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Medical News & Perspectives |

FDA: Flush Certain Unused Medications

Mike Mitka
JAMA. 2009;302(19):2082-2082. doi:10.1001/jama.2009.1634
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Because of safety concerns, certain prescribed medications no longer needed for treatment, including several opioids and other controlled substances, should be flushed down the sink or toilet, said US Food and Drug Administration (FDA) officials during the launching of a new consumer Web site.

This Web site, http://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/EnsuringSafeUseofMedicine/SafeDisposalofMedicines/ucm186187, currently lists 26 medications that consumers should dispose of by flushing. The list will be updated as needed based on future safety risk evaluations of other medications by the FDA.

At an October 14 press briefing announcing the Web site launch, Douglas Throckmorton, MD, deputy director of the FDA's Center for Drug Evaluation and Research, said the agency hopes to help patients avoid unintended consequences. “The focus today is on a very small group of drugs [that pose] imminent or immediate harm to children and pets in a single dose—products we believe that are so dangerous, they should be removed from the house immediately,” said Throckmorton. The FDA estimated that about 5000 children in 2007 had accidental exposures to drugs and perhaps about 100 died.

The Web site suggests that other medications can be disposed of by mixing them with a substance like used coffee grounds or kitty litter (to hide the drug or to make it unappealing), sealing up the mixture in a plastic bag, and placing it in the household trash. And although patients can dispose of certain drugs through take-back programs offered by some city and county governments, the pharmaceuticals recommended for flushing down the sink or toilet are not eligible.

Throckmorton said that the FDA is sensitive to concerns about the small potential risk to people and the environment of having these drugs flushed into the water supply and hopes to develop long-term solutions. However, at least for the short-term, the agency is more worried about life-threatening risks from accidental ingestion of these medications.

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