expired rx disposal

[dr of rx]

the feds say to not flush most down the toilet:

http://www.whitehousedrugpolicy.gov/drugfact/factsht/proper_disposal.html

http://www.epa.gov/ppcp/basic2.html


I read in a pharmacy magazine (can't recall which one) that not flushing is a concern because the unaltered drug can filter down over time and go directly to the ground water.

what do are you telling your customers? I've passed along both methods but don't know whats best.

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[genesis09]

Flushing expired drugs down the toilet hasn't been recommended for quite a while.

 

[dr of rx]

except these..

"The FDA advises that the following drugs be flushed down the toilet instead of thrown in the trash:

Actiq (fentanyl citrate)
Daytrana Transdermal Patch (methylphenidate)
Duragesic Transdermal System (fentanyl)
OxyContin Tablets (oxycodone)
Avinza Capsules (morphine sulfate)
Baraclude Tablets (entecavir)
Reyataz Capsules (atazanavir sulfate)
Tequin Tablets (gatifloxacin)
Zerit for Oral Solution (stavudine)
Meperidine HCl Tablets
Percocet (Oxycodone and Acetaminophen)
Xyrem (Sodium Oxybate)
Fentora (fentanyl buccal tablet)"

 

[npage148]

why recommend flushing rayataz, baraclude, and tequin?

 

[dr of rx]

dunno...seems pretty random.

tequin, but not cipro, avelox etc

 

[genesis09]

Some of the drugs are on the list due to abuse potential.

 

[AggiePharmer]

Some of the drugs are on the list due to abuse potential.

Although I'm not a pharmacy student yet (I'm not in the know as much as you all regarding usage and dosing of the aforementioned drugs), I recognize potential structural similarities between cipro, tequin, and estradiol. Although I can't confirm it without running necessary lab tests, wouldn't such structural homology suggest the potential for some of these to cause estrogenic effects if they were flushed down the drain?

Perhaps this logic just boils down to the EPA wanting to strictly regulate the amount of personal care products in the environment, their potential for affecting the drinking water in the long run, and their potential adverse affects downstream on susceptible groups in the larger population. Although I know some of these off the top of my head readily degrade in the environment (acetaminophen), some drugs may actually be OK to flush down the drain.

On a random note... wouldn't it be cool to see if the EPA and FDA could coordinate a program to simultaneously recycle unwanted/unused meds for needier communities, while also eliminating the need for meds to be flushed down the toilets?

But perhaps that's also wishful thinking.

 

[acetyl]

rap them in newspaper and throw them into a bonfire.

 

[genesis09]

You can't redistribute already dispensed medications. First, it is very illegal under current laws. You have liability issues. You don't know if the meds have been stored properly. They were thinking about starting a program like that in Illinois, and in the law, they wrote that any distributer would be absolved from lawsuits and liability.
Most of the drugs on the flush list are C-IIs. In the release about it, they said some of them were on the list because they are C-IIs.