What Drugs Can You Flush?
In our latest question and answer, our pharmacist discusses what medications are recommended to be flushed down the toilet.
Hi, I have some medication that is old that I need to get rid of. I think I heard at one point that you shouldn't throw medications down the toilet. Is this right? Are there some you can flush?
Aug 23, 2022- Most medications should not be flushed because they can contaminate water, but the FDA publishes a "flush list" of specific drugs where the risk of misuse outweighs environmental concerns. If a medication is on the FDA flush list and no take-back program is available, flushing down the toilet or sink is the recommended way to safely remove it from your home. For medications not on the flush list, mixing them with undesirable substances like used coffee grounds or kitty litter and throwing them in the trash is a safer disposal option than flushing.
Answer
Thanks for reaching out to us! You are right, most drugs should not be flushed down the toilet due to concerns of water contamination. However, there are some drugs that are exempt from this and have been deemed okay to flush based on their inherent safety risk.
"Flush List"
As mentioned, the FDA publishes a 'flush list' of drugs, which are mostly controlled substances, where it has been determined that the potential risk of harm due to misuse or diversion outweighs any environmental risk. Now, if possible, it is still recommended to a drug disposal site for the drugs on the 'flush list' if one is available, but, if there is not a timely take-back program that accepts medicines containing controlled substances, the most effective way to immediately and completely eliminate the potential for harm is to remove these medicines from the home by flushing them down the sink or the toilet.
The below list shows the medications and their dosage forms the FDA recommends flushing if these products cannot be stored safely and securely before disposal.
| Medication | Dosage form(s) |
| Acetaminophen/benzhydrocodone | Tablets |
| Buprenorphine | Transdermal patch system |
| Buprenorphine hydrochloride | Tablets (sublingual), soluble film (buccal) |
| Buprenorphine hydrochloride/naloxone hydrochloride | Tablets (sublingual), film (sublingual) |
| Fentanyl | Tablets (sublingual), patch (extended-release) |
| Fentanyl citrate | Tablets (buccal), soluble film (buccal), oral transmucosal lozenge |
| Hydrocodone bitartrate | Tablets (extended-release), capsules (extended-release) |
| Hydromorphone hydrochloride | Tablets, tablets (extended-release), oral liquid |
| Meperidine hydrochloride | Tablets, oral solution |
| Methadone hydrochloride | Tablets, oral solution |
| Methylphenidate | Patch |
| Morphine sulfate | Tablets (immediate-release), tablets (extended-release), capsules (extended-release), oral solution |
| Morphine sulfate/naltrexone hydrochloride | Capsules (extended-release) |
| Oxycodone hydrochloride | Tablets (immediate-release), tablets (extended-release), capsules, oral solution |
| Oxycodone hydrochloride/acetaminophen | Tablets (extended-release), tablets |
| Oxycodone hydrochloride/aspirin | Tablets |
| Oxycodone hydrochloride/naloxone hydrochloride | Tablets (extended-release) |
| Oxycodone hydrochloride/naltrexone hydrochloride | Capsules (extended-release) |
| Oxymorphone hydrochloride | Tablets (immediate-release), tablets (extended-release) |
| Sodium oxybate | Oral solution |
| Tapentadol | Tablets (extended-release) |
Drug Disposal Info
Even if you have a drug on the list above, flushing should be used as a last resort. Other options are recommended if possible, such as finding a take-back program, public disposal site, etc...
If a take-back program isn't available, and your drug is not on the 'flush' list above, most medications can be thrown in the trash.
If you do decide to throw your unused drugs in the trash, be sure to mix them with something undesirable, like used coffee grounds, dirt, or kitty litter. This will make the drugs less appealing to children, animals, and anyone that may be going through the trash. Also, be sure to put the mixture in a bag or other container that you can seal to prevent leakage.
Final Words
Thanks again for reaching out to us!
References & sources
Glossary — Terms in This Answer
- Controlled substances
- Drugs that are regulated by the government because they have potential for abuse or addiction.
- Diversion
- The illegal distribution or misuse of prescription medications that were intended for someone else.
- Transdermal patch
- A medicated patch applied to the skin that delivers medication through the skin into the bloodstream.
- Sublingual
- Medication placed under the tongue where it dissolves and is absorbed into the bloodstream.
- Extended-release
- A medication formulation designed to slowly release the drug over several hours rather than all at once.
- Buccal
- Medication placed inside the cheek where it dissolves and is absorbed through the mouth tissue.
- Oral transmucosal
- Medication that dissolves in the mouth and is absorbed through the mucous membranes rather than swallowed.
- Take-back program
- A service where pharmacies or other locations accept unused or expired medications for safe disposal.
Dr. Brian Staiger, PharmD
Doctor of Pharmacy, board certified clinical pharmacist (BCPS), American Herbalist Guild, Medication Therapy Management certified
Brian Staiger, PharmD, BCPS, is a licensed pharmacist with more than 13 years of experience across retail pharmacy, clinical pharmacy, medication safety, pharmacy program development, and healthcare administration. He is the founder of HelloPharmacist.com, where he helps patients...
More answers from Brian →