Expired prep

[Guest]

Hi everyone,

as many people around the world I stopped having sex because of the pandemic going on. Now that restrictions are finally being lifted I am considering resuming a bit of sexual life, and here's the bad news, the bottle of prep I had in the house expired in May. With the global economy down the drain I must admit spending 60 euros for a new one is a steep price to pay, and I was wondering if there's a way my prep stack can somehow be still salvageable. It's brand new, sealed and untouched for what matters, so you can imagine my frustration. Any input on the subject is greatly appreciated. 

[Close2MyBro]

1 hour ago, bluewind said:

Hi everyone,

as many people around the world I stopped having sex because of the pandemic going on. Now that restrictions are finally being lifted I am considering resuming a bit of sexual life, and here's the bad news, the bottle of prep I had in the house expired in May. With the global economy down the drain I must admit spending 60 euros for a new one is a steep price to pay, and I was wondering if there's a way my prep stack can somehow be still salvageable. It's brand new, sealed and untouched for what matters, so you can imagine my frustration. Any input on the subject is greatly appreciated. 

The shelf life of most drugs was found to be 90+% effective many years after expiration. There are only a small handful of drugs that become dangerous after expiration. This article might have more info for reference. 

[think before following links] https://www.pharmacytimes.com/view/some-medications-last-long-past-expiration-date

 

[fskn]

I'd recommend replacing the expired medication if at all possible, @bluewind. If old painkillers don't work, you get a headache, but if old PrEP medication doesn't work, you can get HIV!

The article that @Close2MyBro found is reassuring, and it contains a link to the (open-access) study report. Unfortunately, though, it isn't possible to test all drugs, in all storage conditions. What's more, that study involved medicines that had expired two to four decades before 2012. When the study drugs were made, China had not yet cornered the market for ingredients or India, the market for production. Today, those two countries dominate. China's industry is known for corruption and India's, for quality problems.

Some variables I'd consider:

• Source: Whether you obtained the medication from a pharmacy licensed in your jurisdiction, or from an unlicensed or foreign pharmacy. Some counterfeits have made their way into legitimate supply chains, but licensed, local pharmacies are more likely to sell authentic products.

• Brand: Whether the medication is a brand-name product (such as Gilead Truvada or Descovy) or a generic one (such as Teva or Aurobindo Emtricitabine/Tenofovir Disoproxil Fumarate; Teva and Aurobindo are licensed in the US, but other generic manufacturers might be licensed in your jurisdiction). All other factors being equal, the brand-name product is likely to be of a higher quality, because the manufacturer has a reputation to defend. Generic drug manufacturers enjoy little brand recognition. They care about liability, of course, but they don't need to worry much about brand value in addition. Also, they tend not to be headquartered in countries with strict legal systems.

• Country of manufacture: This might be printed on the bottle. If not, it shouldn't be inferred from the drug company; for example, over the years, I've received Gilead Truvada that was made in the US, in India, and most recently, in Germany! The Teva generic that I just received was made in Croatia. All other factors being equal, drugs made in the US or in the EU or Switzerland are likely to be of higher quality. And being on the fringe (Canada, future EU hopefuls, etc.) is not an indicator of quality. For example, Canada's generic drug manufacturing industry has been taken over by unethical companies with strong ties to India.

Good luck with your decision!

Edited June 8, 2021 by fskn
Typos

[viking8x6]

They are (almost certainly) still good. The major causes of deterioration in drugs (or any other chemicals or materials) in storage are air, moisture, light, and heat. If the package is still sealed, air and moisture aren't an issue. Unless you've been keeping the bottle in a rather unusual storage place, light isn't either. That leaves heat. As long as it's been kept at room temperature or below, you're well within the margin of error for the storage life. Former chemist here, so this is all based on substantial knowledge about stability of such things.

[fskn]

A middle-of-the-road option occurred to me, @bluewind. I hesitate to mention this, as it's definitely not medical advice and people should always do their own reading, discuss with their medical practitioner, etc. to reach an informed decision. With those caveats in mind...

When daily dosing is intended, Truvada for HIV PrEP is thought to be much less effective if more than 3 pills are missed in a week. (This is for receptive anal sex; for receptive vaginal sex the margin is smaller and daily means almost daily.)

If you renew your prescription now, and receive the same product, maybe you could interleave, taking 4 new pills each week and 3 expired ones. You'd have to spend the €60 sooner, but the expired medication wouldn't be lost, and even if it were no longer effective, you'd have substantial (if not total) protection from 4 new pills a week.

[Guest]

Thanks everyone, the answers gave me a lot to think about. I'm going to follow @fsknadvice, 4 new pills and 3 old ones a week, and I'll definitely make sure the person I'm getting loaded by is either on prep or undetectable. I guess I'll treat this experience both as a lesson to be more careful about checking expiration dates, also adding just a little bit of the good old pre-prep excitement when condoms were already a thing and hiv was always a calculated risk. Irresponsible, maybe but the thrill was always a part of the game.

[Pigforpoz]

7 hours ago, bluewind said:

Hi everyone,

as many people around the world I stopped having sex because of the pandemic going on. Now that restrictions are finally being lifted I am considering resuming a bit of sexual life, and here's the bad news, the bottle of prep I had in the house expired in May. With the global economy down the drain I must admit spending 60 euros for a new one is a steep price to pay, and I was wondering if there's a way my prep stack can somehow be still salvageable. It's brand new, sealed and untouched for what matters, so you can imagine my frustration. Any input on the subject is greatly appreciated. 

Don't throw away your old prep medication!  Close2mybro got it correct!  Truvada in a sealed container is still 90 + percent effective even a few years after expiration!  Some prescriptions like diabetes test strips always good even a few years after expiration!  Go online and check it out!  I never throw out old expired drugs especially if still in sealed container!  Always store meds in a cool dry place!