Marking Open Medications

Subject to modification by the VTH Director without approval.

Policy

To provide the process for identifying medications that have been opened but are still in use. This policy covers all medications in the VTH Medication Dispensary and throughout the VTH hospital. All medications must be marked that they are open to indicate the package does not contain the full amount. Solid dosage forms (tablets/oral liquids/powders/capsules) should be marked with an ‘X’ on the bottle. Unless the manufacturer specifies an expiration date after opening (i.e. furosemide liquid is only good for 90 days once opened), then no dating is needed, as the manufacturer’s expiration date will apply. Injectable dosage forms must be marked with an expiration date (month/day/year). No medication should be used past the expiration date marked on the packaging (handwritten or manufacturer’s date).

Guidelines

• All medications must be marked when they are opened.
• Solid dosage forms (tablets/oral liquids/powders/capsules) should be marked with an ‘X’ on the bottle. Unless the manufacturer specifies an expiration date after opening (i.e. furosemide liquid is only good for 90 days once opened), then no dating is needed, as the manufacturer’s expiration date will apply.
• Injectable dosage forms must be marked with an expiration date (month/day/year). 
• No medication should be used past the expiration date marked on the packaging (handwritten or manufacturer’s date).
•  If the manufacturer’s expiration date is shorter than the date calculated, then the shorter date applies.

Procedure (if applicable)

1. When an oral medication is opened, an ‘X’ should be marked obviously on the bottle with marker to indicate that it has been opened. If the manufacturer species how long the medication is good for once opened, then the expiration date needs to be calculated and marked on the bottle. Ideally expiration dates will be marked using an expiration date label, but a marker is also acceptable.
2. Injectable medications must have an expiration date calculated and marked on the vial when the vial is opened. If the manufacturer states a duration of use after first puncture, then that duration should be used. If the manufacturer does not specify a duration of use, then it defaults to 28 days. A list of common multi-dose injectable medications and their expiration dates once punctured is available on the Medication Dispensary intranet page at Injectable-Expiration-Dates.pdf (illinois.edu). If the medication in question is not included in the list, Medication Dispensary staff are available to help determine the correct dating.
3. When fluid bags are removed from their outer wrapping, they have limited dating. This varies based on the bag volume and potentially the manufacture but is likely between 14 and 30 days.
4. Fluid bags should not be used longer than 24 hours after puncture. When a fluid bag is first punctured, the date and time should be marked on the bag. If the bag has been hanging longer than 24 hours, then it should be discarded.

Definitions (if applicable)

Veterinary Teaching Hospital (VTH): The collective clinical services of the Large Animal Clinic, Midwest Equine, the Small Animal Clinic, and the Veterinary Medicine South Clinic.