If not, you should immediately flush the medicine down the toilet* only if
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.
|Active Ingredients||Found in Brand Names (Click links to view medicine instructions)|
|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|
|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.