Old medicine: take it back first, trash it mixed and sealed, and flush only what’s on the FDA list

Why clear it out

Old medicine in the house is mostly a risk to kids. FDA’s disposal questions and answers put numbers on it. [S4]

• 36,564 visits. In 2020 there were an estimated 36,564 emergency department visits among children aged 5 and under for unsupervised medication exposures, FDA says. Over two-thirds involved 1- or 2-year-olds, and nearly 13% ended in a hospital stay. [S4]
• Child-resistant isn’t childproof. FDA says even child-resistant containers cannot completely stop a child from taking medicine that belongs to someone else, and keeping medicines after they’re no longer needed creates an unnecessary health risk. [S4]
• One dose can kill. The drugs on FDA’s flush list can cause death from one dose if taken by the wrong person, and they are sought after for misuse. That applies to children, adults and pets. [S3] [S4]

Take-back comes first

FDA lists several kinds of take-back, and says everything dropped off is destroyed. [S5]

• Year-round drop-off. Some retail, hospital and clinic pharmacies and law enforcement sites are registered with the DEA to collect unused medicine, including controlled substances, often in an on-site kiosk or drop box. FDA links the DEA’s year-round location search, and suggests searching a map app for “drug disposal near me.” The DEA Diversion Control Division registration call center, 1-800-882-9539, also has information. [S5]
• Take Back Days. The DEA periodically holds National Prescription Drug Take Back Day, with temporary collection sites in communities nationwide, and local police may run their own events. The DEA says its April 2026 event, the 30th, collected 642,410 pounds at 4,417 sites. Its page has a collection site locator by zip code. [S1] [S5] [S6]
• Mail-back envelopes. Prepaid drug mail-back envelopes are sold at some retail pharmacies and online, and some pharmacies give them out at no cost. Fill the envelope, seal it and mail it through the U.S. Postal Service. [S1] [S5]
• Before you drop it off. FDA says to scratch out all personal information on pill bottle labels and medicine packaging. [S5]

No take-back nearby? Trash it right

FDA says almost all medicines, except those on the flush list, can go in household trash when take-back isn’t available and the medicine has no specific disposal instructions. That covers prescription and over-the-counter pills, liquids, drops, patches and creams. [S1] [S2]

1. Take the drugs out of their original containers. [S2]
2. Mix them with something unappealing, like used coffee grounds, dirt or cat litter. Don’t crush tablets or capsules. FDA says the mix makes medicine less appealing to children and pets, and unrecognizable to someone going through the trash. [S1] [S2]
3. Seal it in something that closes, like a resealable zipper bag or an empty can, so nothing leaks or spills. [S1] [S2]
4. Throw the container away in your trash at home. [S2]
5. Scratch out your name and other personal information on the empty bottles and packaging, then trash or recycle them. [S1] [S2]

The flush list

FDA keeps a short list of medicines to flush down the toilet right away, but only when no take-back option is readily available. Everything else stays out of the toilet. [S3]

• Opioids by name. Any drug whose ingredients include buprenorphine, fentanyl, hydrocodone or benzhydrocodone, hydromorphone, meperidine, methadone, morphine, oxycodone, oxymorphone or tapentadol. Brand examples on FDA’s list include Percocet, OxyContin, Vicodin, Norco and Suboxone. [S3]
• Three that aren’t opioids. Sodium oxybate (Xyrem, Xywav), diazepam rectal gel (Diastat) and the methylphenidate patch (Daytrana). [S3]
• Fentanyl patches, even used ones. FDA says a lot of medicine remains in a patch after use, which is why the drug comes with instructions to flush used or leftover patches. [S1]
• Check the label. The label or patient information leaflet says if a medicine should be flushed, and FDA’s list links each product’s disposal instructions. [S1] [S3]

On the water supply: FDA says the main way drug residues reach water is people taking medicine and passing it through their bodies. Its staff paper on the 15 active ingredients on the list found negligible risk to the environment, though FDA notes more data would help confirm that for some of them. FDA’s view is that the risk of an accidental exposure in the home far outweighs it. [S1] [S3]

Inhalers, sprays and other odd ones

• Inhalers and aerosols. FDA says these could be dangerous if punctured or thrown into a fire or incinerator. Read the handling instructions on the label, and contact your trash and recycling facility to follow local rules. [S1]
• Sprays, lozenges and other uncommon forms can have product-specific disposal instructions. Check what came with the prescription or ask a pharmacist. [S1] [S4]
• A provider’s instructions win. FDA says that if your doctor or pharmacist gave you specific disposal instructions, follow those. [S3]
• Assisted living or hospice. FDA says to check with the community’s or hospice’s care team first; if disposal is up to you, use the same take-back, flush list and trash order. [S4]

Needles, syringes and lancets

FDA says never to throw loose needles or other sharps in the trash or recycling, and never to flush them. It recommends two steps. [S7] [S8]

1. Into a sharps container right after use. FDA-cleared containers are rigid plastic with a fill line and are sold through pharmacies, medical supply companies, health care providers and online. Keep it out of reach of children and pets. [S7] [S9]
2. No container yet? FDA says some organizations and community guidelines accept a heavy-duty plastic household container, like a laundry detergent bottle: leak-resistant, upright and stable, with a tight, puncture-resistant lid, and labeled to warn what’s inside. [S9]
3. Stop at three-quarters full. Overfilling raises the risk of a needle stick. At about 3/4 full, follow your community’s guidelines, and don’t reuse the container. [S7]
4. Where it goes depends on where you live: a drop box or supervised collection site (doctors’ offices, hospitals, pharmacies, health departments, police or fire stations), a household hazardous waste site, a mail-back program, or a special pickup service. Safe Needle Disposal, 1-800-643-1643, has information for your state. [S7]

Until it’s gone

Up and Away, a PROTECT initiative first created with the CDC, says about 35,000 young children go to the emergency room each year after getting into medicine left within reach. Its tips: [S10]

• Up high and out of sight, even between doses, including vitamins and gummies, and medicine in purses, bags, pockets and pill organizers. [S10]
• Hear the click. Keep medicine in its original child-resistant container and twist the cap until it clicks. Many pill organizers aren’t child-resistant. [S10]
• No loose pills on the counter, table or nightstand. To a young child, pills can look like candy. Never call medicine candy. [S10]
• Tell guests, including grandparents, to keep bags and coats with medicine in them up and away. [S10]

If someone got into it

Poison Help, 1-800-222-1222, is free and open 24/7 in over 100 languages. Up and Away says to call right away if you think a child got into a medicine, vitamin or supplement, even if you aren’t completely sure. [S10] [S11]

Find your way out

Pick what you have and whether a take-back kiosk or envelope is easy to get. The answer puts the FDA steps from this page in one place. A pharmacist’s instructions still come first. [S1] [S3] [S7]

Medicine cabinet clear-out

Clearing out a junk drawer too? Our old batteries guide covers taping and drop-off, and our child thermometer guide covers what to use instead of an old mercury thermometer.

Quick answers