# Drugs after Expiry Use or Chuck? New Research



## MarkofSeaLife (Nov 7, 2010)

During a long cruise some drugs expire and they can be hard to replace in weird countries, and very expensive in others (USA!!!).

We have had a couple of threads where its mentioned. Some folks think that asprin a day after expiry will kill you quick smart. Others think they last forever.

There's a new paper out showing none turn toxic. Dry drugs, tablets are usually fine for many years, maybe 5 years. Liquid drugs may have the dose slowly taper off. (One still OK 50 years later!

This paper discusses some of the drugs we have on boats including Epipens etc.

So your comments, especially from the Quacks on the forum would be appreciated









https://m.medicalletter.org/w1483b



> 2650 of 3005 lots (~88%) of 122 different products stored in their unopened original containers remained stable for an average of 66 months after their expiration date. Of these, 312 lots (~12%) remained stable for >4 years after the expiration date. Failure on the basis of potency, pH, water content, dissolution, physical appearance, or presence of impurities occurred in 479 lots (~18%), but none failed within 1 year.


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## Rhapsody-NS27 (Apr 8, 2012)

interesting. I've usually heard they're good for a while after they're considered expired but the strength starts to go down after some time.

I would wonder how strict things would get if some law enforcement official sees expired drugs and try making you throw them out immediately. Personally, I figure if they look ok and not dissolving from humidity, then hold onto them a little longer. Sometimes, having something on hand is better than nothing.


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## tdw (Oct 2, 2006)

Speaking to my GP about this he reckoned that very few if any meds turn toxic with age, rather that they (as mentioned) may not work quite as well. 

Otoh, in recent years I've begun suffering mal de mere at the beginning of any passage. Never happened to me before so I went looking for a cure. Found a pill recommended by various souls mainly involved with fishing that is made up by a compounding chemist (pharmacist) in Sydney. Biggest supposed advantage being no drowsiness. I got hold of some but by the time I needed to take one they were out of date by a month or so. No sea sickness but I became monumentally depressed. Suicide Tuesday had nothing on this. Spoke with chemist afterwards and they could not explain the depression other than that it had something to do with the use by date having passed. I guess all I'm saying is to be careful. Me, I just hang over the side for a couple of hours each trip. Hell, if you keep the lee rail dipped it is even self cleaning. 

(I may have posted this in one of the other meds threads. If so, apologies for bringing it up again.)


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## hellosailor (Apr 11, 2006)

So, the case of original CocaCola that I've been keeping stashed away for a special occasion, probably no longer has any active cocaine in it? Will it still be fizzy, at least?

"A study of eight products that had been stored in their unopened original containers for 28-40 years past expiration found that 12 of 14 active ingredients had retained ≥90% of their original potency; aspirin retained <5% of its potency and amphetamine <60%."
Who'd have guessed that aspirin was less stable than amphetamines?


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## tdw (Oct 2, 2006)

Which reminds me ..... tonic water ..... contains quinine so good for anyone who gets a touch of malaria, or used to be. Nowadays not enough in it to do much good but be warned, if you leave it past use by date the quinine does whatever aged quinine does and you are left with nowt but soda water. All very tragic for those who love a gin or vodka tonic ... taken for medicinal purposes only ... of course.


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## jephotog (Feb 25, 2002)

Drugs expire based on loosing their efficacy by a certain percentage. I believe this is a very small percentage. 

I generally only see the Dr when I am really sick and only take the meds when absolutely needed, so my meds often expire. My wife goes through my medicine cabinet and throws away my meds that are a few years old. After my recent medical mishap I may play it a little more conservative.


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## travlin-easy (Dec 24, 2010)

Sure wish my wife would go through the cabinets and throw stuff away! 

Gary


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## northernsquirrel (Oct 26, 2015)

so, I really think that it depends on the medication, format it is in, etc. So a synthroid tab has a less than a year shelf life. triiodothyronine (T3) is like 3-6 months. crude thyroid- couple months. Wellbutrin is not a stable one either once out of original packaging. like less than a year. antibiotics tablets should be fine, keep them dry and cool. use the oxygen absorber/ dessicant in a sealed container and you're away to the races. I don't think that digoxin is all that stable, and given how it has to be dosed very carefully, I'd be very cautious around that one. Morphine or other painkillers- very stable, can keep for years. liquids or suspensions, no way. Pediatrics suspension of antibiotics,once it's made up, it's only two weeks and it's done.

My daughter's epipen - 70 bucks a pop we keep them around for one extra year, then it goes back to the pharmacy. However, you can run into a problem if you forgot the darn thing at home. So, go into the local farmacia, ask for epinefrina; for 2 bucks, you get an ampule, and a syringe and an alcohol wipe if you want it really fancy. You break off the neck of the ampule, draw up the med into the syringe, knock out the excess air bubbles and inject intramuscularly. the ampule is good for five years. keep out of sunlight. As long as you're OK with the low tech way of administering it, then go for it. My first aid kit is being slowly amassed and will include a list of meds and when they will expire.

amusing story- pulling on a set of examination gloves of the sterile flavour. first one came apart at the wrist, second one came apart at the fingers third one was so glued together that we threw out the whole lot. This was in a major teaching hospital that had a lot of stock rotation. message: the meds can probably last a while. the plastic bandaids, exam gloves, adhesive tape, etc doesn't. If your first aid kit is the same vintage as the boat, the gauze and cotton bandage stuff is probably fine. but check the adhesive and rubber stuff- you might be surprised....


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## SloopJonB (Jun 6, 2011)

For the most part, "best before" dates are a legal ass covering exercise with only a tenuous connection to product lifespan.

I've noticed they are even on canned goods now which is complete B.S. as canned goods are about as eternal as our fiberglass boats - maybe more so, as long as the can is intact.


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## Minnewaska (Feb 21, 2010)

Good to finally see new research. The problem is knowing whether what you have aboard is in the 88% or 12%. I want the drug to work, or I wouldn't bring it, not just know it hasn't become dangerous.

Generics are the real crap shoot. The active ingredient is the same. However, each different generic manufacturer can put whatever inactives they choose for pill size, solubility, etc. Hard to test all the combos.

I'm sure there is planned obsolescence by the manufacturer and, of course, we all want effective drugs on the market before they receive decades long shelf life testing.


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## Sal Paradise (Sep 14, 2012)

This is good, but for anyone who is self prescribing like this, read all you can, everything you can find on the side effects both immediate and long term and potential risks, including interactions. If you are going to be your own physician then go all the way and do your homework. 

Also, opioid type pain killers such as oxycodene - you should hide really well or get rid of. There is risk and you would hate to get someone's kid addicted accidentally. I have a big bottle of these at home that I never used and I am thinking I should get rid of them. I could leave them in my drawer for years, but if some friend of the kids finds them, who knows.....


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## colemj (Jul 10, 2003)

SloopJonB said:


> For the most part, "best before" dates are a legal ass covering exercise with only a tenuous connection to product lifespan.
> 
> I've noticed they are even on canned goods now which is complete B.S. as canned goods are about as eternal as our fiberglass boats - maybe more so, as long as the can is intact.


In the case of pharmaceuticals, the testing methodology, criteria, labeling and enforcement of use by dates are strictly prescribed and executed by government regulation bodies. There is no CYA by the manufacturer.

We recently pulled out two can goods 1-2yrs past their expiration that were like balloons, so I wouldn't put those in the same category as a fiberglass boat.

Well, maybe Don's and Smack's Hunters, of course... :laugh

Mark


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## travlin-easy (Dec 24, 2010)

Mark, there is a huge difference between the actual life span of canned food and medications - which you obviously discovered with your ballooning cans. Most of the canned foodstuffs that tend to go bad usually involve tomatoes. Why that is I do not know, but that's been the experience of myself and many others I know.

As for drugs, they never seem to increase in potency, just slowly, slowly decrease if effectiveness. However, I have some nitro tablets that expired 4 years ago. I keep them in a hermetically sealed, key ring container so they are with me at all times, just in case of an emergency. One day, about 3 months ago, I was showing clear signs of a possible heart attack. I placed that old, out of date, nitro beneath my tongue and within minutes, my blood pressure dropped like a stone. Fortunately, a quick visit to my cardiologist revealed that I did not have another heart attack, but those nitro tablets were still quite potent 4 years out of date - go figure!

All the best,

Gary


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## Don L (Aug 8, 2008)

colemj said:


> Well, maybe Don's and Smack's Hunters, of course... :laugh
> 
> Mark


You are either misinformed or have been taking expired drugs. Food never goes bad on a Hunter! :thewave:


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## colemj (Jul 10, 2003)

travlineasy said:


> Mark, there is a huge difference between the actual life span of canned food and medications - which you obviously discovered with your ballooning cans. Most of the canned foodstuffs that tend to go bad usually involve tomatoes. Why that is I do not know, but that's been the experience of myself and many others I know.
> 
> As for drugs, they never seem to increase in potency, just slowly, slowly decrease if effectiveness. However, I have some nitro tablets that expired 4 years ago. I keep them in a hermetically sealed, key ring container so they are with me at all times, just in case of an emergency. One day, about 3 months ago, I was showing clear signs of a possible heart attack. I placed that old, out of date, nitro beneath my tongue and within minutes, my blood pressure dropped like a stone. Fortunately, a quick visit to my cardiologist revealed that I did not have another heart attack, but those nitro tablets were still quite potent 4 years out of date - go figure!
> 
> ...


In our case, they were canned peaches.

I wasn't commenting on the lifespan of drugs - just pointing out that the determination of that date was a mandated regulatory issue, and not a CYA or planned obsolescence profit motive by the manufacturers.

Mark


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## colemj (Jul 10, 2003)

Don0190 said:


> You are either misinformed or have been taking expired drugs. Food never goes bad on a Hunter! :thewave:


So their owners balloon before the cans do?

Mark


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## NautiG (Apr 23, 2007)

Old Tetracycline and Doxycycline can cause liver and/or kidney damage. I would be especially careful taking old antibiotics. If you are going to take an expired medication, best to do a little research about the med first. Also, why not check your supply once a year for expiring meds and replace? I'd rather spend a few $ to make sure my medical kit was up to date, rather than be on dialysis and need a new kidney.

Scott
Gemini Catamaran Split Decision


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## Waterrat (Sep 8, 2007)

My wife is a pharmacist and works at a very busy pharmacy. She executes recalls at least once a week due to loss of efficacy for active ingredients before expiration date. As has been said it is specific to each drug and heavily dependent on proper storage. Some expired drugs are still good, some are basically placebo, and some can hurt you and even kill you. Your physician will probably be helpful but double check with a pharmacist. There are many mistakes made with medications.


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## hellosailor (Apr 11, 2006)

Gary-
Tomatoes tend to be a canning (or tinning) problem because of their acidity, I'm told. They'll eat through can linings before more "neutral" foods.
Funny thing about those keyring pill holders, they all seem to be cheap thin aluminum these days, the stainless ones disappeared from the market.


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## Don L (Aug 8, 2008)

colemj said:


> So their owners balloon before the cans do?
> 
> Mark


It's a danger of being able to have cold beer.


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## grnrngr (Oct 8, 2014)

+1 on the tetracycline/doxycycline going bad. I dealt with some pharmaceuticals as a veterinary technician, we kept a close eye on expiry dates as we could return them for credit as long as they were within 30 days of expiry. With some drugs, the pharm companies relabel and sell outside the US, others are just disposed of. Theoretically, the drug is supposed to remain viable for up to 90 days after expiration but as has been pointed out, not all drugs last to their expiry, and some last forever. Research carefully.


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## travlin-easy (Dec 24, 2010)

My keyring holder is aluminum, however, it has an O-ring seal and apparently does a good job. I lost my stainless keyring holder several years ago and couldn't find another like it.

As far as things going bad, from my experience and my background in medicine, nothing seems to go bad faster than the human body. I was pretty schvelt (old Jewish term) when I was in my 20s, but shortly after being introduced to life in the fast lane, body parts just seemed to go to Hell in a hand-basket. After some of the bad parts were removed, and I got the Hell out of the medical field, life seemed a bit better, but it's still a downhill slope that increasingly gets a bit steeper every year. Funny thing about that! 

Now, according to the SLEP study, most antibiotics, including tetracycline and other derivatives, usually have a shelf life of 1 years, but properly stored in air-tight containers and at the correct temperatures, can last up to 5 years of longer. As far as liver and kidney damage due to taking out of dates antibiotics, I could not find any verifiable studies in the medical journals. 

I guess I need to continue to self medicate with Margarettas. 

All the best,

Gary


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## Brent Swain (Jan 16, 2012)

hellosailor said:


> So, the case of original CocaCola that I've been keeping stashed away for a special occasion, probably no longer has any active cocaine in it? Will it still be fizzy, at least?
> 
> "A study of eight products that had been stored in their unopened original containers for 28-40 years past expiration found that 12 of 14 active ingredients had retained ≥90% of their original potency; aspirin retained <5% of its potency and amphetamine <60%."
> Who'd have guessed that aspirin was less stable than amphetamines?


Yes, I heard of that study on CBC radio, and have suggested to politicians trying to give us a national pharmacare program that ,if several governments would pool their resources to research the real expiry days on drugs, they could reduce the cost of such a program drastically. They could widely publicize the results, and save us all fortune on the expiry date scam.
When asked about problems with old drugs, drug companies pointed to one study, 52 years ago, where they had a problem with old tetracycline. When asked for any other examples, they had none to offer.


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## Brent Swain (Jan 16, 2012)

travlineasy said:


> My keyring holder is aluminum, however, it has an O-ring seal and apparently does a good job. I lost my stainless keyring holder several years ago and couldn't find another like it.
> 
> As far as things going bad, from my experience and my background in medicine, nothing seems to go bad faster than the human body. I was pretty schvelt (old Jewish term) when I was in my 20s, but shortly after being introduced to life in the fast lane, body parts just seemed to go to Hell in a hand-basket. After some of the bad parts were removed, and I got the Hell out of the medical field, life seemed a bit better, but it's still a downhill slope that increasingly gets a bit steeper every year. Funny thing about that!
> 
> ...


Thanks god I'm only "over the hill," instead of "under the hill!"


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## travlin-easy (Dec 24, 2010)




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## miatapaul (Dec 15, 2006)

Sal Paradise said:


> This is good, but for anyone who is self prescribing like this, read all you can, everything you can find on the side effects both immediate and long term and potential risks, including interactions. If you are going to be your own physician then go all the way and do your homework.
> 
> Also, opioid type pain killers such as oxycodene - you should hide really well or get rid of. There is risk and you would hate to get someone's kid addicted accidentally. I have a big bottle of these at home that I never used and I am thinking I should get rid of them. I could leave them in my drawer for years, but if some friend of the kids finds them, who knows.....


Way back when I was in college, I had some skin grafts done on my hand and one of the pain killers given to me was Tylenol 4 and codeine makes me very sick to my stomach. So I only took one or two. The rest were in the medicine cabinet and a friend found them during a party in the dorm and was running around saying he was the candy man handing them out. All in good fun, as it was NOT OXY, but is really scary looking back. Ironic part is the guy who did that is now (at least to my knowledge) a practicing physician! So I say yes, get rid of them, never know if someone breaks into the house and ODs on them I know while not your fault, you being a human being would feel awful.



colemj said:


> In the case of pharmaceuticals, the testing methodology, criteria, labeling and enforcement of use by dates are strictly prescribed and executed by government regulation bodies. There is no CYA by the manufacturer.
> 
> We recently pulled out two can goods 1-2yrs past their expiration that were like balloons, so I wouldn't put those in the same category as a fiberglass boat.
> 
> ...


Seems that would be more an indictment of steel boats, not fiberglass unless the peaches were canned in some sort of fiberglass can! :wink

Back on topic:
Well biggest thing I see is that boats don't really have very good temperature control, especially for those cruising to warmer climates. So while those kept in controlled temperature may well be fine 50 years after manufacture, I doubt those on a cruising boat in the tropics would be. One day 100 degrees 120% humidity, then a trip to Maine and it is 0 degrees, not going to be good for medications, and they may well not make it to there normal expiration dates.


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## colemj (Jul 10, 2003)

Brent Swain said:


> Yes, I heard of that study on CBC radio, and have suggested to politicians trying to give us a national pharmacare program that ,if several governments would pool their resources to research the real expiry days on drugs, they could reduce the cost of such a program drastically. They could widely publicize the results, and save us all fortune on the expiry date scam.
> When asked about problems with old drugs, drug companies pointed to one study, 52 years ago, where they had a problem with old tetracycline. When asked for any other examples, they had none to offer.


Once again, and this time please pay attention, there is no expiry date scam. The date is not set by the manufacturer - government regulatory bodies specifically prescribe the testing methodology, the interpretation of results and the labeling of the product.

In other words, governments HAVE researched the real expiry dates on every drug produced. There is no "general" date - they are experimentally determine for not only each individual drug, but for each dose level and each formulation of every single drug.

While one can argue that the drug still has some variable level of potency long after the ex date, that is besides the point and does not point to a "scam". Drugs MUST have a tightly known potency and efficacy when they are administered. A physician does not, and should not, want to take wild guesses at what level a dose is being delivered. For those needing drugs like warfarin or certain critical antibiotics, even a slight variation in dose will kill them.

Expiry studies are not guessed at, and it is very easy to do controlled studies 10yrs out in a matter of days using accelerated conditions and statistical methods. These types of studies are done in many industries from mechanical parts, paints, etc. One doesn't need to wait 10yrs to know exactly how something will behave over that time.

Unless you can point to a reference source, your last sentence is pure BS that you made up on the spot and presented as a "fact" to support your personal paranoid views.

Mark


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## Brent Swain (Jan 16, 2012)

UBC based Therapeutic Intitiatives is a non profit drug testing organization, which tests new drugs and their side effects. Being non profit, and taking no money from the drug companies, they are a considered one of the most reliable sources of such info in the world. 
They were highly doubtful of any benefits from Statins , made by Pfiser. Do a search and check it out yourself. Statins made Pfiser 30 billion dollars a year.
Two elections ago ,Pfiser gave huge donations in BC to the right wing politicoes , who thanked them by shutting Therapeutic Initiatives out of the drug testing programs in BC. Both Ontario and Quebec asked Therapeutic Initiatives to come and work for them.
Only recently have Therapeutic initiatives been allowed back into testing drugs in BC.
Pfisers patented statin Lipitor , was claimed to have worked by reducing blood cholesterol. Now that the patent has expired , the US FDA has released its food recommendations, with m no mention of cholesterol, except for a small note, stating that dietary cholesterol has nothing to do with blood cholesterol. Right after the patent expired? Co-incidence?
Pfiser made 30 billion dollars a year off Lipitor, it's patented statin.
With patent law , patent holders are required to disclose enough information to allow an exact copy of the drug to be made the day the patent expires. So any new generics are exact copies of the original. So why do some doctors insist the original, at 5 times the price of generics, are better? For the free trip to the Bahamas which drug companies buy the doctors who prescribe enough of their snake oil?
Health Canada ,responsible for testing drugs for the government, had 1/10th the staff and funding of the gun registry. Which is, statistically the greatest threat to you?How reliable is their understaffed effort, with a government ready to can them if they cost their drug company sponsors money?


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## MedSailor (Mar 30, 2008)

travlineasy said:


> . As far as liver and kidney damage due to taking out of dates antibiotics, I could not find any verifiable studies in the medical journals.


Try the search term "Fanconi Syndrome." with Tetracycline. It was something that popped up in a few case reports in the 60s, 70s and 80s. The data and case reports since then have been quite thin.

I tossed my bottle of Doxycycline that I kept in the boat kit because it's easy enough to replace and I don't want to take the risk that Fanconi Syndrome is a real thing. On the other hand, if I were in mortal peril and had no access to anything else I'd take it and not be too scared.

MedSailor


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## Minnewaska (Feb 21, 2010)

Brent Swain said:


> ......So any new generics are exact copies of the original.......


This statement is actually untrue. The active ingredient is identical and the standard is +/- 10% of the published dosage. The rest of the medicine is usually very different and entirely up to the specific manufacturer.

When the active ingredient makes up the majority of the pill size, for example, it's pretty unlikely the rest matters much. However, in some cases, the active ingredient is very small and the rest are either designed to create a manipulable pill size or intentionally impact absorption rates. For some drugs, it makes zero difference, for others, it matters.

The generics are also regulated, but it's not true that they are all exact copies.

(all learned from my son who is a chemist and used to work for a generic manufacturer.)


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## Brent Swain (Jan 16, 2012)

I once built a boat for a couple of doctors ,one of whom was the BC chief medical officer.They were equally skeptical of the drug industry, whom they considered corporate scammers.


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## travlin-easy (Dec 24, 2010)

Brent is fairly accurate on this - most of the generics are very, very close to the original. I know this from 15 years working in medicine.

Gary


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## colemj (Jul 10, 2003)

I'm not sure what Brent's purpose was with his Pfizer/lipitor post, but it terribly mangles some facts, and seemingly intentionally presents coincidence as something nefarious.

At the height of its sales, lipitor made Pfizer $13 billion a year, not 30. 

At the time of discovery and development of lipitor (and all the other statins from other companies), cholesterol was widely believed to play a major role in heart disease, and lowering it was thought to be a front line therapy. Statins were brought to market in this environment.

During the 20 years spanning the discovery of statins and lipitor going off patent, scientific research advanced to question the actual role and importance of cholesterol in vascular disease. While cholesterol seems to still play a role, the disease is more complicated than just that, and solely lowering cholesterol or avoiding it in diet is not a magic bullet.

This isn't even the coincidence that Brent proclaims, as most of the major studies that changed opinions occurred years before lipitor lost patent protection. Indeed, lipitor sales (as well as all other statins) declined yearly and regularly during this time specifically because of this new understanding. A 5 minute search of company reports will confirm this.

Likewise with FDA food guidelines. Brent's faulty tin foil hat leads him to postulate that a single company has control over the FDA, but a more reasonable person would recognize that even off patent, lipitor still makes money and it would not serve Pfizer well to "allow" the FDA to publish guidelines downplaying cholesterol. No, the only logical conclusion is that the FDA makes their recommendations based on current science, and drug companies don't hold them in their palms.

Generics may or may not be exact duplicates - that is highly variable and specific to the drug and the company. Many patent drug formulations use proprietary formulations and/or manufacturing techniques. These are either patented, or held as trade secrets, and can not be copied by others. In these cases, there remains a difference between the patent and generic versions - not in efficacy, but in convenience or dosage method. For instance, a patent version may use proprietary time release formulation that requires only one pill a day, while a generic may require a pill every 6hrs.

As for why patent versions still sell after losing protection, that has very little to do with physicians wanting a Bahamas vacation, and almost all to do with the patients themselves demanding the name brand. Corn flakes, TV's and other goods are no different in this regards.

Really Brent, you come across as having a lot of paranoia, but a bit of googling to check your "facts" and a little rational thinking would help you here.

Mark


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## Minnewaska (Feb 21, 2010)

colemj said:


> ......almost all to do with the patients themselves demanding the name brand. Corn flakes, TV's and other goods are no different in this regards......


This is so true and advertising is what needs to be stopped. Direct pharmaceutical sales incentives have been reeled in to some degree. It's not just the name brand, but the patients are demanding medication they wouldn't otherwise know existed. Patients doctor shop until one will give them the drug they want. Opioid dispensing is the worst and directly related to the heroine epidemic. In most cases of abuse, the opioid script is funded by govt programs. Claims of chronic soft tissue pain can not be disproven. Booze cost money, but opioids are free on govt programs.

But, we're getting off topic. Everyone should do their own research on all these topics and not just take the word from online political rants or advice from reported nebulous medical backgrounds.


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## momoparagon (Jan 16, 2012)

So, this may be a ridiculous question, but...what about finding a bit of mold on medication. Would you dust it off and still take it? And I'm not talking about crazy black mold or something that looks as though it is about to jump several steps up the evolutionary ladder. Just a bit of fuzz on a couple of pills. 

I wonder if that would have any ill effects. I'm sure it's not optimal, but in a pinch...?


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## travlin-easy (Dec 24, 2010)

Never, in my entire lifetime, have I ever seen mold on any type of medication - NEVER! Now, I do know individuals that cut the mold off old cheese to where they find none, then eat that cheese. Don't think I would do that, either. 

Gary


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## RichH (Jul 10, 2000)

Here's some insite on 'shelf life' of pharmacological agents

A. liquid medication shelf-life is dependent on:
1. the statistical probability that bacteria, mold, funguses, etc. due to cellular growth, using the medication or inert carriers as a nutrient source, will be present in sufficient numbers (titre) to become a potential hazard. 
2. Degradation of Potency/efficacy - oxidation and other ongoing chemical, etc. reactions

B. Tableted, etc. medications
1. Degradation of Potency/efficacy - oxidation and other ongoing chemical, etc. reactions

With most all ethical drugs, during the validation phase of development/manufacture, the establishment of shelf life is among the chief considerations, especially the area of 'auto-contamination'/degradation by 'organisms', even for 'sterile' medications.


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## travlin-easy (Dec 24, 2010)

RichH said:


> Here's some insite on 'shelf life' of pharmacological agents
> 
> A. liquid medication shelf-life is dependent on:
> 1. the statistical probability that bacteria, mold, funguses, etc. due to cellular growth, using the medication or inert carriers as a nutrient source, will be present in sufficient numbers (titre) to become a potential hazard.
> ...


Rich, that sounds like it was written by a politician running for office and dodging a tough question from the press. :eek

Gary :2 boat:


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## RichH (Jul 10, 2000)

With all due respect to you - utter and total BS!!!!! 
What I _summarized_ is standard stability (biological and chemical) FDA "cGMP" (regulatory Good Manufacturing Practice - "the law"). If you had any ethical involvement with pharmacologicals or their administration, you'd KNOW this, sorry.


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## MarcStAug (Nov 2, 2014)

As a guy who badly injured his knee last week and can't get to the orthopedic guy until Monday, my 2008 vintage Hydrocodone worked just fine and was a "sleep-saver" for me. Wonder if certain types of drugs last longer than others? i.e. Pain meds last longer than antibiotics, etc?


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## travlin-easy (Dec 24, 2010)

RichH said:


> With all due respect to you - utter and total BS!!!!!
> What I _summarized_ is standard stability (biological and chemical) FDA "cGMP" (regulatory Good Manufacturing Practice - "the law"). If you had any ethical involvement with pharmacologicals or their administration, you'd KNOW this, sorry.


C'mon Rich - be nice. I was just havin fun with ya.

As for my medical credentials, well how about 15 years as technical director of the Cardio-Pumonary Divisions at The Johns Hopkins and University of Maryland Hospitals. I've administered more drugs than I would like to remember, while administering life support during open heart surgery using a pump oxygenator. I also administered anesthesia during those procedures and all the drugs mandated by the surgeons. And, yes, I am quite aware of the FDA mandates for ALL medications I worked with. As for ethical involvement, I'm really not sure what you are referring to, but I can be enlightened.

All the best,

Gary  :2 boat:


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## momoparagon (Jan 16, 2012)

travlineasy said:


> Never, in my entire lifetime, have I ever seen mold on any type of medication - NEVER!


Ahhh, I'll see if I can upload a picture for you then. (✿◠‿◠) I opened a bottle of medication (just loose in the bottle, not separately sealed in packaging) and there was the lightest little peach fuzz on the pills. I'm glad I was just doing a spot check and didn't actually need it, however, I'm wondering if there would be ill effects if I had.

I'm going to see about replacing it since we're currently in a town with good services, but that is not always the case. If we're in the middle of nowhere and I need some medication, I think I'll just risk the upset stomach...or worse? Just wondering what the worse might be...


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## hellosailor (Apr 11, 2006)

If there was fresh mold on my penicillin, which in itself IS just mold...I think I might go into business raising it and growing it. More likely it would mean I'd gotten counterfeit and the mold was from a gross contaminant though.

With the pharmacies often going to those "snap packs" conveniently individually entombed "for your convenience" (unless you like to pack light, don't have lots of shelf space, or have arthritis, or don't want to re-fondle every pill while placing them all in some other dispenser or case) ignoring the fact that the snap packs allow them to be dispensed 3x faster with zero inventory shrinkage or miscounts...They even last longer when packaged that way.

But if someone, ah, purveyed my meds and OD'd on them? I'd just call that Karma, and I've got the badge and credentials that prove I'm a licensed agent of Karma, with endorsements to help Santa give out coal when the other elves are all wrapping toys, too.

Look, when Big Pharma tells me that I have to pay $10 a pill for something that someone overseas pays 10c for, because somehow, I have to pay for the R&D and the other guy has no obligation to do so? Right, don't piss on my head and tell me it is raining.

The FDA are politicians, the AMA are union bosses, and Big Pharma are wildly successful Capitalists. Somehow, none of that gains my trust.

A friend of mine was down in Panama five year ago and had a script for a dirt cheap malarial preventive, I forget the name. He went down again this year, and instead of a nickel a pill, it was more like a dollar a pill. Same stuff, sold worldwide, but all of a sudden priced wildly higher in the US market. And so much more profitable, if you can convince people to throw out last year's bottle and buy a new one, because the old one WILL KILL THEM.
FUD.


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## colemj (Jul 10, 2003)

Penicillin is not mold. It is derived from a compound produced by a very specific species of mold.

Likewise, aspirin is not a tree...

It seems like I am wasting my breath here attempting to get people to use their brains. Expiration dates are NOT a scam, a CYA, nor a capitalistic ploy. If you believe that, then by all means demand expired drugs next time you need them.

Mark


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## hellosailor (Apr 11, 2006)

Mark, I think we all agree that some of them are for real. After all, only Twinkies are forever.

Using our brains also means that expiry dates are not the writing of the flaming finger of the lord. As the Defense Department's own extensive testing _has proven_.

The drug industry says "Use by...and we don't know what happens after that, because the drugs are in an uncontrolled environment." The DoD says "Yeah, well, we KNOW what happens to certain drugs in a reasonable environment, they often still work for a decade after the expiry date."

So, you think the DoD are lying, and when the drug industry says they just _don't know, _ that somehow contradicts the findings?


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## Minnewaska (Feb 21, 2010)

Put the average joe in an empty room. Make that any joe that isn't a pharmacist or chemist. I will bring you whatever base materials and equipment you ask for, but no instructions. You have to figure out how to make a non-poisonous chemical that will kill a bacteria or shrink a prostate. Have at it. What do you need?

The system isn't perfect, but modern pharma is nearly a miracle in my book.


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## colemj (Jul 10, 2003)

hellosailor said:


> Mark, I think we all agree that some of them are for real. After all, only Twinkies are forever.
> 
> Using our brains also means that expiry dates are not the writing of the flaming finger of the lord. As the Defense Department's own extensive testing _has proven_.
> 
> ...


You have missed my points. Drug stability studies are not magic guesswork or throwing of hands in the air. They are science and fact. There is a reason for that expiration date, and that reason is that the drug can no longer be guaranteed to be what the manufacturer originally put in the packaging (plus or minus a valid statistical margin).

You have also missed the fact that the drug companies themselves don't get to determine these things. Regulatory agencies worldwide require and prescribe the testing and labeling. Of course, I realise you believe there is a world wide conspiracy of these agencies being in bed with the companies and the politicians.

This has absolutely nothing to do with whether the drug is still safe or still has therapeutic efficacy. This is the point you and many others are failing to grasp. These stability studies are valid and the resulting dates are real - there is no conspiracy to uncover and no additional profits to be made.

After all, 99% of all drugs are completely used in the course of a therapy, and the remainder are used outside of the healthcare market place (taking a couple of left over pills when your back hurts, when you weren't going to a doctor to get a new prescription anyway). So where is this huge extra profit scam - they already sold you the pills, and you wouldn't be buying new ones anyway?

Can you imagine the lawsuits if people were finding out that their 100mg therapies were really randomly ranging from 50-100mg, with no way of knowing exactly what they were taking at any point?. Can you imagine the harm if certain drugs with extremely tight therapeutic indexes like warfarin, anesthesia, or certain antibiotics were dosed this way? Or if a time release formulation has become variable and the whole dose gets dumped in the wrong area of the gut?

Do you even understand this subject and what you are talking about? Or is it all just "big corporations are screwing us" paranoia?

Heck, bakers won't even use yeast that they aren't guaranteed 100% activity so that they know exactly what effect they will obtain when they use it.

Please link to the DOD study, along with the pharma companies' statements and responses (there are many more than one of these companies, you know - I don't know which one you have thrown up statements from as a general "fact"). If they exist, I bet you have misunderstood or misrepresented them.

Mark


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## MarkofSeaLife (Nov 7, 2010)

Again it looks like lots of coments without looking at the latest paper that was in the first post.

So a gentle dig... please have a read 

https://m.medicalletter.org/w1483b

No value in a paper if people don't read it but just churn out their previous beliefs. Scientists change knowledge with new evidence, and I have always believed doctors (as my sister is one) are scientists...

Mark


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## colemj (Jul 10, 2003)

OK, seems like HS was referring to that article. His presentation implied a different study with a more forceful conclusion along the lines of "we caught those lying bastards red handed". The article lists no drug company responses or statements.

Nothing in that article goes against any of the points I have tried to make (reinforces them, actually), nor does it suggest or point to any type of conspiracy, scam or profit motive throughout the world governments and industries. It also doesn't point to a general truth that all drugs are safe and effective well past their expiration dates.

There is also nothing scientifically new in that article. It is only exploring the statistical tightness around expiration date setting. This has been well known in the industry for many years. The difference is that the manufacturers rightly use tighter criteria. They are not concerned with ">90%" efficacy, they are concerned with 100%.

Surely this is understandable?

I again ask the question, if pharmacists were allowed to sell drugs many years past their expiration dates, how many of you would be clamoring for them? Even if they were half price?

I have very carefully avoided addressing whether it is ok to use things past their ex date - most people have empirical experiences with common drugs to judge for themselves and their individual circumstances. While someone with a back ache may get by fine taking a couple of left over pain pills, I doubt anyone on warfarin, insulin, or with a life threatening infection would feel the same. I doubt even HS would be ok with 2yr out of date anesthesia being used on him.

I have only attempted to address the tin foil hat brigade. There is no conspiracy or profit motive - particularly no world wide government/industry one - and these stability studies are scientifically and statistically valid and controlled (and highly regulated - the companies simply cannot just slap on any date they wish).

Mark


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## colemj (Jul 10, 2003)

BTW, if you think 122 drugs is "extensive testing", then you really don't understand the industry, the science or the medical practice.

This probably falls on deaf ears, but be very, very careful about drawing generalities in this matter. 

Mark


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## MarkofSeaLife (Nov 7, 2010)

colemj said:


> BTW, if you think 122 drugs is "extensive testing", then you really don't understand the industry.
> 
> This probably falls on deaf ears, but be very, very careful about drawing generalities in this matter.
> 
> Mark


In the realm of long distance cruising on a budget I think it shows that people setting off initially with new drugs on board do not need to be worried when their meds expire in mid-Pacific.



Frank.


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## RichH (Jul 10, 2000)

*Mark* - thats an excellent article that well summarizes the 'stability' (shelf life) issue of pharmaceuticals. A MUST READ for those who have interest ... *and doubts*. AND ... as that article states - once that container/packaging is opened, all bets are off as to stability and efficacy of the drug.

Excellent response also from *colemj*, especially inferring that many drugs, etc. found in 3rd world countries are 'knock offs' and counterfeits, and many are severely contaminated, or at 'different' potencies, etc. .... mostly produced by the unscrupulous, which sometimes includes the unscrupulous participation of 3rd world governments.


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## colemj (Jul 10, 2003)

Who is Frank?

Again, that is not a blanket truth, as I'm sure anyone using warfarin and insulin will tell you (two of the most common drugs in use).

FWIW, we have expired antibiotics and pain medication on board. I'm not being a shill here - just trying to bring common sense to the forefront.

Mark


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## colemj (Jul 10, 2003)

RichH said:


> *Mark* - thats an excellent article that well summarizes the 'stability' (shelf life) issue of pharmaceuticals. A MUST READ for those who have interest ... *and doubts*. AND ... as that article states - once that container/packaging is opened, all bets are off as to stability and efficacy of the drug.
> 
> Excellent response also from *colemj*, especially inferring that many drugs, etc. found in 3rd world countries are 'knock offs' and counterfeits, and many are severely contaminated, or at 'different' potencies, etc. .... mostly produced by the unscrupulous, which sometimes includes the unscrupulous participation of 3rd world governments.


Thank you, but I wasn't inferring anything about counterfeits, nor addressing them in any way. That is a different topic altogether. I was addressing known, major pharmaceuticals and companies.

Mark


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## colemj (Jul 10, 2003)

MarkofSeaLife said:


> In the realm of long distance cruising on a budget I think it shows that people setting off initially with new drugs on board do not need to be worried when their meds expire in mid-Pacific.
> 
> 
> 
> Frank.


In the realm of industry profits and motives, long distance cruisers who stockpile a few (mostly generic) drugs mean diddly squat - even if they could be forced to buy whole new batches when expired.

The conspiracies, scams and extra profits just aren't there folks.

Mark


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## hellosailor (Apr 11, 2006)

Mark, the DoD study I mentioned was in the Wall Street Journal. Probably two or three months ago now. I don't recall if it was the DoD, or just the Army, much less what the URL would be, and you'd have to be a WSJ subscriber to access their articles so a URL wouldn't necessarily help you.

I know the drug companies and the FDA are looking out for my health, just like the states of NJ and Illinois were trying to protect me by requiring a trained gas station operator to pump gas in my car, so I couldn't blow myself up. And yet, somehow, knowing what a burn ward is, I still find it reasonable to pump my own gas.

Make no mistake about it, the bug drug companies are chartered for-profit publicly owned corporations, and their LEGAL responsibility is first and foremost, to make money for the shareholders. _Anything _that can maximize that profit, is fair game.

Now, what's that nice man's name, who took the fifth amendment last week rather than explain to Congress why he bought a drug company making an old drug, and jacked the price up several thousand percent "to fund future development" ? 
Or isn't he "big enough" pharma?

I take the trouble to store my meds carefully, optimally. In cool dark dry places, sealed up nice and tight. I wouldn't take a chance on twenty year old whatevermycin, but if I have a choice between no antibiotic, or one that is two years past date but has been carefully stored and is available at hand? I've got no problem with that. NO ONE, including the FDA and the manufacturer, is willing to go one record and state "That drug will definitely be less effective or dangerous." (And we're not talking about epipens here.)


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## colemj (Jul 10, 2003)

hellosailor said:


> Mark, the DoD study I mentioned was in the Wall Street Journal. Probably two or three months ago now. I don't recall if it was the DoD, or just the Army, much less what the URL would be, and you'd have to be a WSJ subscriber to access their articles so a URL wouldn't necessarily help you.
> 
> I know the drug companies and the FDA are looking out for my health, just like the states of NJ and Illinois were trying to protect me by requiring a trained gas station operator to pump gas in my car, so I couldn't blow myself up. And yet, somehow, knowing what a burn ward is, I still find it reasonable to pump my own gas.
> 
> ...


OK, I'm done arguing against spittle-flecked, bat crap crazy paranoia. Particularly that filled with logical fallacies for every argument. They are all out to get you, and they are playing you like a fiddle. It's all a coordinated scam, and you would be better off with no regulation of the industry at all.

But don't worry, you have it figured out. :thumb:

Mark


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## hellosailor (Apr 11, 2006)

Yeah, me and the Department of Defense, both suffering under the same delusion that someone at the drug companies is trying to do the job they are charged with doing: taking our money any way they can.


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## Minnewaska (Feb 21, 2010)

Here's my learned take away from reading all the posts, as well as the linked articles........... Some drugs may retain much of their potency beyond their expiration dates, depending entirely on how they were stored and at what temps and whether they are growing mold.

In other words, no one has any idea whether the particular drugs in your particular boat are any good or not.


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## travlin-easy (Dec 24, 2010)

Minnewaska said:


> Here's my learned take away from reading all the posts, as well as the linked articles........... Some drugs may retain much of their potency beyond their expiration dates, depending entirely on how they were stored and at what temps and whether they are growing mold.
> 
> In other words, no one has any idea whether the particular drugs in your particular boat are any good or not.


And, for the most part, no one is going to become seriously ill because they took drugs that were properly stored, but out of date. So, that pretty much mutes this entire thread that has obviously gone awry. Lets be honest, if you sincerely believe that taking out of date drugs will do you harm, then don't take the damned things. If you feel otherwise, you are going to take them regardless of what is posted in this thread. 

Good luck on whatever you decide upon,

Gary :2 boat:


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## Minnewaska (Feb 21, 2010)

travlineasy said:


> And, for the most part, no one is going to become seriously ill because they took drugs that were properly stored, but out of date. So, that pretty much mutes this entire thread that has obviously gone awry. Lets be honest, if you sincerely believe that taking out of date drugs will do you harm, then don't take the damned things. If you feel otherwise, you are going to take them regardless of what is posted in this thread. .....


As is the case for most everything in the entire forum. Just a discussion.

As for me, I'm more interested in whether they remain potent, than whether they will cause harm. I'm fairly convinced, they won't cause harm, if stored properly. I would rather know they worked. No way to interpolate these studies to a specific sample aboard my boat.


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## hellsop (Jun 3, 2014)

travlineasy said:


> Never, in my entire lifetime, have I ever seen mold on any type of medication - NEVER! Now, I do know individuals that cut the mold off old cheese to where they find none, then eat that cheese. Don't think I would do that, either.


Avoid rind cheeses like brie then... Those come with mold by default.


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## hellosailor (Apr 11, 2006)

Actually, "real" blue cheese is infested with a mold that is so similar to penicillin that people with penicillin allergies are told not to eat it. And the mold is grown on bread crumbs, so people with wheat allergies are also told not to eat it.

A number of "moldy" cheeses are the same.

But in general, a hard cheese (like swiss, cheddar, edam, gouda) is fairly impervious, you can always safely cut off mold. A soft cheese, or a porous one, may have unseen mold penetrating it, so there's so very simple and safe logic about not throwing out all moldy cheeses. (Toss out any "processed" cheese with mold.)

A lot of folks take an alternative, if the mold is just surface, wash it off with vinegar. Then rinse with water to get the vinegar taste off, and pat try with clean (sterile) paper towels. Most manufactured paper products (even unopened newspapers) are fairly sterile, having come from heavy bleaching and steaming operations, wound in a clean room on a tight roll, and shipped in a plastic skin.

If you've ever bought "wedge" sliced cheese in a supermarket, they often mishandle it with bare hands while cutting. And you'll find moldy green handprint growing where they held the cheese, while cutting the wedges.


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## MarkofSeaLife (Nov 7, 2010)

hellosailor said:


> Actually, "real" blue cheese is infested with a mold that is so similar to penicillin that people with penicillin allergies are told not to eat it. And the mold is grown on bread crumbs, so people with wheat allergies are also told not to eat it.
> 
> A number of "moldy" cheeses are the same.
> 
> But in general, a hard cheese (like swiss, cheddar, edam, gouda) is fairly impervious, you can always safely cut off mold. A soft cheese, or a porous one, may have unseen mold penetrating it, so there's so very simple and safe logic about not throwing out all moldy cheeses. (Toss out any "processed" cheese with mold


Scientists are wondering if the mold on blue cheese is what's keeping the French healthy.
It may just turn out that stinky blue cheese and starting to drink red wine at midday - and not stopping - maybe the path to great health!

We can only hope!


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## travlin-easy (Dec 24, 2010)

Mark, I had the same hopes about Margarettas - plus some others, neither of which seems to have been beneficial, but after three Margarettas I have no way of telling. 

All the best,

Gary


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