Sertraline is a widely prescribed selective serotonin reuptake inhibitor (SSRI) used to manage conditions like depression, anxiety, and obsessive-compulsive disorder. When any pharmaceutical product reaches its expiration date, the manufacturer no longer guarantees the drug’s full potency and safety. The United States Food and Drug Administration (FDA) mandates these dates based on stability testing. This ensures the medication retains its intended strength and purity when stored correctly. Using an expired medication carries risks concerning both its effectiveness and the possibility of unintended side effects.
Loss of Therapeutic Effectiveness
The primary risk associated with taking expired sertraline is that the medication may fail to work as intended, leading to a return or worsening of symptoms. Over time, the active ingredient, sertraline hydrochloride, undergoes chemical degradation, reducing the overall drug concentration. This process is accelerated by environmental factors such as exposure to heat, humidity, and light.
This degradation results in reduced bioavailability, meaning less active sertraline is absorbed into the bloodstream at the necessary therapeutic level. For conditions requiring consistent blood plasma concentrations, a loss of potency is detrimental. This failure to maintain stable serotonin levels can lead to symptoms of relapse, including increased anxiety, depression, or panic attacks.
Safety Risks of Chemical Breakdown
While the loss of potency is a concern, safety risks arise from the unpredictable nature of the chemical breakdown products, or metabolites. Sertraline is generally stable, and expired medications usually become less effective rather than toxic. However, when the drug degrades, it forms new chemical compounds, and the safety profile of these impurities is not fully established by the manufacturer.
Sertraline degradation is accelerated by oxidation and light exposure, creating new degradation products within the tablet. Ingesting these altered compounds can lead to unusual gastrointestinal side effects, such as severe nausea, vomiting, or diarrhea. The altered chemical makeup could cause an uneven release of the drug, potentially leading to an acute surge of serotonergic activity. This surge raises the risk of developing symptoms similar to Serotonin Syndrome, characterized by excessive serotonin levels in the central nervous system.
What To Do After Taking Expired Sertraline
If you realize you have taken a dose of expired sertraline, immediately stop taking it and contact a healthcare professional. Call your prescribing doctor or a pharmacist right away to discuss the situation and determine the appropriate next steps for your treatment plan. Do not attempt to compensate for the lost dose by taking an extra amount of fresh medication.
Monitor yourself closely for any unusual physical or neurological symptoms for the next 24 hours. Be watchful for signs of increased serotonergic activity, such as agitation, confusion, a rapid heart rate, or unexplained changes in blood pressure. Severe symptoms of Serotonin Syndrome require immediate attention:
- Muscle rigidity
- Tremor
- Profuse sweating
- High fever
If you experience severe signs, especially a high fever or seizures, seek emergency medical attention immediately by calling 911 or Poison Control.
Guidance on Medication Disposal
After confirming the medication is expired, safely remove it from your home environment to prevent accidental ingestion by others, including children or pets. The best option for disposal is to use a community drug take-back program, often available at local pharmacies or police stations. These programs ensure the medication is incinerated, which is the most environmentally responsible method of destruction.
If a take-back program is not readily accessible, dispose of the medication in your household trash by following specific FDA guidelines:
- Mix the sertraline tablets, without crushing them, with an unappealing substance like dirt, used coffee grounds, or cat litter.
- Place this mixture into a sealed container, such as a plastic bag, to prevent leaking.
- Dispose of the sealed container in the household trash.
- Remove or scratch out all personal information on the prescription label before disposing of the empty bottle.