Cleaning out the medicine cabinet probably is not what you were thinking of doing Christmas Eve; it's probably not something you particularly want to do any time at all.
And that's exactly why you ought to do yourself a favor by getting rid of the medicinal leftovers as soon as you can: Unlike aged wine, aged medicine can be hazardous to your health.
It's easy enough to figure out what to get rid of. In this state, all drugs -- prescription and over-the-counter -- are labeled with expiration dates. Just like the expiration date on milk and cheese and other foods, they're your notification of the point when the quality is likely to fade.
"There are changes that might not be in the best interest of the patient," warns Larry Augsburger, professor and chairman of the department of pharmaceutics at the University of Maryland School of Pharmacy.
"You can expect a loss of potency," he says. "And you can expect some physical changes in the drug that might affect the bioavailability -- it might not disintegrate as readily as it's supposed to."
The third problem, he says, is drugs deteriorate over time: Simple aspirin degrades to an acid that really irritates the stomach; out-dated tetracycline can become toxic.
Not that you should have your shelves full of old antibiotics anyway: If you've got them sitting around, that means you didn't take as many as your doctor wanted you to, which also means you might not have killed all the bacteria that were making you sick, says Donald O. Fedder, associate professor and director of community pharmacy programs at the University of Maryland Pharmacy School.
"One of the biggest problems is that people tend to stop taking them when they feel better, but their symptoms go away before all the bugs are killed," he says. And that leaves the individual open to reinfection, as the remaining pathogens marshal their forces and continue the attack.
Those few little tablets still stuck in the bottom of the bottle aren't going to do you any good at this point, anyway. But human nature being what it is, a lot of us have a hard time with the idea of flushing unused medicine down the toilet; given the cost of drugs these days, it's like tossing money in a stream.
But, tell the truth, now: What else are you going to do with old medicine? Swallow it on your own? Pass it on to your friends?
You don't need another lecture on how dangerous it is to give your medicine to others. And everyone knows the person who diagnoses and treats himself has a fool for a patient.
"If you start from the perspective that there is legitimacy to the requirement that an authorized prescriber [doctor, dentist, podiatrist, for instance] has to make the determination, the decision by a patient to take a leftover drug is inappropriate," Dr. Fedder warns.
"But if you have recurring symptoms, like allergies or pain, and you have leftover drugs prescribed for those problems, and the drugs are within the expiration date, and they have been stored safely -- as long as all those things are true -- there's nothing wrong with retaining and reusing those drugs," he says. "But the greater the potency, the greater the danger, and if the drug is a narcotic, a reasonable, intelligent person might call the doctor and say, 'I've got this leftover drug for pain. Do you think it's OK to take it?' "
If cleaning the medicine cabinet has joined your list of New Year's resolutions, here's another thing to remember: Out with the old should not be followed by in with the new.
"The medicine cabinet is a terrible place to keep medicine," because the heat and humidity in the bathroom can hasten the natural degradation of the drugs, Dr. Augsburger says. You don't have to refrigerate them, unless the label tells you to, he continues, but you should find another place in your house, cooler and drier than the bathroom, where drugs can be kept out of the reach of children.