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.
fentanyl citrate	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
hydrocodone bitartrate	Zohydro ER	ext‑rel caps
hydro– morphone HCl	—	ext‑rel tabs
	Dilaudid	oral liq
	Dilaudid	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
oxymorphone HCl	—	ext-rel tabs
tapentadol	Nucynta	tabs
tapentadol	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/ acetamin–ophen	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)

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