Drug Disposal: Questions and Answers

This questions and answers section provides additional details on drug disposal options and why FDA recommends flushing certain potentially dangerous medicines only when you cannot readily get to a drug take-back location, or if a pre-paid drug mail-back envelope is not available to you.

Q1 What's the best way to get rid of medicines (including prescription, over-the-counter (OTC), and dietary supplements) I no longer need or that have expired?

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.

• drop off the medicine at a drug take-back location, or
• mail your expired or unused medicines using a pre-paid drug mail-back envelope.

If you cannot readily use a drug take-back option, follow these guidelines:

• If your medicine is on the FDA flush list, your next best option is to immediately flush these potentially dangerous medicines down the toilet.
• If your medicine is not on the flush list, you should follow these instructions to discard the medicine in your trash at home.

You can also check with your pharmacist. Some pharmacies offer mail-back programs and other ways to help you safely dispose of your unused or expired medicines.

*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.

How do I get rid of needles, syringes, and other sharps?

Follow this link to get information on the proper way to dispose of sharps (needles, syringes, and lancets).

Q3 If I live in an assisted living community and take my own medicines, or my family member was in hospice and has since passed away, how can I safely dispose of medicines that are no longer needed or expired?

First, check with the health care management team in your community or hospice to find out the best way to dispose of unused or expired medicines.

If you learn that you are responsible for disposal of these medicines, follow the directions below:

1. The preferred method of disposing of most types* of unused or expired medicines (both prescription and over-the-counter) is to immediately use a drug take-back option.
   • drop off the medicine at a drug take-back location, or
   • mail your expired or unused medicines using a pre-paid drug mail-back envelope.
2. If the above options are not readily available, check to see if your medicine is on the flush list. If it is, you should dispose of your medicine by flushing it down the toilet. These flush list medications are potentially dangerous and should not be disposed of in the trash.
3. If your medicine is not on the flush list, you can follow these instructions to dispose of your medicine in the trash at home.

*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.

Q4 Why are some medicines on the flush list while other medicines are not? What is the rationale for this policy?

The few, select medicines recommended for disposal by flushing are safe and effective when used as prescribed. However, medicines on the flush list can result in death from one dose if inappropriately taken. These medicines are those sought-after for their misuse and abuse potential. 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.

For these reasons, FDA recommends that when it is not possible to immediately drop off these medicines at a drug take-back location, or if a pre-paid drug mail-back envelope is not available, consumers should flush them down the toilet to immediately and permanently remove this risk from their home.

Based on the available data, we believe that the risk of harm from accidental exposure to these few select medicines far outweighs any potential risk to the environment that may come from disposal by flushing.

Q5 How big of a problem is accidental pediatric exposure to medicine in the United States?

Accidental exposure to medicine in the home is a major source of pediatric poisonings in the United States. In 2020, there were an estimated 36,564 emergency department (ED) visits among children aged 5 years and under for unsupervised medication exposures. Over two-thirds of ED visits for accidental pediatric medication exposures involve 1- or 2- year old children and nearly 13% result in hospitalization.

Keeping medicines after they are no longer needed creates an unnecessary health risk in the home, especially if there are children present. Even child resistant containers cannot completely prevent a child from taking medicines that belong to someone else.

Q6 Does flushing medicines on the flush list pose a risk to human health or the environment? Do FDA’s recommendations about medicine disposal consider the effects of medicines in the environment?

FDA is aware of reports of very low, but measurable levels of the medicines on the flush list in surface waters such as rivers and streams, and to a lesser extent in drinking water. To date, FDA is not aware of new evidence of harmful effects to human health from these few, select medicines in the environment.

The majority of medicines found in water are a result of the body’s natural routes of drug elimination (in urine or feces). Disposal of these few, select medicines by flushing, which is encouraged only when drug take-back options are not readily available, would only contribute a small fraction of the total amount of medicine found in our surface and drinking water.

Based on the available data, FDA believes that the known risk of harm to humans from accidental exposure to these medicines far outweighs any potential risk to human health or the environment from flushing these medicines.

FDA works with other agencies, including the U.S. Environmental Protection Agency (EPA), to better understand the human health and environmental risks from medicines in our water.

Q7 Can unused or unexpired medications be donated?

This depends on which state you live in. There are some online resources that may help you determine whether pharmaceutical donation and reuse programs exist in your state. It should be noted that most state programs do not accept controlled substances.

Also, please note that FDA does have concerns regarding the donation of unused drugs and does not endorse this practice. This is because the ultimate end user would have no assurance that the medications were appropriately stored. For many medications, appropriate storage is essential to maintain their strength and quality.

Here is a question and answer sheet about donating drugs for international humanitarian relief.

Q8 Does FDA have information on drug disposal I can print and hand out?

Yes, please see our Consumer Update: Where and How to Dispose of Unused Medicines which can be printed.