Disposal of Unused Medicines (January 2015)

CAPT Kremzner: What do you do with medications
that have not been used or are out of date? When they are no longer needed, it’s important
to dispose of them properly to avoid harm to others. Hi, I’m Captain Mary Kremzner and this is
Drug Info Rounds, brought to you by the pharmacists in the FDA’s Division of Drug Information. I’m joined today by two FDA pharmacists,
Commander Ray Ford and Dr. Henry Yu, who will discuss medication disposal options and some
special disposal instructions for you to consider when throwing out expired, unwanted, or unused
medicines. CDR Ford let’s start a discussion with the
medicine take-back programs. CDR Ford: Medicine disposal through take-back
programs is a good way to remove expired, unwanted, or unused medicines from the home
and reduce the chance that others may accidentally take the medicine. The local city or county government’s household
trash and recycling services are good contacts to inquire about medicine take-back programs
in the community. Dr. Yu: Also, the U.S. Drug Enforcement Administration’s
website contains information on the National Prescription Drug-Take Back Events. You can access this information from the DEA’s
home page. CAPT Kremzner: If there are no medicine take-back
programs in the area, will you explain how most medicines can be disposed of in the household
trash? Dr. Yu: As long as local laws and ordinances
allow for medicines to be legally disposed of in household trash, medicines should be
mixed, NOT crushed, with an unpalatable substance such as kitty litter or used coffee grounds. Then the mixture should be placed in a container
such as a sealed plastic bag. The entire container is thrown in the household
trash. Before throwing out a medicine container,
such as a pill bottle, remember to scratch out all information on the prescription label
to make it unreadable. CDR Ford: It is also important to remember
that loose needles or other sharp objects should not be disposed of in household or
public trash cans or recycling bins. Sharp objects should never be flushed down
the toilet. This practice puts trash and sewage workers,
janitors, housekeepers, household members, and children at risk of being harmed. Sharps should always be disposed of in a sharps
container. CAPT Kremzner: There are a small number of
medicines that may be especially harmful and, in some cases, fatal with just one dose if
they are used by someone other than the person for whom the medicine was prescribed. Will you discuss how to properly dispose of
these medications? CDR Ford: To prevent accidental ingestion
by children, pets, or anyone else, a few medicines have specific disposal instructions indicating
they should be flushed down the sink or toilet as soon as they are no longer needed. Dr. Yu: FDA has published a list of medicines
recommended for disposal by flushing. This list can be found on FDA’s website
by searching for two key words – “disposal” and “flushing.” As an example, patients in assisted living
communities using fentanyl patches should fold the used or unneeded patch in half so
that the sticky sides meet, and immediately flush it down the toilet. This ensures that these medicines cannot be
used again or accidentally ingested and cause harm. CDR Ford: If a medicine has specific disposal
instructions, that information is typically included in the product’s Information for
Patients and Caregivers, Patient Information, Patient Counseling Information, Safety and
Handling Instructions, or the Medication Guide section. CAPT Kremzner: A common question that FDA
receives is in reference to flushing medicines down the toilet or the sink drain and the
possible risk to human health and the environment. Dr. Yu: The majority of medicines found in
the water system are a result of the body’s natural routes of drug elimination, meaning
in the urine or feces. Disposal of these select medicines by flushing
contributes only a small fraction of the total amount of medicine found in the water. Scientists, to date, have found no evidence
of harmful effects to human health from medicines in the environment. CDR Ford: When a medicine take-back program
isn’t available, FDA believes that any potential risk to people and the environment from flushing
this small, select list of medicines is outweighed by the real possibility of life-threatening
risks from accidental ingestion of these medicines. CAPT Kremzner: FDA remains committed to working
with other federal agencies and pharmaceutical manufacturers to develop alternative, safe
disposal policies. If you have additional questions about medication
disposal, call or email FDA’s Division of Drug Information.

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