Drugs in our Water Supply

 Updated 3/2017-- all links removed as many no longer active.

The news today is full of the headlines -- "Pharmaceuticals in Drinking Water".

As I mentioned in my post on "Unused Medicines", the question of what to tell patients to do with unused medicines has changed since I was in medical school. We were taught to tell patients to flush them. That is not a good idea. But what do we tell them? It seems that the new advise is not always always clear. The two best sites I found were the American Pharmacy Association and the White House Drug Policy.

The Federal Guidelines state:

• Take unused, unneeded, or expired prescription drugs out of their original containers and throw them in the trash.
• Mixing prescription drugs with an undesirable substance, such as used coffee grounds or kitty litter, and putting them in impermeable, non-descript containers,such as empty cans or sealable bags, will further ensure the drugs are not diverted.
• Flush prescription drugs down the toilet only if the label or accompanying patient information specifically instructs doing so ( see list below).
• Take advantage of community pharmaceutical take-back programs that allow the public to bring unused drugs to a central location for proper disposal. Some communities have pharmaceutical take-back programs or community solid-waste programs that allow the public to bring unused drugs to a central location for proper disposal. Where these exist, they are a good way to dispose of unused pharmaceuticals.

The FDA advises that the following drugs be flushed down the toilet instead of thrown in the trash:
Actiq (fentanyl citrate)
Daytrana Transdermal Patch (methylphenidate)
Duragesic Transdermal System (fentanyl)
OxyContin Tablets (oxycodone)
Avinza Capsules (morphine sulfate)
Baraclude Tablets (entecavir)
Reyataz Capsules (atazanavir sulfate)
Tequin Tablets (gatifloxacin)
Zerit for Oral Solution (stavudine)
Meperidine HCl TabletsPercocet (Oxycodone and Acetaminophen)
Xyrem (Sodium Oxybate)Fentora (fentanyl buccal tablet)