What Drugs Can You Flush?

In our latest question and answer, our pharmacist discusses what medications are recommended to be flushed down the toilet.

Question

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?

Asked by Elaine On Aug 23, 2022

Answered by
Medical Content Reviewed By HelloPharmacist Staff

Published Aug 23, 2022
Last updated May 02, 2024

Key points

  • Most drugs should not be flushed down the toilet. Only certain medications that pose a safety risk are recommended by the FDA to be flushed if other disposal options aren't available.
  • A drug take-back or public disposal site is the preferred option for drug disposal. If that is not an option for you, and your drug is not on the 'flush list', you should mix it with something undesirable, like kitty litter, and throw it away in the trash.

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.

MedicationDosage form(s)
Acetaminophen/benzhydrocodoneTablets
BuprenorphineTransdermal patch system
Buprenorphine hydrochlorideTablets (sublingual), soluble film (buccal)
Buprenorphine hydrochloride/naloxone hydrochlorideTablets (sublingual), film (sublingual)
FentanylTablets (sublingual), patch (extended-release)
Fentanyl citrateTablets (buccal), soluble film (buccal), oral transmucosal lozenge
Hydrocodone bitartrateTablets (extended-release), capsules (extended-release)
Hydromorphone hydrochlorideTablets, tablets (extended-release), oral liquid
Meperidine hydrochlorideTablets, oral solution
Methadone hydrochlorideTablets, oral solution
MethylphenidatePatch
Morphine sulfateTablets (immediate-release), tablets (extended-release), capsules (extended-release), oral solution
Morphine sulfate/naltrexone hydrochlorideCapsules (extended-release)
Oxycodone hydrochlorideTablets (immediate-release), tablets (extended-release), capsules, oral solution
Oxycodone hydrochloride/acetaminophenTablets (extended-release), tablets
Oxycodone hydrochloride/aspirinTablets
Oxycodone hydrochloride/naloxone hydrochlorideTablets (extended-release)
Oxycodone hydrochloride/naltrexone hydrochlorideCapsules (extended-release)
Oxymorphone hydrochlorideTablets (immediate-release), tablets (extended-release)
Sodium oxybateOral solution
TapentadolTablets (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

  • Drug Disposal: FDA’s Flush List for Certain Medicines, FDA
  • Drug Disposal Information, DEA

About the Pharmacist

Dr. Brian Staiger, PharmD

Dr. Brian has been practicing pharmacy for over 13 years and has wide-ranging experiences in many different areas of the profession. From retail, clinical, program development, and administrative responsibilities, he's your knowledgeable and go-to source for all your pharmacy and medication-related questions! Dr. Brian Staiger also has herbalist training and educational certificates in the field of medical ethnobotany. Feel free to send him an email at [email protected]! You can also connect with Dr. Brian Staiger on LinkedIn.

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