This rapid review confirms that strict global guidelines are available for use of expired primary health care drugs on the essential medicines list. There are World Health Organisation (2011) and Partnership for Quality Medical Donations (2018) guidelines for drug donations; the Pan American Health Organisation’s recommendations for humanitarian aid provide additional guidance for drug donors (2009). Many LICs/LMICs have adapted the WHO guidelines to their own situations, and limited data is available on ‘expected’ or ‘acceptable’ levels of drug expiry or common standards.