How to Dispose of Unused Medicines

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					         Consumer Health Information

How to Dispose of
Unused Medicines
    s your medicine cabinet filled with expired
    drugs or medications you no longer use?
    How should you dispose of them?

Most drugs can be thrown in the household trash, but
consumers should take certain precautions before tossing
them out, according to the Food and Drug Administra-
tion (FDA). A few drugs should be flushed down the toi-
let. And a growing number of community-based “take-
back” programs offer another safe disposal alternative.

Guidelines for Drug Disposal
FDA worked with the White House Office of National
Drug Control Policy (ONDCP) to develop the first
consumer guidance for proper disposal of prescrip-
tion drugs. Issued by ONDCP in February 2007 and
updated in October 2009, the federal guidelines are
summarized here:
• Follow any specific disposal instructions on the
  drug label or patient information that accompanies
  the medication. Do not flush prescription drugs
  down the toilet unless this information specifically
  instructs you to do so.
• Take advantage of community drug take-back
  programs that allow the public to bring unused
  drugs to a central location for proper disposal. Call
  your city or county government’s household trash
  and recycling service (see blue pages in phone book)
  to see if a take-back program is available in your
  community. The Drug Enforcement Administration,
  working with state and local law enforcement
  agencies, is sponsoring National Prescription
  Drug Take Back Days (
  throughout the United States.
• If no instructions are given on the drug label and no

Take drugs out of their original containers and mix them with
  an undesirable substance, such as used coffee grounds …
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          Consumer Health Information

 take-back program is available in            Drugs such as powerful narcotic          flushing,” says Bloom. In addition,
 your area, throw the drugs in the          pain relievers and other controlled sub-   according to the Environmental Pro-
 household trash, but first:                stances carry instructions for flushing    tection Agency, scientists to date have
 ° Take them out of their original          to reduce the danger of unintentional      found no evidence of adverse human
   containers and mix them with             use or overdose and illegal abuse.         health effects from pharmaceutical
   an undesirable substance, such             For example, the fentanyl patch, an      residues in the environment.
   as used coffee grounds or kitty          adhesive patch that delivers a potent         Nonetheless, FDA does not want
   litter. The medication will be           pain medicine through the skin, comes      to add drug residues into water sys-
   less appealing to children and           with instructions to flush used or left-   tems unnecessarily, says Hunter.
   pets, and unrecognizable to peo-         over patches. Too much fentanyl can        The agency reviewed its drug labels
   ple who may intentionally go             cause severe breathing problems and        to identify products with disposal
   through your trash.                      lead to death in babies, children, pets,   directions recommending f lush-
 ° Put them in a sealable bag, empty        and even adults, especially those who      ing or disposal down t he sink.
   can, or other container to prevent       have not been prescribed the drug.         This continuously revised listing
   the medication from leaking or           “Even after a patch is used, a lot of      can be found at FDA’s Web page
   breaking out of a garbage bag.           the drug remains in the patch,” says       on Disposal of Unused Medicines
                                            Hunter, “so you wouldn’t want to throw     (
FDA’s Deputy Director of the Office         something in the trash that contains a     Consumers/BuyingUsingMedicineSafely/
of Compliance Ilisa Ber nstein,             powerful and potentially dangerous         En sur ingSafeUse ofMe di c in e/Safe
Pharm.D., J.D., offers some addi-           narcotic that could harm others.”          DisposalofMedicines/ucm186187.htm).
tional tips:                                                                              Another environmental concern
• Before throwing out a medicine            Environmental Concerns                     lies with inhalers used by people who
  container, scratch out all                Despite the safety reasons for flushing    have asthma or other breathing prob-
  identifying information on the            drugs, some people are questioning         lems, such as chronic obstructive pul-
  prescription label to make it             the practice because of concerns about     monary disease. Traditionally, many
  unreadable. This will help protect        trace levels of drug residues found in     inhalers have contained chlorofluo-
  your identity and the privacy of          surface water, such as rivers and lakes,   rocarbons (CFC’s), a propellant that
  your personal health information.         and in some community drinking             damages the protective ozone layer.
• Do not give medications to                water supplies. However, the main way      The CFC inhalers are being phased
  friends. Doctors prescribe drugs          drug residues enter water systems is by    out and replaced with more environ-
  based on a person’s specific              people taking medications and then         mentally friendly inhalers.
  symptoms and medical history. A           naturally passing them through their          Depending on the type of prod-
  drug that works for you could be          bodies, says Raanan Bloom, Ph.D., an       uct and where you live, inhalers and
  dangerous for someone else.               environmental assessment expert in         aerosol products may be thrown into
• When in doubt about proper                FDA’s Center for Drug Evaluation and       household trash or recyclables, or may
  disposal, talk to your pharmacist.        Research. “Most drugs are not com-         be considered hazardous waste and
                                            pletely absorbed or metabolized by         require special handling. Read the
Bernstein says the same disposal meth-      the body, and enter the environment        handling instructions on the label, as
ods for prescription drugs could apply      after passing through waste water treat-   some inhalers should not be punctured
to over-the-counter drugs as well.          ment plants.”                              or thrown into a fire or incinerator. To
                                               A company that wants FDA to approve     ensure safe disposal, contact your local
Why the Precautions?                        its drug must submit an application        trash and recycling facility.
Disposal instructions on the label are      package to the agency. FDA requires,
part of FDA’s “risk mitigation” strategy,   as part of the application package,
says Capt. Jim Hunter, R.Ph., M.P.H.,       an assessment of how the drug’s use          Find this and other Consumer
senior program manager on FDA’s             would affect the environment. Some           Updates at
Controlled Substance Staff. When a          drug applications are excluded from the      ForConsumers/ConsumerUpdates
drug contains instructions to flush it      assessment requirement, says Bloom,                  Sign up for free e-mail
down the toilet, he says, it’s because      based on previous agency actions.            subscriptions at
FDA, working with the manufacturer,            “For those drugs for which envi-
has determined this method to be the        ronmental assessments have been
most appropriate route of disposal that     required, there has been no indica-
presents the least risk to safety.          tion of environmental effects due to

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