Medication/Pharmaceutical Waste

Healthcare Facilities

Pills In Containers

Healthcare facilities are required to manage their pharmaceuticals properly. Many facilities use a Reverse Distributor to manage their unused and outdated pharmaceuticals. Those pharmaceuticals that cannot be managed through a reverse distributor program, such as outdated (but not returnable for credit), used in compounding or IV preparation, spilled, no longer useable for its intended purpose and any items used in spill cleanup (vermiculite, paper towels and the like) must be characterized as either hazardous or non-hazardous waste and managed properly. The North Dakota Pharmaceutical Waste Guidance can assist you in determining if your waste pharmaceuticals are hazardous waste or not.




Following are links to various sites regarding disposal of medication/pharmaceuticals from healthcare facilities:

North Dakota Board Of Pharmacy

Minnesota Pollution Control Agency - Health Care Industry

Healthcare Environmental Resource Center

Great Lakes Regional Pollution Prevention Roundtable Sector Resource: Managing Pharmaceutical Waste

PharmEcology - Establishing Compliant And Cost-Effective Procedures To Manage Pharmaceutical Waste

Florida Department Of Environmental Protection - List of Pharmaceuticals That Are Potentially Hazardous Wastes When Discarded

Office Of National Drug Control Policy - Proper Disposal Of Prescription Drugs

US Fish and Wildlife Service - Improper Disposal Of Unused Medication Sparks Creation Of New Awareness Program

Minnesota Pollution Control Agency - Pharmaceutical Waste: Disposing of Unwanted Medications

Household wastes also contain medications that, in the past, have been disposed of by flushing them down the toilet. In response to increasing concentrations of pharmaceuticals, hormones and other organic wastewater contaminates found in the rivers and streams across the nation, various agencies (the Office of National Drug Control policy, the Department of Health and Human Services, the Environmental Protection Agency, Fish & Wildlife Service and the American Pharmacists Association and this Department) no longer encourage this practice.

Under a law in North Dakota, consumers can return their unused prescription drugs to pharmacists or clinics so they can be given to someone else who can use them.  A drug donated under the program must be in the original, unopened package, except drugs packaged in single-unit doses, or punch cards, which may be accepted and dispensed if the outside packaging has been opened and the single-unit dose package is unopened.  A nominal fee may be charged.  Check with your local pharmacist or the North Dakota Board of Pharmacy to see who is participating in this program.

Take Back Program - Prescription Drugs
Dipose My Meds

If you have medications that cannot be returned, we now recommend they be disposed of in the trash. Here are the disposal methods for unused medications:

1. Do not flush most medications*

2. Remove the label or scratch your name off the label

3. Make the drugs unusable or undesirable by:

    - If liquid, mix with coffee grounds, kitty litter, salt, flour or charcoal
    - If solid, add a small amount of water or vinegar to partially dissolve them

4. Place the unusable medication in a leak-proof, non-descript container (empty coffee can, detergent bottle, or sealable bag) and tape shut.

5. Place in the garbage.

6. If the medications are in a blister pack, wrap the blister packages together in multiple layers of duct tape or other tape, then place in the garbage.

* The Food And Drug Administration advises that the following drugs be flushed down the toilet instead of thrown in the trash:

Actiq (fentanyl citrate)
Daytrana Transdermal Patch (methylphenidate)
Duragesic Transdermal System (fentanyl)
OxyContin Tablets (oxycodone)
Avinza Capsules (morphine sulfate)
Baraclude Tablets (entecavir)
Reyataz Capsules (atazanavir sulfate)
Tequin Tablets (gatifloxacin)
Zerit for Oral Solution (stavudine)
Meperidine HCl Tablets
Percocet (Oxycodone and Acetaminophen)
Xyrem (Sodium Oxybate)
Fentora (fentanyl buccal tablet)

If you have further questions contact, by e-mail, Christine Roob, or telephone 701.499.5207.