Abstract
Background Unsafe storage of unused medications at home leads to an increased risk of toxicity, accidental childhood poisoning or risk for suicide, whereas an improper disposal of unwanted/expired medications from household raises concern about environmental pollution. Objective The aim of the study was to characterize expired medications collected according to the types of therapeutic groups, pharmaceutical dosage forms, expiration dates and were prescribed or over the counter drugs, and whether they came from Mexican health system or purchased by patients themselves. Setting The study was conducted in the metropolitan area of Monterrey during a 12-month period from March 2012 to February 2013. Method Unused/expired drugs were collected according to the collection and disposal of expired medication program instituted by the Department of Health of the State of Nuevo León. Pharmacists and students from The Autonomous University of Nuevo León recorded types of therapeutic groups, total of medicines in each group, among other classification criteria. Main outcome measure The proportion of every collected therapeutic group, type of dosage forms, and expiration date. Results The amount of medications classified was 22,140 items corresponding to a 30 % of the total collected medications in that period of time; most of them belonged to the non-steroidal anti-inflammatory drugs (16.11 %). According to the pharmaceutical dosage forms, results showed that a high percentage were solid dosage forms (73.39 %), of the total unused/expired medications, most of them were prescription drugs (91 %) which were purchased at private pharmacies. Expiration date of medications ranges from 1995 to 2016, being 2011 the outstanding year (36.66 %). Conclusion Addressing the aspect of unused drug disposition constitutes a challenge for Mexican government, due to health implications related to inadequate disposition. No matter how efficient the programs of collection and disposal of expired drugs are, none of them can collect all unused or expired drugs, that is the reason why the best approach might be to prevent this need.
Similar content being viewed by others
References
Ruhoy IS, Daughton CG. Beyond the medicine cabinet: an analysis of where and why medications accumulate. Environ Int. 2008;34:1157–69.
Corcoran J, Winter MJ, Tyler CR. Pharmaceuticals in the aquatic environment: a critical review of the evidence for health effects in fish. Crit Rev Toxicol. 2010;40(4):287–304.
Consejo Nacional de Población. Datos de proyecciones (2013). http://www.conapo.gob.mx/es/CONAPO/Proyecciones_Datos. Accessed May 2014.
Instituto Nacional de Estadística Geografía e Informática. México en cifras (2012). http://www3.inegi.org.mx/sistemas/mexicocifras/. Accessed May 2014
Kusturica MP, Sabo A, Tomic Z, Horvat O, Solak Z. Storage and disposal of unused medications: knowledge, behavior, and attitudes among Serbian people. Int J Clin Pharm. 2012;34:604–10.
Annear B, Sinclair K. Response to ‘returned medicines: waste or a wasted opportunity?’. J Public Health. 2008;30(2):209–10.
Guirguis K. Medications collected for disposal by outreach pharmacists in Australia. Pharm World Sci. 2010;32:52–8.
Runnalls TJ, Margiotta-Casaluci L, Kugathas S, Sumpter P. Pharmaceuticals in the aquatic environment: steroids and anti-steroids as high priorities for research. Hum Ecol Risk Assess. 2010;16:1318–38.
Bound JP, Voulvoulis N. Household disposal of pharmaceuticals as a pathway for aquatic contamination in the United Kingdom. Environ Health Perspect. 2005;113:1705–11.
Braund R, Peake BM, Shieffelbien L. Disposal practices for unused medications in New Zealand. Environ Int. 2009;35:952–5.
Prescott JD, Estler K. Waste not want not: drug disposal and the role of the pharmacist. Pharm Times. 2010;76:107–113.
Ríos L. Medicamentos caducos, riesgo para la salud [Internet]. México DF: Luis Quiroga; 03 Sep 2013 [Updated 15 Dec 2013; cited 27 Jan 2014]. http://www.vertigopolitico.com/articulo/21946/Medicamentos-caducos-riesgo-para-la-salud.
Tong AYC, Peake BM, Braund R. Disposal practices for unused medications around the world. Environ Int. 2011;37:292–8.
Butler CC, Rollnick S, Pill R, Maggs-Rapport F, Stott N. Understanding the culture of prescribing: qualitative study of general practitioners’ and patients’ perceptions of antibiotics for sore throats. BMJ. 1998;317:637–42.
Sorensen L, Stokes JA, Purdie DM, Woodward M, Roberts MS. Medication management at home: medication-related risk factors associated with poor health outcomes. Age Ageing. 2005;34:626–32.
Jassim AM. In-home drug storage and self-medication with antimicrobial drugs in Basrah, Iraq. Oman Med J. 2010;25(2):79–87.
Daughton CG, Ruhoy IS. Green pharmacy and pharmEcovigilance: prescribing and the planet. Expert Rev Clin Pharmacol. 2011;4(2):211–32.
Garey KW, Johle ML, Behrman K, Neuhauser MM. Economic consequences of unused medications in Houston, Texas. Ann Pharmacother. 2004;38:1165–1168.
Ley General de Salud, México, Editorial SISTA, S.A. de C.V., 2008.
Wieczorkiewicz SM, Kassamali Z, Danziger LH. Behind closed doors: medication storage and disposal in the home. Ann Pharmacother. 2013;47:82–489.
Budnitz DS, Salis S. Preventing medication overdosing in young children: an opportunity for harm elimination. Pediatrics. 2011;127(6):1597–9.
Norma Oficial Mexicana NOM-073-SSA1-2005, Estabilidad de fármacos y medicamentos. 2005.
Therapeutic Research Center. Proper disposal of expired or unwanted drugs. Pharm Lett. 2007;23(230401):1–9.
Department of Health and Human Services (US). How to Dispose of Unused Medicines: Consumer Health Information [Internet]. Silver Spring (MD): Food and Drug Administration; 1 Apr 2011 [updated 28 Jan 2014; cited 29 Jan 2014]. http://www.fda.gov/forconsumers/consumerupdates/ucm101653.htm.
Thompson CA. Return-and-disposal programs commence at health systems. Am J Health Syst Pharm. 2007;64:1254–5.
Litchfield SM. Medications in the workplace. AAOHN J. 2010;58:45–7.
Thach AV, Brown CM, Pope N. Consumer perceptions about a community pharmacy-based medication take back program. J Environ Manag. 2013;127:23–7.
Kotchen M, Kallaos J, Wheeler K, Wong C, Zahller M. Pharmaceuticals in wastewater: behavior, preferences, and willingness to pay for a disposal program. J Environ Manag. 2009;90:1476–82.
De Bolle L, Mehuys E, Adriaens E, Remon JP, Van Bortel L, Christiaens T. Home medication cabinets and self-medication: a source of potential health threats? Ann Pharmacother. 2008;42(4):572–9.
Kiyingi KS, Lauwo JAK. Drugs in the home: danger and waste. World Health Forum. 1993;14:381–4.
Edwards GPL. The family medicine cabinet. J R Coll Gen Pract. 1982;32:681–3.
Kheir N, El Haj MS, Wilbur K, Kaissi RML, Yofusif A. An exploratory study on medications in Qatar homes. Drug Healthc Patient Saf. 2011;3:99–106.
Zavaleta BM. Evaluación de la prescripción de medicamentos en los Servicios Médicos de la Universidad de las Áméricas Puebla. Tesis Licenciatura Ciencias Farmacéuticas. Departamento de Ciencias Químico-Biológicas, Escuela de Ingeniería y Ciencias, Universidad de las Américas Puebla. Mayo 2006;1:54–58.
Allen L, Ansel H, Popovich N. Pharmaceutical dosage forms and drug delivery systems. 9th ed. EUA: Ed Lippincott Williams and Wilkins; 2009.
Gómez LM, Galar M, Téllez AM, Carmona FC, Amaya A. Estudio de automedicación en una farmacia comunitaria de la Ciudad de Toluca. Rev Mex Cienc Farm. 2009;40(1):5–11.
Daugherty KK. Samples: to use or not to use? J Clin Pharm Ther. 2005;30:505–10.
Evans KL, Brown SR. Many sample closet medications are expired. J Am Board Fam Med. 2012;25(3):394–5.
Acknowledgments
The authors acknowledge Universidad Autónoma de Nuevo León, Facultad de Ciencias Químicas for providing financial assistance and research facilities to carry out this research.
Funding
The authors acknowledge Secretaría de Salud del Estado de Nuevo León (The State Health System) for providing funding to accomplish this research.
Conflicts of interest
The authors report no conflicts of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Gracia-Vásquez, S.L., Ramírez-Lara, E., Camacho-Mora, I.A. et al. An analysis of unused and expired medications in Mexican households. Int J Clin Pharm 37, 121–126 (2015). https://doi.org/10.1007/s11096-014-0048-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11096-014-0048-1