Medication that is beyond the use date (expired) or has been stored such that the beyond use date has shortened (Example: refrigerated product left at room temperature) must be destroyed appropriately.
Medication should be destroyed per pharmacy policy. A log is maintained regarding all med destruction in compliance with the EPA, DSCSA, and your destruction vendor. The medication destruction logshould include:
- Date of destruction or placing in Regulated Medical Waste Bin
- Medication name, strength and dosage form
- Lot number
- Expiration Date (from container; may add note if different due to storage conditions)
- Quantity destroyed (units not containers) Example: Tablets, milliliters, grams, etc.
Remove external packaging as described in Figure 3(below) to decrease weight and destroy only medication waste. Remove patient identifying information from packaging by removing patient labels and shredding them or covering with stickers such as an Identi-Hidesticker. A de-blister machine is a time saver for removing tablets and capsules from blister packaging.
Controlled Substances and products considered hazardous (Hazmat) or p-wastesuch as oncology medications, warfarin, estrogen and progestin products, finasteride, lindane, nicotine, and nitroglycerin may require segregation for destruction. See CDC Antineoplasticsand Healthcare Environmental Resource Centerfor current listings.
- Segregation may be required in a red bag or containeror container provided by the destruction vendor.
- These products, unlike regular waste, require the destruction of the empty container, lid, cotton, seal, etc. (all packaging that has touched the product.)
- Wear gloves and work in a well ventilated area or wear a face mask.
When storing and preparing meds for destruction follow guidelines provided by destruction vendor. See Figure 3(below)for general guidelines. Vendors may require separation of control substances, hazmat, aerosols and other items.
|Where?||How to destroy|
|Bulk Containers||Return to vendor/wholesaler when possible|
|Bulk ContainersNOT eligible for return||Regulated Medical Waste bin||Dispose of paper packaging and container in regular trash|
|Oral Samples||Regulated Medical Waste bin||Dispose of paper packaging and container in regular trash|
|Inhalers||Regulated Medical Waste bin or separated as per vendor requirements||Dispose paper packaging and removable plastic mouth piece in regular trash. Discard only inhaler in Regulated Medical Waste Bin or as per vendor|
|Injectables: Pens, Vials, Ampules, etc.||Regulated Medical Waste bin||Dispose of paper packaging and plastic caps in regular trash. Do NOT open container to empty. Discard with container or vial intact.Discard only medication in container in Regulated Medical Waste Bin.|
|Oncology/ Hazmat Bulk Containers||Return to vendor/wholesaler when possible|
|Oncology/HazmatSamples, empty bulk containers||Regulated Medical Waste bin Or Hazmat Waste bin||Samples,empty containers including lids, cotton, etc. discard in Regulated Medical Waste bin or as per vendorWear protective clothing|
|Regulated medical waste bin||Remove paper packaging. Discard with container or vial intact.|
Adapted from HOPE Dispensary of Greater Bridgeport
Incinerating medications that are beyond use/expired may be completed economically by collaborating with law enforcement departments and manufacturing companies such as steel mills. In some states or communities, the DEA or law enforcement agency will permit charitable pharmacies to drop expired medications at the Drug Take Back Days orDrop of Sites. It is also possible that a law enforcement agency will share a “burn” at a manufacturer’s furnace when they are burning guns and other evidence. The law enforcement and security staff at the incineration company will coordinate the burn. The companies may work directly with the charitable pharmacy to permit them to have their own burn, with or without charge.
There is usually not a charge for the service when combined with law enforcement; however, the charitable pharmacy may have an expense of renting a vehicle if there is not access or pharmacy ownership of a van or truck. The cost is well worth it. A licensed pharmacist from the charitable pharmacy will accompany the medications to the furnace area and will observe the medications being thrown into the furnace. The pharmacist will wait the brief period of time it takes for the drugs to be destroyed. The company’s security department will give the pharmacy guidance on protocols for participating in a burn and clothing requirements.