Do you have expired drugs or medications that are no longer in use? How should you dispose of them?
Medicines play an important role in treating many conditions and diseases and when they are no longer needed it is important to dispose of them properly to help reduce harm from accidental exposure or intentional misuse. Below, we list some options and special instructions for you to consider when disposing of expired, unwanted, or unused medicines.
Almost all medicines can be thrown in the household trash, but consumers should take the precautions described below.
A small number of medicines may be especially harmful if taken by someone other than the person for whom the medicine was prescribed. Many of these medicines have specific disposal instructions on their labeling or patient information leaflet to immediately flush them down the sink or toilet when they are no longer needed. Many community-based drug “take-back” programs offer the best option.
Drug Disposal Guidelines and Locations
The following guidelines were developed to encourage the proper disposal of medicines and help reduce harm from accidental exposure or intentional misuse after they are no longer needed:
- In Nepal we hardly find any specific disposal instruction but if available follow specific disposal instructions on the prescription drug labeling or patient information that accompanies the medicine. Do not flush medicines down the sink or toilet unless this information specifically instructs you to do so.
- If possible take unused drugs to a central location for proper disposal, where unused medicines are specially disposed. Talk to your pharmacy shop to see if the distributor has any take-back programs in your community. Contact your city’s household trash and recycling service to learn about medication disposal options and guidelines for your area. For those staying in villages contact to the pharmacy shop is the best way to for disposal
- Transfer unused medicines to collectors registered with the Department of Drug Administration (DDA). Authorized sites may be retail, hospital or clinic pharmacies, and law enforcement locations. You can drop the expired medicine at authorized medicine distributor too. Even public health office can take your unused medicines.
- There is no proper guideline for the disposal of unused medicines but it is recommended to deposit the unused medicines to pharmacist.
If no disposal instructions are given on the prescription drug labeling and no take-back program is available, throw the drugs in the household trash following these steps:
- Remove them from their original containers and mix them with an undesirable substance, such as used coffee grounds, dirt or kitty litter (this makes the drug less appealing to children and pets, and unrecognizable to people who may intentionally go through the trash seeking drugs).
- Place the mixture in a sealable bag, empty can or other container to prevent the drug from leaking or breaking out of a garbage bag.
Some more tips:
- Scratch out all identifying information on the prescription label to make it unreadable. This will help protect your identity and the privacy of your personal health information.
- Do not give your medicine to friends or your relatives. Before giving the medicine consult doctor or pharmacist. Doctors prescribe medicines based on your specific symptoms and medical history. Something that works for you could be dangerous for someone else. Before managing and doing something, consult pharmacist.
- When in doubt about proper disposal, ask your pharmacist. Only a pharmacist or assistant pharmacist can guide you in best way.
Same disposal methods for prescription drugs could apply to over-the-counter drugs as well.
Why the Precaution?
Some prescription drugs such as powerful narcotic pain relievers and other controlled substances carry instructions for flushing to reduce the danger of unintentional use or overdose and illegal abuse.
For example, the fentanyl patch, an adhesive patch that delivers a potent pain medicine through the skin, comes with instructions to flush used or leftover patches. Too much fentanyl can cause severe breathing problems and lead to death in babies, children, pets and even adults, especially those who have not been prescribed the medicine.
“Even after a patch is used, a lot of the medicine remains in the patch,” says Jim Hunter, R.Ph., M.P.H., an FDA pharmacist. “So you wouldn't want to throw something in the trash that contains a powerful and potentially dangerous narcotic that could harm others.”
Environmental Concerns
Some people are questioning the practice of flushing certain medicines because of concerns about trace levels of drug residues found in surface water, such as rivers and lakes, and in some community drinking water supplies.
“The main way drug residues enter water systems is by people taking medicines and then naturally passing them through their bodies,” says Krity Shrestha, an environmentalist. “Many drugs are not completely absorbed or metabolized by the body and can enter the environment after passing through waste water treatment plants.” She also suggested that the regulatory agency of Nepal, specially DDA should enforce all the pharmaceutical Industry to take ISO certification 14000 for environmental management of all the wastes come out of Pharmaceutical industry. She said, "We have some guidelines as suggested by WHO, Nepal Health Research Council has prepared a guideline entitled under 'National Health Care Waste Management Guidelines, but we hardly see its proper implementation"
“Though flushing helps to mitigate the misuse of medicines, but its directly or indirectly has environment impact.We haven't seen any serious effect but it will show signs soon." Shrestha said.
“The medicinal residue present in the water sometimes helps to develop resistant in harmful bacteria and microbes ,” adds Poudel, Expert in pharmacology.
"Next challenge for human race is the antibiotic resistant bacteria, we have limited arsenal of antibiotics but due to improper management of medicines especially antibiotics, We are creating antibiotic resistant strains among us which is a new challenge for Pharmacist." Bimal prajapati, who is doing his research in medical and pharmaceutical drugs innovation at Universitair Medish Centrum Groningen, Neatherlands.
DDA has to review drug labels to identify products with disposal directions recommending flushing down the sink or toilet.
Disposal of Inhaler Products
Another environmental concern involves inhalers used by people who have asthma or other breathing problems, such as chronic obstructive pulmonary disease. Traditionally, many inhalers have contained chlorofluorocarbons (CFCs), a propellant that damages the protective ozone layer. CFCs have been phased out of inhalers and are being replaced with more environmentally friendly inhaler propellants.
Read handling instructions on the labeling of inhalers and aerosol products, because they could be dangerous if punctured or thrown into a fire or incinerator. To ensure safe disposal that complies with local regulations and laws, contact your local trash and recycling facility.
Vienna Convention for the protection of Ozone layer and Montreal Protocol ensure the decrease use of CFC gases as the alternative gases are avaliable for inhalation products.
Transfer Unused Medicine to Authorized Collectors for Disposal
Consumers and caregivers should remove expired, unwanted, or unused medicines from their home as quickly as possible to help reduce the chance that others may accidentally take or intentionally misuse the unneeded medicine.
Medicine take-back programs are a good way to safely dispose of most types of unneeded medicines. DDA do not have particular guideline but any customer can safely drop the expired, unwanted or unused medicine at local authorities or DDA office. Local Public health Office may take-back your medicines in your community. Likewise, consumers can contact their local waste management authorities, Environmentalist or Pharmacist to learn about medication disposal options and guidelines for their area.
Another option for consumers and long-term care facilities, like nursing homes, hospitals to dispose of unneeded medicines is to transfer unused medicines. Collectors safely and securely collect and dispose of pharmaceuticals containing controlled substances and other medicines. In your community, authorized collection sites may be retail pharmacies, hospital or clinic pharmacies, and Public health Office.
Consumers can visit the mail enquiry to DDA for more information about drug disposal, Consumers may also call the DDA Office at 01-4780 227,01- 4780432
Email: ddadirector@dda.gov.np or druginfo@dda.gov.np
Disposal in Household Trash
If no medicine take-back programs or DDA-authorized collectors are available in your area, you can also follow these simple steps to dispose of most medicines in the household trash:
1. Mix medicines (do not crush tablets or capsules) with an unpalatable substance such as dirt, kitty litter, or used coffee grounds;
2. Place the mixture in a container such as a sealed plastic bag;
3. Throw the container in your household trash;
4. Scratch out all personal information on the prescription label of your empty pill bottle or empty medicine packaging to make it unreadable, then dispose of the container.
Flushing of Certain Medicines
There is 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. To prevent accidental ingestion of these potentially dangerous medicines by children, or pets, it is recommended that these medicines be disposed of quickly through a medicine take-back program or by transferring them to a DDA-authorized collector. If these disposal options are not readily available, it is recommended that these medicines be flushed down the sink or toilet as soon as they are no longer needed. We have given you the list of medicines that is recommended for flushing which is as defined by US FDA, as Nepal DDA haven't made such list. Click here for a list of medicines recommended for disposal by flushing.
For example, patients in assisted living communities using fentanyl patches for pain should immediately flush their used or unneeded patches down the toilet. When you dispose of these patches and certain other powerful medicines down the sink or toilet you help to keep others safe by ensuring that these medicines cannot be used again or accidentally ingested and cause harm.
You may have also received disposal directions when you picked up your prescription. If your medicine is on the list given, and you did not receive information containing disposal instructions along with your prescription, you can find instructions on how to dispose of the medicines at DailyMed, by searching on the drug name and then looking in one of the following sections of the prescribing information:
Information for Patients and Caregivers
Patient Information
Patient Counseling Information
Safety and Handling Instructions
Medication Guide
List of Medicine you need to flush
There is 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.
This list from FDA tells you what expired, unwanted, or unused medicines you should flush down the
sink or toilet to help prevent danger to people and pets in the home. Here is the list of medicine that has to be flushed, List .
Reference:
Do you have expired drugs or medications that are no longer in use? How should you dispose of them?
Medicines play an important role in treating many conditions and diseases and when they are no longer needed it is important to dispose of them properly to help reduce harm from accidental exposure or intentional misuse. Below, we list some options and special instructions for you to consider when disposing of expired, unwanted, or unused medicines.
Almost all medicines can be thrown in the household trash, but consumers should take the precautions described below.
A small number of medicines may be especially harmful if taken by someone other than the person for whom the medicine was prescribed. Many of these medicines have specific disposal instructions on their labeling or patient information leaflet to immediately flush them down the sink or toilet when they are no longer needed. Many community-based drug “take-back” programs offer the best option.
Drug Disposal Guidelines and Locations
The following guidelines were developed to encourage the proper disposal of medicines and help reduce harm from accidental exposure or intentional misuse after they are no longer needed:
- In Nepal we hardly find any specific disposal instruction but if available follow specific disposal instructions on the prescription drug labeling or patient information that accompanies the medicine. Do not flush medicines down the sink or toilet unless this information specifically instructs you to do so.
- If possible take unused drugs to a central location for proper disposal, where unused medicines are specially disposed. Talk to your pharmacy shop to see if the distributor has any take-back programs in your community. Contact your city’s household trash and recycling service to learn about medication disposal options and guidelines for your area. For those staying in villages contact to the pharmacy shop is the best way to for disposal
- Transfer unused medicines to collectors registered with the Department of Drug Administration (DDA). Authorized sites may be retail, hospital or clinic pharmacies, and law enforcement locations. You can drop the expired medicine at authorized medicine distributor too. Even public health office can take your unused medicines.
- There is no proper guideline for the disposal of unused medicines but it is recommended to deposit the unused medicines to pharmacist.
If no disposal instructions are given on the prescription drug labeling and no take-back program is available, throw the drugs in the household trash following these steps:
- Remove them from their original containers and mix them with an undesirable substance, such as used coffee grounds, dirt or kitty litter (this makes the drug less appealing to children and pets, and unrecognizable to people who may intentionally go through the trash seeking drugs).
- Place the mixture in a sealable bag, empty can or other container to prevent the drug from leaking or breaking out of a garbage bag.
Some more tips:
- Scratch out all identifying information on the prescription label to make it unreadable. This will help protect your identity and the privacy of your personal health information.
- Do not give your medicine to friends or your relatives. Before giving the medicine consult doctor or pharmacist. Doctors prescribe medicines based on your specific symptoms and medical history. Something that works for you could be dangerous for someone else. Before managing and doing something, consult pharmacist.
- When in doubt about proper disposal, ask your pharmacist. Only a pharmacist or assistant pharmacist can guide you in best way.
Same disposal methods for prescription drugs could apply to over-the-counter drugs as well.
“Even after a patch is used, a lot of the medicine remains in the patch,” says Jim Hunter, R.Ph., M.P.H., an FDA pharmacist. “So you wouldn't want to throw something in the trash that contains a powerful and potentially dangerous narcotic that could harm others.”
Environmental Concerns
Some people are questioning the practice of flushing certain medicines because of concerns about trace levels of drug residues found in surface water, such as rivers and lakes, and in some community drinking water supplies.
“The main way drug residues enter water systems is by people taking medicines and then naturally passing them through their bodies,” says Krity Shrestha, an environmentalist. “Many drugs are not completely absorbed or metabolized by the body and can enter the environment after passing through waste water treatment plants.” She also suggested that the regulatory agency of Nepal, specially DDA should enforce all the pharmaceutical Industry to take ISO certification 14000 for environmental management of all the wastes come out of Pharmaceutical industry. She said, "We have some guidelines as suggested by WHO, Nepal Health Research Council has prepared a guideline entitled under 'National Health Care Waste Management Guidelines, but we hardly see its proper implementation"
“Though flushing helps to mitigate the misuse of medicines, but its directly or indirectly has environment impact.We haven't seen any serious effect but it will show signs soon." Shrestha said.
“The medicinal residue present in the water sometimes helps to develop resistant in harmful bacteria and microbes ,” adds Poudel, Expert in pharmacology.
"Next challenge for human race is the antibiotic resistant bacteria, we have limited arsenal of antibiotics but due to improper management of medicines especially antibiotics, We are creating antibiotic resistant strains among us which is a new challenge for Pharmacist." Bimal prajapati, who is doing his research in medical and pharmaceutical drugs innovation at Universitair Medish Centrum Groningen, Neatherlands.
"Next challenge for human race is the antibiotic resistant bacteria, we have limited arsenal of antibiotics but due to improper management of medicines especially antibiotics, We are creating antibiotic resistant strains among us which is a new challenge for Pharmacist." Bimal prajapati, who is doing his research in medical and pharmaceutical drugs innovation at Universitair Medish Centrum Groningen, Neatherlands.
DDA has to review drug labels to identify products with disposal directions recommending flushing down the sink or toilet.
Disposal of Inhaler Products
Another environmental concern involves inhalers used by people who have asthma or other breathing problems, such as chronic obstructive pulmonary disease. Traditionally, many inhalers have contained chlorofluorocarbons (CFCs), a propellant that damages the protective ozone layer. CFCs have been phased out of inhalers and are being replaced with more environmentally friendly inhaler propellants.
Read handling instructions on the labeling of inhalers and aerosol products, because they could be dangerous if punctured or thrown into a fire or incinerator. To ensure safe disposal that complies with local regulations and laws, contact your local trash and recycling facility.
Vienna Convention for the protection of Ozone layer and Montreal Protocol ensure the decrease use of CFC gases as the alternative gases are avaliable for inhalation products.
Transfer Unused Medicine to Authorized Collectors for Disposal
Consumers and caregivers should remove expired, unwanted, or unused medicines from their home as quickly as possible to help reduce the chance that others may accidentally take or intentionally misuse the unneeded medicine.
Medicine take-back programs are a good way to safely dispose of most types of unneeded medicines. DDA do not have particular guideline but any customer can safely drop the expired, unwanted or unused medicine at local authorities or DDA office. Local Public health Office may take-back your medicines in your community. Likewise, consumers can contact their local waste management authorities, Environmentalist or Pharmacist to learn about medication disposal options and guidelines for their area.
Another option for consumers and long-term care facilities, like nursing homes, hospitals to dispose of unneeded medicines is to transfer unused medicines. Collectors safely and securely collect and dispose of pharmaceuticals containing controlled substances and other medicines. In your community, authorized collection sites may be retail pharmacies, hospital or clinic pharmacies, and Public health Office.
Consumers can visit the mail enquiry to DDA for more information about drug disposal, Consumers may also call the DDA Office at 01-4780 227,01- 4780432
Email: ddadirector@dda.gov.np or druginfo@dda.gov.np
Disposal in Household Trash
If no medicine take-back programs or DDA-authorized collectors are available in your area, you can also follow these simple steps to dispose of most medicines in the household trash:
1. Mix medicines (do not crush tablets or capsules) with an unpalatable substance such as dirt, kitty litter, or used coffee grounds;
2. Place the mixture in a container such as a sealed plastic bag;
3. Throw the container in your household trash;
4. Scratch out all personal information on the prescription label of your empty pill bottle or empty medicine packaging to make it unreadable, then dispose of the container.
Flushing of Certain Medicines
There is 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. To prevent accidental ingestion of these potentially dangerous medicines by children, or pets, it is recommended that these medicines be disposed of quickly through a medicine take-back program or by transferring them to a DDA-authorized collector. If these disposal options are not readily available, it is recommended that these medicines be flushed down the sink or toilet as soon as they are no longer needed. We have given you the list of medicines that is recommended for flushing which is as defined by US FDA, as Nepal DDA haven't made such list. Click here for a list of medicines recommended for disposal by flushing.
For example, patients in assisted living communities using fentanyl patches for pain should immediately flush their used or unneeded patches down the toilet. When you dispose of these patches and certain other powerful medicines down the sink or toilet you help to keep others safe by ensuring that these medicines cannot be used again or accidentally ingested and cause harm.
You may have also received disposal directions when you picked up your prescription. If your medicine is on the list given, and you did not receive information containing disposal instructions along with your prescription, you can find instructions on how to dispose of the medicines at DailyMed, by searching on the drug name and then looking in one of the following sections of the prescribing information:
Information for Patients and Caregivers
Patient Information
Patient Counseling Information
Safety and Handling Instructions
Medication Guide
List of Medicine you need to flush
There is 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.
This list from FDA tells you what expired, unwanted, or unused medicines you should flush down the
sink or toilet to help prevent danger to people and pets in the home. Here is the list of medicine that has to be flushed, List .
Reference: