27 July, 2017
Side Effects of Out-of-Date Albuterol
Albuterol is essentially a white crystalline solid, soluble in ethanol. In controlled clinical trials, this medication relaxes smooth bronchial muscles and reduces hypersensitivity, or "ticklish lungs," characteristic of asthma. Although known to have several unpleasant but mostly temporary side effects, there seems to be no increased hazards to using albuterol long past its expiration date.
The expiration date printed on pharmacy labels is generally one year after the prescription is filled. Albuterol is a popular medication that does not sit for long periods on pharmacy shelves; the merchant is continually reordering and restocking. It is unlikely that the medication is even close to the manufacturer's expiration date, which is considerably longer. While the argument could be made that one year from the time it is opened seems reasonable, if it is stored properly, albuterol should be safe and effective for several years, according to Lawrence Koenig, Pharm.D., proprieter of The Prescription Center in Indio, California. "I'd give it to my own family members," he said.
According to a Food and Drug Administration (FDA) study done for the U.S. military that was started in 1985, 90 percent of prescription and over-the-counter drugs remain safe and effective up to 15 years. The results of this study were first published in "The Wall Street Journal" by reporter Laurie Cohen in April 2000. Manufacturers rarely test beyond two years because there's no monetary incentive to guarantee potency.
According to manufacturer Armstrong Pharmaceuticals, inhalers should be stored between 59 to 86 degrees F. Therapeutic effect of the medication is decreased when the canister is cold; it should be shaken and warmed to room temperature before use. Just as recommended with a first use, a "test spray" is advised before using the inhaler if it has not been used for prolonged periods. Each inhalation delivers 90mcg of albuterol from the mouthpiece and the manufacturer states a canister contains 200 doses. After 200 doses, the canister will not be completely empty, but Armstrong Pharmaceuticals states in the accompanying literature that "the correct amount of medication in each actuation cannot be assured" beyond the 200 doses. To assure potency, counting doses may be more important than awareness of expiration dates.
Albuterol has been known to raise blood pressure and to make heart conditions worse. Common side effects are palpitations, chest pain, rapid pulse, tremor, nervousness, throat irritation, heartburn, unusual taste, dry mouth, insomnia, nausea and vomiting. The action of albuterol lasts for approximately six hours. Whether medication has expired or not, do not exceed the prescribed dosage.
It is wise to examine medication prior to use regardless of how old it is. Albuterol liquid for use in nebulizers is also generally considered safe and effective for years past the expiration date. It should be stored in the original container and protected from temperature extremes. Any medication that is discolored or contains precipitate matter is suspect. When in doubt, consult a pharmacist.
- Don’t be tempted to use expired mediation. (2016, March 1)
- Drug Enforcement Administration. (2016, May 6). DEA collects record-setting amount of meds at latest national Rx take-back day [Press release]
- Expiration dating extension. (2015, September 17)
- Expiration of the ventolin inhaler. (n.d.)
- How to dispose of unused medicine. (2017, February 21)
- Image by Flickr.com, courtesy of Christian Guthier