    Authorised by: Effective Prescribing & Performance Committee
    Review date: Dec 2014 Version 2
    Good Practice Guidance documents are believed to accurately reflect the literature at the time of writing.

    Generally, solid dose formulations have a longer expiry date than liquid preparations. The manufacturers
    expiry on a container is the unopened expiry date. After opening, the expiry date may be dramatically
    shortened. This should be highlighted on the medicine label or container or in the service users medicine
    profile.
    Certain external factors can affect expiry contact with water, temperature, air or light e.g. antibiotics to be
    taken as a liquid formulation are stored in the pharmacy as a dry powder which is then reconstituted with
    water and then given a shorter expiry date.
    Monitored Dosage Systems (MDS)
    It is recommended that medicines dispensed in a MDS are discarded after 8 weeks if they have not been
    used. Please note not all medicines are suitable for inclusion in MDS for example:
    Medicines that may be harmful when handled, e.g. cytotoxic products like methotrexate
    Medicines that are sensitive to moisture, e.g. effervescent tablets
    Light-sensitive medicines, e.g. chlorpromazine
    Medicines that should only be dispensed in glass bottles, e.g. glyceryl trinitrate (GTN)
    Medicines that should only be taken when required, e.g. painkillers
    Medicines whose dose may vary depending on test results, e.g. warfarin.
    In all cases, the printed manufacturers expiry date should be used if it is earlier than the suggested
    guideline dates listed in the table below.
    Some products now show an expiry symbol e.g.
    .However, in the care home setting where storage
    conditions may be variable, it is recommended that the above suggested expiry dates are followed.
    Any product whose appearance suggests it may be unfit for use should be discarded irrespective of
    expiry date. If there is any doubt contact the community pharmacy for advice.
    When required medication (PRNs)
    Be aware of the expiry date of PRNs especially if they are not used frequently. It is good practice to date
    and initial on opening all PRN medication for audit trail purposes.
    Some Exceptions:
    Certain oral preparations have a shorter shelf life once they have been opened. The following list is not
    exhaustive and is only intended to cover some of the most frequently used products. Please add your own
    products as they become known to you. Many specials will have a short shelf life.

    Tips for Care Home Staff:


    Tip 1 ordering medication
    Check quantities of medication ordered are appropriate for requirement in order to avoid
    medication waste.
    Do not forget to check medication not routinely stored in the medicines trolley e.g. PRNs,
    topical preparations.
    A nominated member of staff should be responsible for ordering medication with a named
    deputy.
    Request PRNs in original packs rather than in MDS. (MDS has reduced expiry therefore more
    frequent prescriptions will be necessary and more medication waste generated).
    Tip 2 receiving medication from pharmacy
    Check if there are any specific expiry date instructions on labels e.g. some liquid antibiotics.
    Author: Sundus Bilal, Care Home Prescribing Support Pharmacist Issue date: Dec 2012
    Page 2
    Authorised by: Effective Prescribing & Performance Committee
    Review date: Dec 2014 Version 2
    Good Practice Guidance documents are believed to accurately reflect the literature at the time of writing.

    Check the medication is still within its expiry date.

    Tip 3 storing medication


    Note and act on any specific storage instruction e.g. store in the fridge.
    Rotate stock so the earliest expiry is at the front and therefore going to be used first i.e. first in,
    first out.
    Check expiry dates of medication stock monthly.
    Medication is to remain in the container in which it was received batches must not be mixed.
    Tip 4 administering medication
    Check expiry date before each administration.
    Record the date opened and the calculated expiry on the medicine package/label where
    appropriate e.g. creams, eye drops. Some packaging does not allow for the pharmacy label to be
    placed on the product e.g. eye drops. In these instances the outer packaging will have to be
    endorsed with the date of opening .It is essential that the product remains in the outer packaging
    throughout duration of the treatment.
    Highlight any short expiry as a reminder to all staff.
    Any product whose appearance suggests it may be unfit for use should be discarded
    irrespective of expiry date. If there is any doubt contact the community pharmacy for advice.
    Tips for Prescribers:
    Prescribing quantities
    Prescribe appropriate quantity of medication in order to avoid waste.
    Quantities which appear to be excessive should be queried.
    Repeat prescribing process
    Consider nominating a named practice member to process care home prescription requests
    and to act as contact known to the care home to deal with queries.
    Tips for Community Pharmacists:
    Dispensing medication
    If decanting from bulk container, label with appropriate expiry date
    Highlight any shortened expiry dates.
    Do not obscure expiry dates with labels.
    If the care home generally receives medicines in a MDS, inform staff if a particular medicine is
    unsuitable for inclusion due to problems with stability. The foil packing around individual tablets
    must not be cut and placed in a MDS; doing so has potential to cause harm if inadvertently
    swallowed by service user.
    Further information:
    Further information on managing medicines in care homes is available in Outcome 9 of the CQC Essential
    Standards of Quality and Safety.
    RPS The Handling of Medicines in Social Care.
    The Pharmaceutical Journal How stable are medicines moved from original packs into compliance aids,
    Jan. 2006, Vol 276.
    British National Formulary. 64th ed. London: BMA and Royal Pharmaceutical Society; 2012.
    Author: Sundus Bilal, Care Home Prescribing Support Pharmacist Issue date: Dec 2012
    Page 2
    Authorised by: Effective Prescribing & Performance Committee
    Review date: Dec 2014 Version 2
    Good Practice Guidance documents are believed to accurately reflect the literature at the time of writing.

    Formulation type

    Expiry details

    Tablets & capsules in


    original blister strips or
    container with printed
    expiry date
    Tablets & capsules stored
    in dispensing bottles from
    pharmacy

    Manufacturers expiry date as printed on


    original box or individual foils (check patient
    information leaflet)

    Aspirin Dispersible tablets


    stored in dispensing
    bottles from pharmacy
    Tablets/Capsules stored in
    pharmacy packed blisters Monitored Dosage System
    (MDS)
    Oral liquids (in original
    manufacturers packaging
    or amber bottles)

    1 months from date of dispensing

    External liquids
    (e.g. Lotions, shampoos &
    bath oils)
    Creams in tubes or pump
    dispensers
    Creams in pots, tubs or
    jars.
    Ointments in tubes or
    pump dispensers
    Ointments in pots, tubs or
    jars.
    Sterile Eye/Ear/Nose
    drops/Ointments
    Rectal Diazepam
    SIP Feeds/ oral
    supplementary nutrition

    Inhalers
    Glyceryl trinitrate sprays
    Insulin

    6 months from date of dispensing unless


    otherwise informed by Community pharmacist

    Comments
    PRN (when required) medication,
    wherever possible, should be used
    from the manufacturers original
    pack. (The expiry date is printed on
    each strip). Medicines kept for use in
    next month should be recorded in
    the carried forward section of the
    MAR chart.

    8 weeks from date of dispensing

    6 months from date of opening or follow


    manufacturers guidance e.g. for specially
    manufactured items or expiry date on
    packaging. For antibiotics, check with
    community pharmacist if not clear from
    label.
    6 months from opening or manufacturers
    recommendation where shorter
    3 months from date of opening or
    manufacturers recommendations if shorter
    1 months from date of opening
    6 months from date of opening or
    manufacturers recommendations if shorter
    3 months from date of opening or
    manufacturers recommendations if shorter
    28 days from date of opening

    Estimate the amount of any liquids


    carried over. Medicines retained for
    use should be recorded in the
    carried forward section of the MAR
    chart.

    Write the DATE and initial when


    opened on the dispensing
    Label for audit trail purposes.

    Individual foil wrapped tubules Manufacturers expiry date


    Non-foil wrapped
    6 months from date of opening
    Unopened, follow Manufacturers expiry date. Calogen will last 14 days after
    Follow manufacturers guidance once opened opening. Tube feeds like Nutrison
    (most keep for 24 hours in fridge)
    will last 24 hours (stored in fridge)
    from opening and supplements such
    as Complan Shake will last 24 hours
    (stored in fridge) once prepared.
    Manufacturers expiry date
    If inhalers / sprays are used on a PRN
    basis, keep for on-going use; do not
    routinely re-order each month.
    Manufacturers expiry date
    Write details on current MAR chart.
    Unopened: Manufacturers expiry date when
    One pen/ cartridge will often be
    stored in a fridge at temperature between 2C sufficient per month.
    and 8C.
    (A box of 5 will rarely be needed
    Once opened: 4 weeks for insulin vials and
    every month). Ask the G.P to
    pens unless otherwise stated. When in use
    prescribe the nearest number of
    can be kept at normal room temperature
    pens/ cartridges needed per month
    (i.e. less than 25C).
    to reduce stock piling.

    Author: Sundus Bilal, Care Home Prescribing Support Pharmacist Issue date: Dec 2012
    Page 2
    Authorised by: Effective Prescribing & Performance Committee
    Review date: Dec 2014 Version 2
    Good Practice Guidance documents are believed to accurately reflect the literature at the time of writing.

    List of products with Expiry Dates different to the above Guidelines


    Persantin Retard
    (Dipyridamole SR)
    Glyceryl Trinitrate tablets
    Madopar capsules and tablets
    Nicorandil

    Asasantin Retard Capsules

    Chlorpromazine Syrup 25mg/5ml & 100mg/5ml


    (Rosemont)
    Gastrocote Liquid
    Largactil Syrup
    Oramorph 10mg/5ml Liquid
    Risperdal 1mg/ml Liquid

    6 weeks after opening original dispensing container.


    Once capsules are packed down into another
    container then 4 weeks expiry
    8 weeks after opening
    2 weeks when dispensed into another container
    Manufacturer recommendation, then once opened
    each blister has a 30-day expiry. Use each blister
    strip at a time before opening the next. The blister
    strip contains a drying agent to protect the tablets
    from moisture which should NOT be removed or
    swallowed.
    6 weeks after opening original dispensing container.
    Once capsules are packed down into another
    container then 4 weeks expiry
    6 months after opening
    1 month after opening
    1 month after opening
    90 days after opening
    3 months after opening

    References used:

    Joint Formulary Committee. British National Formulary. 64th ed. London: BMA and Royal Pharmaceutical Society; 2012.
    The Pharmaceutical Journal How stable are medicines moved from original packs into compliance aids, Jan. 2006, Vol 276.
    Continuing Professional Pharmacy Education (CPPE) Supporting Care Homes in Medicines Management April 2007
    Lowe R A. Storage, stability and in-use shelf-life guidelines for non-sterile medicines. London, Eastern and South East Specialist Pharmacy
    Services. 2001 Mar. [http://www.nhsppu.uea.ac.uk/assets/docs/qa/storage_stability_in_use_shelf_lives_of_non_sterile_medicines.pdf]

    These guidelines are subject to correct storage at ambient temperatures recommended by


    manufacturers and are based on general consensus and not evidence-based due the lack of
    information available.

    Author: Sundus Bilal, Care Home Prescribing Support Pharmacist Issue date: Dec 2012
    Page 2
    Authorised by: Effective Prescribing & Performance Committee
    Review date: Dec 2014 Version 2
    Good Practice Guidance documents are believed to accurately reflect the literature at the time of writing.

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