U.S. flag An official website of the United States government

On Oct. 1, 2024, the FDA began implementing a reorganization impacting many parts of the agency. We are in the process of updating FDA.gov content to reflect these changes.

U.S. Food and Drug Administration
  1. Home
  2. Drugs
  3. Resources | Drugs
  4. Information for Consumers and Patients | Drugs
  5. Buying & Using Medicine Safely
  6. Safe Disposal of Medicines
  7. Disposal of Unused Medicines: What You Should Know
  8. Drug Disposal: FDA’s Flush List for Certain Medicines
  1. Disposal of Unused Medicines: What You Should Know

Drug Disposal: FDA’s Flush List for Certain Medicines

If you received specific disposal instructions from your healthcare provider (e.g., doctor, pharmacist) for your unused or expired medicine, you should follow those instructions to dispose of your medicine.

The best way to dispose of most types* of unused or expired medicines (both prescription and over-the-counter) is to immediately use a take-back option.

If you don’t have a drug take-back location near you or if drug mail-back envelopes are not available to you, check the FDA’s Flush List to see if your medicine is on the list. 

Medicines on the flush list are those (1) sought-after for their misuse and/or abuse potential and (2) that can result in death from one dose if inappropriately taken. If children, adults, or pets in your home accidentally or intentionally ingest, touch, misuse, or abuse a medicine on the flush list, they can suffer serious consequences including death.

Remember, don’t flush your medicine unless it is on the flush list.

Drug Name

Examples of Products on the Flush List1

Drugs That Contain Opioids

Any drug that contains the word “buprenorphine”

BELBUCA, BUAVAIL, BUTRANS, SUBOXONE, SUBUTEX, ZUBSOLV

Any drug that contains the word “fentanyl”

ABSTRAL, ACTIQ, DURAGESIC, FENTORA,ONSOLIS

Any drug that contains the word “hydrocodone” or “benzhydrocodone”

APADAZ, HYSINGLA ER, NORCO, REPREXAIN, VICODIN, VICODIN ES, VICODIN HP, VICOPROFEN, ZOHYDRO ER

Any drug that contains the word “hydromorphone”

EXALGO

Any drug that contains the word “meperidine”

DEMEROL

Any drug that contains the word “methadone”

DOLOPHINE, METHADOSE

Any drug that contains the word “morphine”

ARYMO ER, AVINZA, EMBEDA, KADIAN, MORPHABOND ER, MS CONTIN, ORAMORPH SR

Any drug that contains the word “oxycodone”

CODOXY, COMBUNOX, OXADYDO (formerly OXECTA), OXYCET, OXYCONTIN, PERCOCET, PERCODAN, ROXICET, ROXICODONE, ROXILOX, ROXYBOND, TARGINIQ ER, TROXYCA ER, TYLOX, XARTEMIS XR, XTAMPZA ER

Any drug that contains the word “oxymorphone”

OPANA, OPANA ER

Any drug that contains the word “tapentadol”

NUCYNTA, NUCYNTA ER

Drugs That Do Not Contain Opioids

Any drug that contains the term “sodium oxybate” or “sodium oxybates”

XYREM, XYWAV

Diazepam rectal gel

DIASTAT, DIASTAT ACUDIAL

Methylphenidate transdermal system

DAYTRANA

1 Links in the flush list direct you to specific disposal instructions in each medicine’s labeling (the labeling generally represents the last FDA-approved labeling at the time this webpage was updated). To see the most recently approved labeling see www.fda.gov/drugsatfda or to see the most current labeling see FDALabel at https://nctr-crs.fda.gov/fdalabel/ui/search.

Impact of flushing medicines on the environment

FDA recognizes that the recommendation to flush a few specific medicines when a take-back option is not available raises questions about the impact of the medicines 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. FDA concluded that these medicines present negligible risk to the environment, although additional data would be helpful for confirming this finding for some of the medicines.

Based on the available data, FDA believes that the known risk of harm, including toxicity and death, to humans from accidental exposure to medicines on the flush list far outweighs any potential risk to human health and the environment from flushing these unused or expired medicines. Remember only flush medicines on the flush list if 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 including how to dispose of needles and syringes. Some products with uncommon dosage forms (e.g., sprays, lozenges) have product-specific disposal instructions. Review the instructions that came with your prescription or contact your health care professional (e.g., pharmacist, doctor) to find out how to properly dispose of these medicines.

 

Back to Top