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  9. Drug Disposal: Flush Potentially Dangerous Medicine
  1. Disposal of Unused Medicines: What You Should Know

Drug Disposal: Flush Potentially Dangerous Medicine

Check the flush list for select medicines you can immediately get rid of by flushing

If you received specific disposal instructions for your old, unused, unwanted, or expired medicine, you should follow those instructions to dispose of it.

If not, you should immediately flush the medicine down the toilet* only if

 

Drug Disposal2
 
FDA Flush List: Medicines recommended for disposal by flushing only when take back options are not readily available

Medicines on this flush list 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 they were prescribed. An example of such a drug is the fentanyl patch, which is an opioid.

Immediately flushing these types of medicines down the toilet helps keep children, pets, and other individuals safe by making sure these powerful and potentially dangerous drugs are not accidentally ingested, touched, or misused.

The FDA flush list tells you which old, unwanted, expired, or unused medicines to immediately flush only when take back options are not readily available.

Links in the flush list direct you to specific disposal instructions in each medicine’s label.

 
 
Printable version of this list (PDF; Revised April 2018)
Active Ingredients Found in Brand Names (Click links to view medicine instructions)
Benzhydrocodone/ Acetaminophen Apadaz
Buprenorphine Belbuca, Bunavail, Butrans, Suboxone, Subutex, Zubsolv
Fentanyl Abstral, Actiq, Duragesic, Fentora, Onsolis
Diazepam Diastat/ Diastat AcuDial rectal gel
Hydrocodone Anexsia, Hysingla ER, Lortab, Norco, Reprexain, Vicodin, Vicoprofen, Zohydro ER
Hydromorphone Dilaudid, Exalgo
Meperidine Demerol
Methadone Dolophine, Methadose
Methylphenidate Daytrana transdermal patch system
Morphine Arymo ER, Embeda, Kadian, Morphabond ER, MS Contin, Avinza
Oxycodone Combunox, Oxaydo (formerly Oxecta), OxyContin, Percocet, Percodan, Roxicet, Roxicodone, Targiniq ER, Xartemis XR, Xtampza ER, Roxybond
Oxymorphone Opana, Opana ER
Tapentadol Nucynta, Nucynta ER
Sodium Oxybate Xyrem oral solution

NOTE: For disposal information on other types of prescription and over the counter medications (such as antibiotics) that are not on this flush list, 

  • First, find your medication on MedlinePlus. Once you get to your medication page, click on “What should I know about storage and disposal of this medication?” to get this information. Visit MedlinePlus now.

 

*Impact of flushing medicines on the environment

FDA recognizes that the recommendation to flush certain potentially dangerous medicines only when a take back option is not readily available raises questions about the impact of the drugs on the environment and the contamination of surface and drinking water supplies.

In an effort to address this concern, FDA staff published a paper entitled "Risks Associated with the Environmental Release of Pharmaceuticals on the U.S. Food and Drug Administration ‘Flush List’". This paper evaluates the environmental and human health risks associated with the flushing of 15 active ingredients found in these medicines. Although FDA concluded that these medicines present negligible risk to the environment, some additional data would be helpful for confirming this finding for some of the medicines.

FDA believes that the known risk of harm to humans from accidental, and sometimes fatal, exposure to medicines on the flush list far outweighs any potential risk to human health and the environment from flushing these leftover or unneeded medicines only when a take-back option is not readily available. FDA will continue to conduct risk assessments as a part of our larger activities related to the safe use and disposal of medicines.

Check out the Medication Disposal Q&A for more information about flushing.