Medications Disposable by Flushing

MEDICATIONS DISPOSABLE BY FLUSHING
Generic Brand Form Special Instructions
BENZODIAZEPINE
diazepam Diastat rectal gel

• Pull on plunger until it is completely removed from the syringe body.

• Point tip over sink or toilet.

• Replace plunger into syringe body, gently pushing plunger until it stops.

• Flush toilet or rinse sink with water until gel is no longer visible.

• Discard all used materials in the trash out of children’s reach.

• Do not reuse.

CNS DEPRESSANT
sodium oxybate Xyrem oral soln

• Empty any unused Xyrem down the sink drain.

• Cross out the label on the Xyrem bottle with a marker.

• Place the empty Xyrem bottle in the trash.

CNS STIMULANT
methylphen
idate
Daytrana transdermal patch

• Fold the used patch in half and press it together firmly so that the sticky side sticks to itself.

• Flush the used patch down the toilet or put the patch in a container with a lid right away.

• Do not flush the protective pouches or liners down the toilet. Discard in a container with a lid.

• Use or throw away the patches within 2 months after the sealed tray or outer pouch is opened.

• Unused patches should be removed from the pouch and liner, folded onto itself, and disposed of in the same manner.

OPIOID AGONIST
fentanyl Duragesic trans
dermal patch

• Fold the sticky sides of the patch together and flush down the toilet. Do not put patches in a trash can.

• Do not flush the protective pouches or liners down the toilet. Discard in a container with a lid.

• Unused patches should be removed from the pouch and liner, folded onto itself, and flushed down the toilet.

fentanyl citrate Actiq lozenge

• After complete consumption of the unit, throw handle away in a trash container out of children’s reach.

• If drug matrix remains on handle, place under hot running water until completely dissolved.

• Remove unused units from blister packages using scissors.

• Hold Actiq by its handle over the toilet bowl. Using wire-cutting pliers, cut the medicine end off so that it falls into the toilet.

• Throw the handle away in a place that children cannot reach.

• Repeat steps for each Actiq unit.

• Flush the toilet twice after 5 units have been deposited.

• Do not flush entire unit, handles, blister packages, or cartons down the toilet.

• Units kept in a temporary child-resistant container must be disposed of, one at a time, in the same manner.

Fentora buccal tabs

• Remove unused tabs from blister packages and flush down the toilet.

• Do not flush blister packages or cartons down the toilet.

hydrocodone bitartrate Hysingla ER ext‑rel tabs
Zohydro ER ext‑rel caps
hydro
morphone HCl
ext‑rel tabs
Dilaudid oral liq
tabs
meperidine HCl tabs
methadone HCl Dolophine tabs
morphine sulfate scored tabs
oral soln
Kadian ext‑rel caps
Morphabond ER ext‑rel tabs
MS Contin ext‑rel tabs
oxycodone caps
Oxaydo tabs
Oxycontin ext‑rel tabs
Roxicodone tabs
Xtampza ER ext‑rel caps
oxymorphone HCl tabs
ext-rel tabs
tapentadol Nucynta tabs
Nucynta ER ext‑rel tabs
OPIOID AGONIST/ANTAGONIST
buprenor
phine
sub
lingual tabs
Belbuca buccal films

• Remove unused films from foil packages and flush down the toilet.

• Discard foil packaging and cartons in the trash.

Butrans trans
dermal patch

• Dispose used patches by folding the adhesive side of the patch to itself, then flushing the patch down the toilet immediately upon removal.

• Unused patches should be removed from their pouches, the protective liners removed, the patches folded so that the adhesive side of the patch adheres to itself, and immediately flushed down the toilet.

buprenor
phine HCl/
naloxone HCl
sub
lingual tabs
Bunavail buccal films

• Remove unused films from foil packages and flush down the toilet.

Suboxone sub
lingual film

• Unused films should be removed from the foil pouch and flushed down the toilet.

Zubsolv sub
lingual tabs
OPIOID AGONIST + NON-OPIOID
benzhydro
codone HCl/ acetamin
ophen
Apadaz tabs
hydrocodone bitartrate/ acetaminophen Norco tabs
hydrocodone bitartrate/ ibuprofen tabs
oxycodone HCl/
acetamin
ophen
Percocet tabs
oxycodone HCl/aspirin Percodan tabs
NOTE

* Immediately flush old, unused, unwanted, or expired medication down the toilet only when a drug take back options are not readily available.

REFERENCE

U.S. Food & Drug Administration. Drug Disposal: Flush Potentially Dangerous Medicine. https://www.fda.gov/drugs/disposal-unused-medicines-what-you-should-know/drug-disposal-flush-potentially-dangerous-medicine. Accessed on May 13, 2020.

(Rev. 5/2020)