Do Ivermectin and Mebendazole Expire?

Yes. Ivermectin and mebendazole both expire: manufactured tablets carry an expiration date, and compounded preparations, like the ones dispensed through Get It Prescribed, carry a beyond-use date set by the compounding pharmacy. The FDA says that once the expiration date has passed there is no guarantee a medicine will be safe to use, and that if your medicine has expired, you should not use it.

This page explains where to find the date, why it matters, how to store these two medicines until then, and how to get rid of tablets or capsules you no longer need. It is general education, not medical advice, and it does not cover dosing.

Where to find the date on your medicine

The FDA began requiring an expiration date on prescription and over-the-counter medicines in 1979. It says the date is printed on the label or stamped onto the bottle or carton, sometimes after the letters "EXP." The FDA calls the expiration date a critical part of deciding whether a product is safe to use, and it advises sticking to it.

Compounded preparations are labeled a little differently. A compounding pharmacy assigns each compounded preparation a beyond-use date, often shortened to BUD, under the United States Pharmacopeia (USP) standard for nonsterile compounding, General Chapter 795. USP's published answers about that standard say a pharmacy can extend the beyond-use date of a compounded nonsterile preparation only up to a maximum of 180 days, and only when a stability study supports it.

What this means for you:

• Brand-name or generic tablets from a retail pharmacy: look for the expiration date on the bottle, carton or blister pack.
• Compounded preparations: look for the beyond-use date on your prescription label. The ivermectin tablet and the 222 mg mebendazole capsule dispensed through Get It Prescribed are compounded preparations, so the date that applies is the one on your own label.
• Can't find a date? Ask the pharmacy that filled the prescription before you take it.

Why the date matters

The FDA explains that expired medicines can change in chemical makeup or lose strength over time, and that some expired medicines are at risk of bacterial growth. That is why its advice is simple: if your medicine has expired, do not use it.

Keeping an old bottle around also carries a second risk. The FDA notes that medicines left in the home can injure children and pets if taken by mistake, which is one reason it encourages people to clear out medicines they no longer need. MedlinePlus adds that you should not let anyone else take your medicine.

How to store ivermectin and mebendazole until the date

Storage affects whether a medicine stays in good condition up to its date. The FDA says improper storage, such as a damp bathroom cabinet, can harm a medicine before its posted expiration date. MedlinePlus gives the same storage directions for both medicines:

• Keep the medicine in the container it came in, tightly closed.
• Store it at room temperature, away from excess heat and moisture, and not in the bathroom.
• Keep it out of sight and reach of children. Many containers are not child-resistant, so lock safety caps and put the medicine somewhere up and away.

The prescribing information for the brand-name products also gives temperature ranges. The ivermectin tablet label says to store it below 30°C (86°F). The mebendazole chewable tablet label says to store it at 68°F to 77°F (20°C to 25°C). Those ranges describe the brand-name products. For a compounded preparation, follow the storage directions on your own prescription label.

For most medicines, the FDA suggests a cool, dry place such as a dresser drawer, a storage box, a closet shelf or a kitchen cabinet away from the stove and the sink, where temperature and humidity change.

How to get rid of expired ivermectin or mebendazole

Don't flush them. MedlinePlus says not to flush ivermectin or mebendazole down the toilet. The patient information for the brand-name mebendazole chewable tablet also says to safely throw away medicine that is out of date or no longer needed.

The FDA's preferred options are, in order:

• A drug take-back location. Many retail, hospital and clinic pharmacies, and some law enforcement offices, have drop boxes or kiosks. The Drug Enforcement Administration (DEA) also runs National Prescription Drug Take Back Day events. Your pharmacist can tell you about take-back programs near you.
• A prepaid drug mail-back envelope. These are sold at retail pharmacies and online, and some pharmacies give them out at no cost. Seal your unused or expired medicine inside and mail it.

If neither option is available, the FDA says most medicines that are not on its flush list can go in the household trash:

• Take the tablets or capsules out of the original container.
• Mix them with something unappealing, such as used coffee grounds, dirt or cat litter.
• Put the mixture in a sealed bag, an empty can or another container that closes.
• Throw the container in your trash at home.
• Scratch out your personal information on the empty bottle or label before you throw it away.

If you have a question about a specific medicine, the FDA suggests asking your health care professional or pharmacist.

Getting a prescription through Get It Prescribed

Get It Prescribed is a telehealth service for adults. A licensed provider reviews a written health assessment, including your current medicines, and decides whether ivermectin or mebendazole is appropriate for a labeled use. Ivermectin's labeled uses are intestinal strongyloidiasis and onchocerciasis (river blindness). Mebendazole's labeled uses are intestinal infections caused by pinworm, roundworm, whipworm and hookworm. No prescription is guaranteed, and the provider may recommend testing or an in-person visit instead. How it works shows each step.

The medicines dispensed through Get It Prescribed are compounded preparations made by a licensed compounding pharmacy. They are not FDA-approved, the FDA has not reviewed them for safety, effectiveness or quality, and they are not generics of, or substitutes for, the brand-name products. The storage ranges quoted above come from the prescribing information for the brand-name products.

The cost is a one-time $50 provider consultation fee, plus $3.00 per ivermectin tablet or $3.50 per mebendazole capsule if a prescription is issued, with the quantity decided by the provider. The service is available in all 50 states and the District of Columbia; some states require a live phone or video visit.

This article is general education, not medical advice. It does not replace an evaluation by a licensed clinician who knows your history.

Related questions

Where is the expiration date on a medicine bottle?

The FDA says the expiration date is printed on the label or stamped onto the bottle or carton, sometimes after the letters "EXP." On a compounded preparation, look for the beyond-use date on the prescription label.

What is a beyond-use date on a compounded medicine?

It is the date a compounding pharmacy assigns to a compounded preparation under the USP standard for nonsterile compounding. USP's published answers say it can be extended only up to a maximum of 180 days, and only with a supporting stability study.

Can I take ivermectin after the expiration date?

The FDA says there is no guarantee a medicine is safe to use once its expiration date has passed, and that you should not use expired medicine. Ask your pharmacist or provider if you are unsure about a date.

How should I store mebendazole capsules?

MedlinePlus says to keep mebendazole in its original container, tightly closed, at room temperature, away from excess heat and moisture, not in the bathroom, and out of reach of children. Follow any storage directions on your own prescription label.

Can I flush expired worm medicine down the toilet?

Not ivermectin or mebendazole. MedlinePlus says not to flush either one. Use a drug take-back location or a mail-back envelope, or, if neither is available, the FDA's household trash steps.

Sources

• FDA: Don't Be Tempted to Use Expired Medicines — expiration dates required since 1979; where the date is printed ("EXP"); no guarantee after the date; do not use expired medicine; changes in chemical composition, decreased strength, bacterial growth; storage in a cool, dry place, not a damp bathroom; take-back, mail-back and trash options.
• FDA: Where and How to Dispose of Unused Medicines — take-back locations, DEA Take Back Day, prepaid mail-back envelopes, household trash steps, scratching out personal information.
• MedlinePlus: Ivermectin — storage and disposal: original container, room temperature, away from heat and moisture, not in the bathroom, out of reach of children, do not flush, use a take-back program.
• MedlinePlus: Mebendazole — the same storage and disposal directions for mebendazole.
• DailyMed: ivermectin tablet prescribing information — store below 30°C (86°F); labeled uses.
• DailyMed: mebendazole chewable tablet prescribing information — store at 68°F to 77°F (20°C to 25°C); safely throw away medicine that is out of date; labeled uses.
• USP: General Chapter 795 frequently asked questions (PDF) — compounded nonsterile preparations are assigned a beyond-use date; extension only up to a maximum of 180 days with a stability study.
• FDA: Compounding and the FDA — Questions and Answers — what compounded preparations are and how they are regulated.