Medicine storage and disposal: keeping your home and water safe

1. Introduction

Medicines that are stored badly or kept past their expiry date may not work as intended, and children may mistake medicines for sweets ^[2]. This article explains how to store medicines and how to get rid of those you no longer need. It draws on guidance from the US Food and Drug Administration (FDA) and the US Centers for Disease Control and Prevention (CDC). Disposal rules vary by country and city, so in India ask your pharmacist or local health authority about collection options. This is general education.

2. Storing medicines safely

The FDA advises following each medicine's storage instructions. Most should be kept in a cool, dry place, away from extreme heat or cold, for example not in a hot or freezing car. Some medicines need a refrigerator ^[2].

Keep all medicines out of children's reach, because children may mistake them for sweets ^[2]. The CDC adds these steps ^[3]:

• Make sure the safety cap on each bottle is locked.
• Put medicines back in a safe storage place after every use.
• Keep medicines where young children can neither reach nor see them.
• Explain to children what medicine is and why a trusted adult must give it to them.

3. Check expiry dates

The FDA explains that degraded or expired medicine may work poorly or become harmful, and that people with serious illnesses may face greater risk. Check expiry dates and dispose of unused or expired medicines promptly ^[2]. Keep a medicine list so you know what you hold ^{[2, 3]}.

4. Disposal option 1: take-back programmes

The FDA says the best way to dispose of most expired, unwanted or unused medicines is a drug take-back programme. In the United States, options include National Prescription Drug Take Back Day events, which the US Drug Enforcement Administration sponsors, local community events and authorised collectors, and some pharmacies have drop-off boxes or kiosks or run mail-back programmes ^[1]. To find a take-back site, check with local law enforcement or search the database of authorised collectors kept by the US Drug Enforcement Administration ^[1]. The CDC also notes that take-back programmes are often at community pharmacies ^[4]. Do not save leftover antibiotics for a future illness, because the wrong medicine can delay correct treatment ^[4].

5. Disposal option 2: mail-back envelopes

Prepaid mail-back envelopes are sold at retail pharmacies and online, and some pharmacies provide them free. You fill the envelope with unused or expired medicines, seal it and post it ^[1]. This service is described for the United States.

6. Disposal option 3: household trash

If no take-back option is available, the FDA says almost all medicines that are not on its flush list can go in household trash. This includes pills, liquids, drops, patches and creams. The steps are ^{[1, 4]}:

1. Take the medicine out of its original container and mix it with something unappealing, such as used coffee grounds, dirt or cat litter. This makes it less attractive to children and pets and unrecognisable to anyone searching the trash.
2. Put the mixture in a closable container, such as a sealed bag or an empty can, so it cannot leak or spill.
3. Put the container in the trash.
4. Scratch out personal information on the empty packaging, then discard it.

7. The flush list and special items

Some medicines are considered especially harmful to other people, so the FDA says a small number of medicines should be flushed right away when no longer needed and no take-back option is readily available. Check the label, the patient leaflet or the FDA flush list, and do not flush a medicine unless it is on the list ^[1]. Drug residues mostly reach waterways when people take medicines and their bodies pass them out. Many drugs are not fully absorbed or broken down and can pass through wastewater treatment plants. The FDA reports no sign of environmental effects from flushing the recommended medicines and found the risk to be negligible ^[1].

Inhalers, which are used for asthma and conditions such as chronic obstructive pulmonary disease (COPD), and other aerosol products can be dangerous if punctured or burned, so read the handling instructions on the label and ask your waste and recycling facility about local rules ^[1]. For needles and syringes, the FDA refers readers to its separate medication disposal Q and A. Medicines in uncommon forms, such as sprays and lozenges, may have their own disposal instructions, so check the prescription paperwork or ask a health professional ^[1].

8. When to see a doctor

Ask your pharmacist or doctor if you are unsure how to store or dispose of a particular medicine, especially if it needs refrigeration or has special instructions ^{[1, 2]}. Do not use a medicine that has passed its expiry date, and ask your pharmacist how to dispose of it ^[2]. Do not skip doses or stop a prescribed medicine without asking your doctor, even if you feel better ^[2].

In an emergency, call your local emergency number (112 in India, 911 in the United States). If a child or pet has swallowed a medicine that was not meant for them, call emergency services or a poison information service straight away.

9. Conclusion

Safe storage keeps medicines working and away from children, and safe disposal removes leftovers from the home. Use take-back programmes first where they exist, follow label instructions, and ask your pharmacist about local options. Tell your doctor about every treatment you use.