Look through the drawers and cupboards of most households in the United States it's likely you'll find a blister pack or pill bottle with out-of-date or expired medication tucked away somewhere. So what should you do with these medicines? Are they safe to use, and how should you dispose of them if they are not?
Last month, a study on the efficacy of expired EpiPens published on the American College of Physicians website suggested that the expired medications could still hold a life-saving dose. However, the U.S. Food & Drug Administration (FDA) states taking out-of-date drugs could be dangerous, noting the expiration date is a "critical part" of deciding whether a product is safe and will have the desired effect.
Ilisa Bernstein, PharmD, JD, deputy director of the Office of Compliance in FDA's Center for Drug Evaluation and Research, is very clear on the organization's stance on expired medication: "Once the expiration date has passed there is no guarantee that the medicine will be safe and effective… If your medicine has expired, do not use it."
However, with more than four billion prescriptions filled in the US last year, many patients find they have an excess or medication or are left with a medicine cabinet full of out-of-date products. It is vital patients to follow the correct procedures when ridding their home of unused, unwanted or expired medication. Official FDA guidelines advise patients to dispose of expired medication and purchase replacements to ensure they are safe, effective and do not fall into the wrong hands.
Check the label
No matter what medication you take, always read the label and take note of the expiration date. Certain medications will carry greater risks, for example bacterial growth or sub-potent antibiotics, when left beyond the date on the label. Packaging may also feature information on proper storage and disposal recommendations.
Find a nearby take-back program or authorized collector
There are many take-back programs where patients can bring in expired and unwanted medication for proper disposal. Each year, the DEA co-ordinates National Prescription Drug Take-Back Day, which this year fell on April 30th. Events such as these provide a great opportunity for patients to do a bit spring cleaning and rid their medicine cabinets of unwanted medication.
Local law enforcement agencies and local waste management authorities may also sponsor take-back programs. Some pharmacies, hospitals and clinics also have facilities to properly dispose of unwanted medication. However, when events such as these are not an option, the FDA has other guidelines for patients disposing of medication at home…
Throw away in household trash
Some medication can simply be disposed of in the household trash. However, there are a number of steps patients are advised to follow to ensure drug disposal is done safely.
MIX medication with something unpalatable, such as coffee grounds or dirt (do not crush tablets or capsules)
PLACE this mixture in a container, such as a sealed plastic bag.
THROW the container in the trash.
SCRATCH out any personal information on the label of the empty pill bottle or packaging, then dispose of the container.
Flush down the sink or toilet
In the case of some dangerous medications, the FDA suggests flushing them down the sink or toilet rather than simply disposing of them in the household trash. This is particularly important when pets or small children are around, as it prevents accidental ingestion of the medicines. If you are unsure which drugs should be disposed of in this way, check this FDA list of medication recommended for flushing. Among the drugs on the list are Abstral (fentanyl), Xtampza ER (oxycodone) and Avinza (morphine sulfate).
If you are unsure about how to properly dispose of any medication, talk to your local pharmacist or physician about the correct methods for your medicine. Make sure you regularly go through your medication and correctly dispose of any past their expiration date.
Search for official DEA drug disposal sites in your area.
DEA drug disposal information: https://www.deadiversion.usdoj.gov/drug_disposal/index.html