Safe Prescription Drug Disposal: Goodbye, Gengraf

If your experience with autoimmune disease has been like mine, you have probably been prescribed medications that were discontinued at some point. My latest med to be discontinued is Gengraf, since Dr. YG suspects that it may have caused my blood pressure to rise.

What's that? How's my blood pressure these days, you ask? Well. John has become remarkably proficient about slinging his/my stethoscope around his neck and deftly placing the blood pressure cuff. And overall, my blood pressure has decreased somewhat. But not dramatically, as I had hoped that it would.

Whatever. I guess a downward direction is much better than the other options. Patience, Julia. Patience.....

I don't believe that I will begin taking Gengraf again, which leaves me with the question of what to do with a full 90 day's worth of individually blister-packed capsules since I had just refilled my prescription. I have such greeeaaaat timing.

After asking some questions and looking around the FDA website among others, I've decided to do two things.

A. I'm going to hang onto these expensive puppies for awhile. The expiration date on this batch is December 2013, and who knows? It could be that at some point over the next year, Dr. YG may decide that Gengraf wasn't my hypertension culprit after all. I have a place to store them where they will remain cool, dry, and out of direct sunlight. I'm going to take a big ol' black magic marker and put the expiration date on the outside of the box, so that I don't forget to dispose of them eventually.

B. At some point before these drugs expire, I'll have to figure out a safe way to dispose of them. The question is, how?

I removed the package insert from one of the MANY BOXES, and read every bit of the teensy tiny print -- both sides -- in the hopes that disposal information was included.

Yikes. And, of course that information wasn't included.

.:blink:. This called for a serious eyedrop break.

Not to be deterred, I called my pharmacy. I was told that they couldn't accept drugs that had already been labeled and dispensed and that I should sit down with a pair of scissors, cut open each little blister package and throw all the capsules into a garbage bag, then throw used coffee grounds or used kitty litter in with them. Then I was advised to put the sealed garbage bag in with the rest of the trash, not with recyclable materials.

"Don't flush medications down the toilet unless specifically advised to," she added.

"The drugs could make their way into and contaminate our water."

The pharmacy technician also commented that I could wait until the next National Take-Back day, sponsored by the U.S. Department of Justice Drug Enforcement Administration. This year's event took place on May 3rd, this from the DOJ press release:

May 03 (Washington, D.C.) – The American people have again responded overwhelmingly to the most recent DEA-led National Prescription Drug Take-Back Day. On April 28th, citizens turned in a record-breaking 552,161 pounds (276 tons) of unwanted or expired medications for safe and proper disposal at the 5,659 take-back sites that were available in all 50 states and U.S. territories. When the results of the four Take Back Days to date are combined, the DEA and its state, local, and tribal law-enforcement and community partners have removed over 1.5 million pounds (774 tons) of medication from circulation.

I can do that. You can read more about the Drug Take-Back program and participating sites here.

If you don't have a participating Take-Back site nearby, or want to dispose of your medications sooner than the scheduled event date, here's what the FDA recommends for safe prescription drug disposal:


FDA worked with the White House Office of National Drug Control Policy (ONDCP) to develop the first consumer guidance for proper disposal of prescription drugs. Issued by ONDCP in February 2007 and updated in October 2009, the federal guidelines are summarized here: 


Follow any specific disposal instructions on the drug label or patient information that accompanies the medication. Do not flush prescription drugs down the toilet unless this information specifically instructs you to do so. 
     Take advantage of community drug take-back programs that allow the public to bring unused drugs to a central location for proper disposal. Call your city or county government's household trash and recycling service (see blue pages in phone book) to see if a take-back program is available in your community. The Drug Enforcement Administration, working with state and local law enforcement agencies, is sponsoring National Prescription Drug Take Back Days throughout the United States. 
     If no instructions are given on the drug label and no take-back program is available in your area, throw the drugs in the household trash, but first:
     - Take them out of their original containers and mix them with an undesirable substance, such as used coffee grounds or kitty litter. The medication will be less appealing to children and pets, and unrecognizable to people who may intentionally go through your trash.
     - Put them in a sealable bag, empty can, or other container to prevent the medication from leaking or breaking out of a garbage bag. 
     FDA's Deputy Director of the Office of Compliance Ilisa Bernstein, Pharm.D., J.D., offers some additional tips: 
     Before throwing out a medicine container, scratch out all identifying information on the prescription label to make it unreadable. This will help protect your identity and the privacy of your personal health information.
     Do not give medications to friends. Doctors prescribe drugs based on a person's specific symptoms and medical history. A drug that works for you could be dangerous for someone else.
     When in doubt about proper disposal, talk to your pharmacist.