TORONTO (CP) - If you're making plans for spring cleaning, don't forget the medicine cabinet. The all-too-human, "just in case" habit of hoarding prescription drugs is at best unwise and could endanger your health, pharmacists warn.

"It's a huge problem. People keep things around for-ev-er," says pharmacist Peter Ford, drawing out the word for emphasis. "It's really amazing what people have stored out there." Prescription drugs are expensive commodities.

Getting a prescription involves the time and effort of seeing a doctor. So some people hold on to unused drugs, figuring they may come in handy somewhere down the line.

Some think a relative or a friend might be able to use those left over painkillers. Others reckon the antibiotics they didn't finish taking might do the trick the next time the baby has an ear infection.

"Infections are a big concern," admits Janet Cooper, director of practice development for the Canadian Pharmacists Association.

"Because . . . people could share (old antibiotics) with their spouse, their kids, their parents, whatever, because they think it's the same infection. And it's not.

"And if you truly have a bacterial infection, you want to make sure you're on the right antibiotic to treat it and not on something that maybe is just covering up the symptoms but you're going to end up getting a worse infection because treatment has been delayed for a while."

Misuse of antibiotics is the key factor behind the spread of drug-resistant bacteria, which threaten public health. People prescribed a course of antibiotics should take the pills until they are done and should never hoard or share unused pills.

"We do a lot of community speaking and we always tell people: If you're not sure of the directions, ask. And don't share your medications. Because what's unique to you is unique to you and doesn't fit your neighbour," says Ford, who owns Ford's Apothecary in Moncton, N.B.

"There's lots of second- and third-generation antibiotics out there that are very specialized as far as what infections they'll treat," Cooper agrees.

People should make a habit of clearing old drugs out of their medicine chests, pharmacists say, getting rid of prescriptions they no longer use and over-the-counter drugs that have expired.

That's because drugs deteriorate with age. While most just lose their potency, some old drugs can actually make you sick.

"Tetracycline (an antibiotic) is an example of a drug that if it's past it's expiry date, it could actually be very harmful," says Cooper, "because when the chemical breaks down, it breaks down into toxic compounds."

Most prescription drugs are repackaged by pharmacists - transferred from bulk bottles to those little plastic prescription vials. Once that happens, patients have no way of knowing whether those pills gathering dust at the back of the medicine cabinet are past their best-before date.

The answer? Get rid of them.

"It should be part of spring cleaning or fall cleaning," Ford insists.

"As you're doing that, go through your medicine cabinet or your box of prescription and non-prescription drugs and just see what hasn't been touched in the last 12 months."

If you do have old drugs to dispose of, bring them to a pharmacy.

"Don't dump them down the toilet, because then they get into our environment. And if everyone was dumping little bits down there, then it could become a problem. Especially antibiotics and stuff like that," Cooper says.

"Then you get antibiotics into your water system and into the fish. And we already have too much antibiotics going into fish farms and animals. We don't need more coming in from that source and increasing the potential risk of antibiotic resistance."

Don't know whether you need a drug any more? Not sure if one is still good? Maybe it's time for a brown bag review.

People who are confused about what they ought to be taking should put all their pill vials into a bag and bring them to a pharmacist. Then she or he can go them with you, ensuring you know what to take and when, and that none of the medications is going to interact adversely with the others.

And don't forget herbal remedies and vitamins, which can interact badly with some drugs.

"For instance, we had an elderly lady . . . and she went to the health food store and they gave her a product called hawthorn for her heart, which, by itself, is pretty safe," Ford says.

"She was also on a drug for her cardiac arrhythmia. Of course, they wouldn't question her on her arrhythmia at the health food store, but I did. And the combination of her anti-arrhythmic drug that she was taking and the hawthorn could have been lethal."

You need to make an appointment for a brown bag review and you should be aware that some pharmacists will charge for the service. Ford charges $45 for a review, which takes about 30 minutes.

Cooper insists that for people on a lot of medication, a review will be money well spent. The review could lead to a reduction in the overall number of prescriptions people need to take and could shed light on some unexplained health problems.

"If you have a parent who is 75 years old who you know is having trouble with their medications, it's probably well worth the money that you'd spend to have their medications assessed. It may very well help them to live independently a lot longer," she says.

"Because if they're having medication problems, good chance they might end up in hospital and then into a nursing home . . . because it's felt that they're not coping with their medications. It might be that they're on too many. They're on too many sedatives and sleeping pills."

Some recommendations on safe use and storage of medication:

- Don't hoard unused prescription drugs. If you no longer need them, dispose of them.

- Don't give leftover prescription drugs to others.

- Ask your pharmacist to note the expiry date on prescriptions you only use sporadically, such as migraine pills.

- Don't flush used drugs down the toilet. Bring them to your pharmacist for safe disposal.

- Make sure your pharmacist knows your full drug profile. That way he or she can spot problem combinations before they make you sick.

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