Drug regulator lists 17 drugs that should be flushed down toilet if expired

New Delhi Apex drug regulatory body CDSCO has listed 17 drugs which should be flushed down the toilet rather than being thrown in dustbins if they have expired or are unused to help prevent harm to people and pets at home.

These include tramadol, tapentadol, diazepam, oxycodone and fentanyl which may be especially harmful and in some cases fatal with just one dose if they are used by someone other than the person for whom the medicine was prescribed, the Central Drugs Standard Control Organisation (CDSCO) said.

Most of these medicines are used to control pain, anxiety and other conditions.

Safe and proper disposal of expired or unused medicines is crucial for protecting the environment and public health, the CDSCO said in its Guidance Document on Disposal of Expired/Unused Drugs.

Ensuring the quality, safety and efficacy of these products is a critical aspect which contributes significantly to strengthening the assurance in public health system, including healthcare professional and other stakeholders.

Improper disposal of expired/unused drugs may be hazardous to public health, animal health and environment, it said.

Expired drug refers to drugs which have crossed the expiry date mentioned on the label. Further unused drugs refer to medications that have not been used by the individual for whom they were prescribed or purchased, the document said.

"Improper disposal of expired/unused drugs is detrimental to human, animal and environment and may be hazardous if it leads to contamination of water supplies or local sources used by nearby communities or wildlife. Expired drugs may come into the hands of scavengers and children if a landfill is insecure," the document said.

Pilfering from a stockpile of waste drugs or during sorting may result in expired drugs being diverted to the market for resale and misuse, it said.

Most pharmaceuticals past their expiry date become less efficacious and a few may develop a different adverse drug reaction profile. There are some categories of expired drugs or defective disposal practices that carry a public health risk, the document stated.

The document advised the state drugs control departments and chemists and druggists' association concerned to jointly launch 'Drug take back' site or programmes at designate locations, where people can drop expired or unused drugs from their homes.

The objective of this guidance document is to provide clear and comprehensive instructions in accordance with the Drugs and Cosmetics Act and Rules and other laws as applicable for the safe disposal of expired and unused drugs.

The document will also help to achieve the compliance with legal requirements and minimise environmental impact and mitigate public health risk, including antimicrobial resistance.