Do Inhalers Expire?

Yes, inhalers do expire as each inhaler has a manufacturer’s expiry date. However, the medicine within the inhaler does not lose its potency completely after the expiry date.

If the inhaler is stored according to recommendations, the medicine will retain most of its potency even past the expiry date.

Introduction

A survey by Asthma UK found that of the 2.3 million people in England suffering from asthma who have to pay for prescriptions, 76% say that they struggle to afford the costs.1

This has led people with asthma to skip their medication or resort to using inhalers after their expiry date. Throughout this article, the different types of inhalers, their proper storage, disposal and use beyond their expiry date will be discussed. 

The 3 most important takeaways are:

  1.  Inhalers come with expiry dates.
  2.  There are no adverse effects from using an expired inhaler.
  3. The efficacy of medicines in an expired inhaler is diminished.

Types of inhalers

Inhalers are devices that hold medicine needed for you to take in. You usually take in the medicine by simply breathing in from the inhaler. At the moment, inhalers are the main treatment for asthma.

There are 3 main types of inhalers for asthma patients.2 The medicine found inside these inhalers goes straight into your airways.

Reliever inhaler (or rescue inhaler)

  • Reliever inhalers are taken when asthma symptoms flare up. These symptoms include feeling tight-chested, breathlessness, or wheezing.
  • This asthma medication relaxes the muscles in the airways.
  • The 2 main reliever drugs used are salbutamol (albuterol) and terbutaline.
  • Salbutamol inhalers (also known as albuterol inhalers) contain the albuterol sulfate which is an active drug in different asthma inhaler medications such as Proair HFA, Proventil HFA, or Ventolin HFA.
  • The reliever inhaler usually comes in a blue coloured case.

Preventive inhaler

  • Used daily by asthma patients to prevent their symptoms from flaring up.
  • It is a steroid inhaler so there might be side effects from long-term use of high doses of this steroid.
  • Always seek medical advice from a healthcare professional before using a preventative inhaler.

Long-acting bronchodilator inhaler

  • It works the same way as the reliever inhaler but the effect lasts for up to 12 hours.
  • Your healthcare provider may advise the use of both a long-acting bronchodilator inhaler and steroid inhaler as they are part of the MART regime (Maintenance and Reliever Therapy).
  • This is usually the case if your symptoms of asthma or chronic obstructive pulmonary disease (COPD) cannot be fully controlled by a single inhaler.
  • Always make sure that your healthcare professional or asthma nurse explains the MART regime clearly to you.

Inhaler devices

There are separate devices used to deliver asthma medication. There are 4 major groups of inhaler devices:2

  • Pressurized metered-dose inhalers (MDIs)
    • These are the most widely used inhalers.
    • Each dose of medication is released by pressing the top of the inhaler.
  • Breath activated inhalers
    • These are alternatives to the standard MDIs.
    • You don’t need to press at the top of the inhaler.
    • You trigger a dose by simply breathing in at the mouthpiece.
  • Inhalers with spacer devices
    • Spacer devices are placed between the inhaler and the mouth.
    • They overcome the challenges of using MDIs properly.
  • Nebulisers
    • Turns the liquid form of asthma medication into a fine mist.
    • The mist becomes an inhalation aerosol.
    • Nebulisers are used by patients suffering from severe asthma attacks.

Lifetime of inhalers 

The inhaler has 2 main parts: a plastic actuator and a metal canister. Both parts should last for up to 6 months after you remove them from their packaging.3

However, like many other medications, the albuterol sulfate drug will lose its potency over time.

How are inhaler expiration dates determined?

Researchers carry out experiments by exposing the medicines to heat, light, and humidity to observe how the drug reacts and changes over time. Although any drug potency will decrease over time, most medications tend to retain much of their potency.

The Institute for Safe Medication Practices (ISMP) has highlighted that if medicines are stored according to the guidelines, the medicine will retain at least 70 – 80% of their potency for several years past the expiry date.4

Tips for proper storage of inhalers

  • Keep the inhaler in its original packaging if possible.
  • Store it at a temperature between 15°C and 30°C.
  • Keep the inhalers away from light and moisture.
  • Avoid damage to the canister. For added protection, always place the inhaler in a box or padded bag.
  • Always replace the cap after use.

Can you use an expired inhaler?

Is it harmful?

It is safe to use it for 12 months after the expiry date. However, the effectiveness is not guaranteed once the expiration date has passed.4

What are the side effects?

There are no adverse effects from using an expired inhaler. Nonetheless, you may not be able to control your asthma symptoms as effectively because the active ingredients in the medication break down and lose their potency.

How do I know my inhaler has expired? 

The expiration can be easily found on the box or the foil packaging of your inhaler. You can also find it on the label attached to your metal canister.3 

Proper disposal of inhalers

Used or expired inhalers cannot be just thrown away into the bin as there may still be remaining drug products in the inhaler. Therefore, this can lead to the inhaler exploding when it is compacted or heated for too long.5

As most expired inhalers are treated as hazardous waste, the easiest procedure to dispose of them is to return them to your local chemist.

Summary

Inhalers used to treat asthma do expire and have the manufacturer’s expiry date on the box or metal canister. Nonetheless, it is generally safe to use an albuterol sulfate inhaler for 12 months after the expiry date; however, the potency of the medicine cannot be assured once the expiry date is passed.

References

  1. Independent Nurse [Internet]. London: MA Healthcare Ltd; 2019. Asthma: sufferers skip doses due to expense; 2019 Feb 27 [cited 2022 Mar 26]
  2. Patient.info [Internet]. Leeds: Egton Medical Information System Limited; 2018. Asthma Inhalers; 2018 Feb 20 [cited 2022 Mar 26]
  3. UK Health Centre [Internet]. [place unknown]. Expiration of the Ventolin Inhaler; [cited 2022 Mar 26]
  4. Five Star Nursing [Internet]. [place unknown]. Is an Inhaler Good after Expiration?;[cited 2022 Mar 26]
  5. MedProDisposal [Internet]. Illinois: MedProDisposal; 2016. How to Dispose of Expired Inhalers; 2016 Oct 19 [cited 2022 Mar 26]

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Vijendran Santhirasegaran

Master's degree - Instructional Design and Technology, Nanyang Technological University, Singapore
Santhirasegaran has 9 years of experience in the private equity industry. As such, he has worked with others to raise capital for seed and start-up investments such as health tech start-ups.
He is passionate about health and fitness. Moreover, he is intrigued by preventive healthcare and longevity studies. Santhirasegaran is a Chartered Financial Analyst (CFA Charterholder), and a fellow member of the Association of Chartered Certified Accountants (FCCA).https://www.linkedin.com/in/v-santhirasegaran-72b24921a/

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