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<DIV><FONT face=Arial><SPAN class=079573711-07112007></SPAN></FONT><FONT
face=Tahoma><FONT size=2> </FONT></FONT></DIV>
<DIV><SPAN class=079573711-07112007><FONT size=4> Hello, I'm a medical
correspondent with NBC News Channel. </FONT></SPAN></DIV>
<DIV><SPAN class=079573711-07112007><FONT size=4></FONT></SPAN> </DIV>
<DIV><SPAN class=079573711-07112007><FONT size=4> I've been working on a
story about Prescription Drug Disposal and came across your list serv during a
simple term search. The information I found there was by far the most
helpful and most insightful. It helped change the focus of my story.
</FONT></SPAN></DIV>
<DIV><SPAN class=079573711-07112007></SPAN><SPAN class=079573711-07112007><FONT
size=4> </FONT></SPAN></DIV>
<DIV><FONT size=4><SPAN class=079573711-07112007>I want to say thank you and to
share the clarification stumbling blocks I'm working on as I try to get this
piece on the air. Below is the note to media contacts at the EPA, White House,
and FDA. I also forwarded a link to the list serv thread that
highlights the confusion to some of those contacts. Please know I am not
publishing or quoting any of the thread - just used it as a resource for my
research.</SPAN></FONT></DIV>
<DIV><FONT size=4><SPAN class=079573711-07112007></SPAN></FONT> </DIV>
<DIV><FONT size=4><SPAN class=079573711-07112007>Here's the latest note.
I'd love to get your feedback and any updates on efforts to get the list
updated.</SPAN></FONT></DIV>
<DIV><FONT size=4><SPAN class=079573711-07112007></SPAN></FONT> </DIV>
<DIV><FONT size=4><SPAN class=079573711-07112007>Kind
regards,</SPAN></FONT></DIV>
<DIV><FONT size=4><SPAN class=079573711-07112007>Helen</SPAN></FONT></DIV>
<DIV><FONT size=4><SPAN class=079573711-07112007>Helen
Chickering</SPAN></FONT></DIV>
<DIV><FONT size=4><SPAN class=079573711-07112007>Medical
Correspondent</SPAN></FONT></DIV>
<DIV><FONT size=4><SPAN class=079573711-07112007>NBC News
Channel</SPAN></FONT></DIV>
<DIV><FONT size=4><SPAN class=079573711-07112007> </SPAN></FONT><SPAN
class=079573711-07112007><FONT face=Arial color=#0000ff size=2>
</FONT></SPAN><SPAN class=504271601-07112007><FONT
size=4></FONT></SPAN></DIV>
<DIV><SPAN class=504271601-07112007></SPAN><FONT size=4> We've delayed this
piece fo<SPAN class=504271601-07112007>r a noon release tomorrow. </SPAN><SPAN
class=504271601-07112007> </SPAN>A few more questions/clarification
issues<SPAN class=504271601-07112007> with an ASAP
deadline. </SPAN></FONT></DIV>
<DIV><FONT size=2><SPAN class=504271601-07112007></SPAN><FONT size=4><SPAN
class=504271601-07112007> I'm sending this message to all parties.
Please answer areas that apply. Thank you!</SPAN></FONT></FONT></DIV>
<DIV><FONT size=2><FONT size=4><SPAN
class=504271601-07112007></SPAN></FONT></FONT> </DIV>
<DIV><FONT size=2><FONT size=4><SPAN
class=504271601-07112007></SPAN></FONT></FONT> </DIV>
<DIV><FONT size=2><FONT size=4><SPAN class=504271601-07112007>Story
angle: As scientists continue to study pharmaceuticals and the water
supply - (science that has uncovered trace amounts - parts per trillion,
suggests an impact on environment/aquatic life - no impact so far on
people) The public is becoming aware of drug disposal concerns -
specifically - flushing isn't environmentally friendly. While we wait for
science to uncover a greener way to dispose of drugs - what's the
consensus about the best way for consumers to dispose of prescription
drugs?</SPAN></FONT></FONT></DIV>
<DIV><FONT size=2><FONT size=4><SPAN
class=504271601-07112007></SPAN></FONT></FONT> </DIV>
<DIV><FONT size=2><FONT size=4><SPAN class=504271601-07112007><FONT face=Arial
size=2>Right now my story is focusing more on the confusion by different
messages a person might find - depending on where they go first.
Jennifer DeVallance with ONDCP - has this comment about the different
guidelines the public may encounter in their search for green disposal
information.</FONT></SPAN></FONT></FONT></DIV>
<DIV><FONT size=2><FONT size=4><SPAN class=504271601-07112007><FONT face=Arial
size=2></FONT></SPAN></FONT></FONT> </DIV>
<DIV><FONT size=2><FONT size=4><SPAN class=504271601-07112007><FONT face=Arial
size=2>" Regardless of the approach - federal state and local entities are
all interested safeguarding legitimate access to prescription medications, while
preventing diversion, abuse and protecting the environment. All
encourage people to monitor and safeguard prescription drugs and dispose of them
when they are expired or no longer needed. "</FONT></SPAN></DIV>
<DIV><BR><BR></FONT><BR>1. <SPAN class=504271601-07112007><FONT
size=3><STRONG>Consumer Prescription Drug Disposal Programs</STRONG></FONT>
-<FONT size=3> </FONT></SPAN></FONT><FONT size=3>While I appreciate the
information about past <SPAN class=504271601-07112007>pilot
projects</SPAN>, <SPAN class=504271601-07112007>m</SPAN>y
question <SPAN class=504271601-07112007>is Where are we now?
Are the EPA and other organizations in a research and development phase -
gathering stats, etc. from various pilot projects in an effort to come up with
recommendations or some sort of national standard? <STRONG>Is there
any formal effort to find a reasonable/environmentally friendly drug disposal
option for consumers? IF so what is the plan and deadline? If not -
what is the purpose of these pilot programs - is there any unified goal - or are
they just a collection of efforts by different organizations?
</STRONG></SPAN></FONT></DIV>
<DIV><SPAN class=504271601-07112007><FONT face=Arial
size=2></FONT></SPAN> </DIV>
<DIV><FONT size=2><FONT size=3> Is this more recent project through the the
Substance Abuse and Mental Health Services Administration - which seems to be an
education effort - an effort to take<SPAN
class=504271601-07112007>/study</SPAN> a different<SPAN
class=504271601-07112007> </SPAN>angle to this problem - or just another groups
effort to tackle the drug disposal-environment-abuse issue?</FONT></FONT></DIV>
<DIV><FONT size=2><FONT size=3></FONT></FONT> </DIV>
<DIV><FONT size=2><SPAN class=504271601-07112007><FONT size=3>2. <STRONG>Where
can consumers go</STRONG> - now - for the most accurate information on
prescription drug disposal? <STRONG>Is the issue of how drugs are disposed -
kitty litter v. flushing - a real risk factor when it comes to drug
abuse/addiction? How do you know - Is there scientific or other
evidence that proves or suggests this? Or is it a drug storage
issue? </STRONG></FONT></SPAN></DIV>
<DIV><FONT face=Arial></FONT><BR></DIV></FONT>
<DIV><BR><FONT size=2><SPAN class=504271601-07112007>3</SPAN> <FONT
size=3><STRONG>The FDA list </STRONG></FONT><SPAN
class=504271601-07112007><FONT size=3><STRONG>of drugs consumers should
flush</STRONG></FONT>. <FONT size=3> Questions - Where did this
list come from? What is the reasoning behind the list? Specific
questions - </FONT></SPAN></FONT><FONT size=3><SPAN
class=504271601-07112007>Oxycodone and other opiates - obviously the abuse issue
here. But where is Hydrocodone? </SPAN><SPAN class=504271601-07112007>Drug
patches are on the list too - are they meant to be flushed?
Daytrana drug info on FDA site recommends not
flushing. </SPAN><SPAN class=504271601-07112007>Xyrem is a
rarely used drug - a narcolepsy drug - Why is this on the list?
Antibiotics -</SPAN><SPAN class=504271601-07112007>Gatifloxacin/
Fluoroquinolones are </SPAN></FONT><SPAN class=504271601-07112007>antibiotics -
why are they on the list - especially when even patients who take the drug send
concentrated amounts into the system. </SPAN></DIV>
<DIV><SPAN class=504271601-07112007>Baraclude Tablets (entecavir), Reyataz
Capsules (atazanavir sulfate),Zerit for Oral Solution (stavudine) are all
anti-HIV meds. Why are they on the list?</SPAN></DIV>
<DIV><SPAN class=504271601-07112007><FONT
face=Arial> </FONT></SPAN></DIV>
<DIV><FONT size=2><SPAN class=504271601-07112007></SPAN></FONT> </DIV>
<DIV><FONT size=2><SPAN class=504271601-07112007><FONT size=3><STRONG>More FDA
flushing list questions.</STRONG></FONT> <FONT size=3>The White House website -
(and today's AP article note - Once, patients were told to flush old drugs down
the toilet. No more — do not flush unless you have one of the few prescriptions
that the Food and Drug Administration specifically labels for
flushing....).<BR></FONT></SPAN></FONT></DIV>
<DIV><SPAN class=504271601-07112007>I researched the list - and that is not the
case for every drug - at least not from what I could find on the FDA website -
patient and/or label info. In addition, most of the disposal
information is buried - not sure how patients would even see
it.</DIV></SPAN><FONT face=Arial size=2></FONT>
<DIV><BR><FONT size=2> The FDA advises that the
following drugs be flushed down the<BR> toilet
instead of thrown in the trash:<SPAN class=504271601-07112007>
</SPAN><BR>
Actiq (fentanyl citrate)<SPAN class=504271601-07112007> -<FONT
color=#ff0000> - narc pain med - lollipop - rinse down drain - toss
the
sticks</FONT></SPAN><BR>
Daytrana Transdermal Patch (methylphenidate)<SPAN class=504271601-07112007>
-<FONT color=#ff0000> - this is an adhd patch - Says Do Not
Flush</FONT></SPAN><BR>
Duragesic Transdermal System (fentanyl)<SPAN class=504271601-07112007>
- <FONT color=#ff0000>pain patch - do
flush</FONT></SPAN><BR>
OxyContin Tablets (oxycodone)<SPAN class=504271601-07112007> - <FONT
color=#ff0000>narcoctic pain med -
flush</FONT></SPAN><BR>
Avinza Capsules (morphine sulfate)<SPAN class=504271601-07112007> <FONT
color=#ff0000>narcotic pain -
flush</FONT></SPAN><BR>
Baraclude Tablets (entecavir)<SPAN class=504271601-07112007> <FONT
color=#ff0000>hep b medicine - flush or down
sink</FONT></SPAN><BR>
Reyataz Capsules (atazanavir sulfate)<SPAN class=504271601-07112007> <FONT
color=#ff0000>hiv med - flush or down
sink</FONT></SPAN><BR>
Tequin Tablets (gatifloxacin)<SPAN class=504271601-07112007> - <FONT
color=#ff0000>antibiotic -
flush</FONT></SPAN><BR>
Zerit for Oral Solution (stavudine)<SPAN class=504271601-07112007> - <FONT
color=#ff0000>HIV - oral kids drug - first rec says throw away, bottom notes
flush</FONT></SPAN><BR>
Meperidine HCl Tablets<SPAN class=504271601-07112007> - <FONT
color=#ff0000>narcotic
flush</FONT></SPAN><BR>
Percocet (Oxycodone and Acetaminophen)<SPAN class=504271601-07112007> - <FONT
color=#ff0000>narcotic
flush</FONT></SPAN><BR>
Xyrem (Sodium Oxybate)<SPAN class=504271601-07112007> - <FONT
color=#ff0000>narcolepsy drug/controlled -
flush</FONT></SPAN><BR>
Fentora (fentanyl buccal tablet)<SPAN class=504271601-07112007> - <FONT
color=#ff0000>narc/pain for cancer patients - flush</FONT></SPAN></FONT></DIV>
<DIV><FONT size=2></FONT> </DIV>
<DIV><SPAN class=504271601-07112007><FONT size=2>Details from website search:
</FONT></SPAN></DIV>
<DIV><FONT size=2>FDA consumer drug disposal information from FDA website: - no
flush - but rinse down drain or trhow away<BR>1. How should I dispose of Actiq
after use?<BR>Partially used Actiq units may contain enough medicine to be
harmful or fatal to a child or other adults<BR>who have not been prescribed
Actiq. You must properly dispose of the Actiq handle right away<BR>after use
even if there is little or no medicine left on it. Please follow these
directions to dispose of<BR>the handle:<BR>1. Once you have finished the Actiq
unit and the medicine is totally gone, throw the handle away<BR>in a place that
is out of the reach of children.<BR>2. If any medicine remains on the handle
after you have finished, place the handle under hot<BR>running water until the
medicine is gone, and then throw the handle away out of the reach of<BR>children
and pets.<BR>3. NDA 20-747/S-023<BR>Page 54<BR>3. If you did not finish the
entire Actiq unit and you cannot dissolve the medicine under hot<BR>running
water right away, put the Actiq in the temporary storage bottle that you
received in the<BR>Actiq Welcome Kit for safe keeping. Push the Actiq unit into
the opening on the top until it falls<BR>completely into the bottle. Never leave
unused or partially used Actiq units where children<BR>or pets can get to
them.<BR>4. Dispose of the handles in the temporary storage bottle as soon as
you can by following the<BR>directions in steps 1 and 2. You must dispose of all
handles in the temporary storage bottle at<BR>least once a day.<BR>Do not flush
entire unused Actiq units, Actiq handles, or blister packages down the
toilet.</FONT></DIV>
<P><FONT color=#ff0000><FONT color=#000000 size=2>2. How should I store
DaytranaTM? - no flush<BR>• Store DaytranaTM in a safe place at room
temperature, 59 to 86° F (15 to 30° C). Keep DaytranaTM patches in<BR>their
unopened pouches until ready to use.<BR>• Once a tray of patches has been
opened, use or discard the patches within 2 months.<BR>• Keep DaytranaTM and all
medicines out of the reach of children.</FONT></FONT><FONT color=#ff0000><FONT
color=#000000 size=2> HOW TO REMOVE AND DISCARD DAYTRANATM<BR>• When you
remove the patch, peel it off slowly.<BR>• Fold the used DaytranaTM patch in
half and press firmly so that the sticky side sticks to<BR>the used patch down
the toilet or dispose of it in a lidded container right away.<BR>• Do not flush
the pouches or the protective liners down the toilet. These items should
be<BR>in a lidded container.<BR>• If any sticky material (adhesive) remains on
the child’s skin after removing the patch, gently<BR>area with oil or lotion to
remove the adhesive from the skin.<BR>• Wash your hands after handling the
patch.<BR>• After the patch is removed and disposed of, record this time on the
administration chart.</FONT></FONT></P>
<P><FONT size=2>3. Duragesic Transdermal System (fentanyl) - yes flu<SPAN
class=504271601-07112007>sh </SPAN></FONT><FONT color=#ff0000><FONT
color=#000000><FONT size=2>After you have stopped using a patch, be sure to fold
the sticky sides of the patch together and flush it down the toilet. Do not put
used fentanyl skin patches in a garbage c</FONT></P>
<LI><FONT size=2>If your healthcare professional tells you to stop using the
fentanyl skin patch, throw away the unused packages. Open the unused packages
and fold the sticky sides of the patchtogether, and flush them down the toilet.
</FONT>
<LI>
<DIV><FONT color=#0000ff size=2></FONT> </DIV>
<DIV><FONT color=#0000ff size=2>4. Oxycontin - yes flush</FONT></DIV>
<DIV><FONT color=#0000ff size=2>11. Patients should be instructed to keep
OxyContin in a secure place out of the reach of<BR>children. When OxyContin is
no longer needed, the unused tablets should be destroyed<BR>by flushing down the
toilet.</FONT></DIV>
<DIV><FONT color=#0000ff size=2>you have been taking it for more than a few
days.<BR>After you stop taking OxyContin, flush the unused tablets down the
toilet.<BR>What Should I Avoid While Taking OxyContin®?</FONT></DIV>
<DIV><FONT color=#0000ff size=2></FONT> </DIV>
<DIV><FONT color=#0000ff size=2>4. Avinza - Narcotic - yes - Flush</FONT></DIV>
<DIV><FONT color=#0000ff size=2> Patients should be instructed to keep
AVINZA in a secure place out of the reach<BR>of children. When AVINZA is no
longer needed, the unused capsules should be<BR>destroyed by flushing down the
toilet.</FONT></DIV>
<DIV><FONT color=#0000ff size=2></FONT> </DIV>
<DIV><FONT color=#0000ff size=2>5. Baraclude is a prescription medicine used for
chronic infection with hepatitis B virus (HBV) in adults who also have active
liver damage. - No disposal info on patient info sheet. Lactic
Acidosis/Liver problems side effects. - Found flushing info on more
detailed label section:</FONT></DIV>
<DIV><STRONG><FONT color=#0000ff size=2></FONT></STRONG> </DIV>
<DIV><FONT color=#0000ff><FONT size=2>Storage<BR>616 BARCLUDE Tablets should be
stored in a tightly closed container at 25° C (77° F);<BR>617 excursions
permitted between 15-30° C (59-86° F) (see USP Controlled Room<BR>61 8
Temperature).<BR>619 BARCLUDE Oral Solution should be stored in the outer carton
at 25° C (77° F);<BR>620 excursions permitted between 15-30° C (59-86° F) (see
USP Controlled Room<BR>621 Temperature). Protect from light. After opening, the
oral solution can be used up to the<BR>622 expiration date on the
botte.</FONT><FONT size=2><STRONG> The bottle and its contents should be
discarded after the<BR>623 expiration date.<BR></STRONG>624</FONT></FONT></DIV>
<DIV><FONT color=#0000ff size=2></FONT> </DIV>
<DIV><FONT color=#0000ff size=2>side effects.<BR>771 How should i store
BARACLUDE?<BR>772 · Store BARCLUDE Tablets or Oral Solution at room temperature,
59° to 86° F (15°<BR>773 to 30° C). They do not require refrigeration. Do not
store BARCLUDE Tablets in a<BR>77 4 damp place such as a bathroom medicine
cabinet or near the kitchen sink.<BR>775 . Keep the container tightly closed.
BARCLUDE Oral Solution should be stored in<BR>776 the original carton and
protected from light.<BR>777 . Throwaway BARCLUDE when it is outdated or no
longer needed by flushing<BR>778 tablets down the toilet or pouring the oral
solution down the sink.<BR>779 . Keep BARACLUDE and all medicines out of the
reach of children and pets.</FONT></DIV>
<DIV><BR><FONT color=#0000ff size=2> </FONT></DIV>
<DIV><FONT color=#0000ff size=2>6. Reyataz is a prescription medicine used with
other anti-HIV medicines to treat people who are infected with the human
immunodeficiency virus (HIV). Reyataz is a type of anti-HIV medicine called a
protease inhibitor. Reyataz helps to block HIV protease, an enzyme that is
</FONT></DIV>
<DIV><FONT color=#0000ff size=2>FLush - yes </FONT></DIV>
<DIV><FONT color=#0000ff size=2>Store REYATAZ Capsules at room temperature, 59°
to 86° F (15° to 30° C). Do not store this<BR>medicine in a damp place such as a
bathroom medicine cabinet or near the kitchen sink.<BR>• Keep your medicine in a
tightly closed container.<BR>• Throw away REYATAZ when it is outdated or no
longer needed by flushing it down the toilet or<BR>pouring it down the
sink.<BR>General information about REYATAZ</FONT></DIV>
<DIV><FONT color=#0000ff size=2></FONT> </DIV>
<DIV><FONT size=2><FONT color=#0000ff>7. Tequin<SPAN class=504271601-07112007> -
flushing yes - Tequin</SPAN> is an antibiotic used to treat adults with
lung, sinus, or urinary tract infections and also to treat certain sexually
transmitted diseases caused by germs called bacteria. <SPAN
class=504271601-07112007> </SPAN></FONT><FONT color=#0000ff>The sexually
transmitted disease called gonorrhea is treated by Tequin. Other sexually
transmitted diseases including syphilis and non-gonococcal diseases are not
treated by Tequin. </FONT></FONT></DIV>
<DIV><FONT color=#0000ff></FONT><FONT color=#0000ff></FONT><FONT color=#0000ff
size=2>Remember<BR>• Take your dose of TEQUIN once a day.<BR>• Complete the
course of medication (take all of the pills) even if you are feeling
better.<BR>• Do not use TEQUIN for another condition or give it to others.<BR>•
Store TEQUIN tablets at room temperature in a tightly sealed container.<BR>•
Throw away TEQUIN when it is outdated or no longer needed by flushing it down
the<BR>toilet.<BR>• Keep this and all medications out of reach of
children.<BR></FONT></DIV>
<LI>
<DIV><SPAN class=504271601-07112007></SPAN><FONT color=#0000ff><FONT
size=2>8</FONT><SPAN class=504271601-07112007><FONT size=2>. Zerit - ZERIT oral
solution - "throw away - then at very bottom - Flush" (pronounced ZAIR
it) is a prescription medicine used in combination with other<BR>drugs to treat
adults and childen who are infected with HIV (the human<BR>immunodeficiency
virus), the virus that causes AIDS. ZERIT belongs to a class of drugs<BR>called
nucleoside reverse transcriptase inhibitors (NRTIs). By reducing the growth
of<BR>HIV, ZERIT helps your body maintain its supply of CD4 cells, which are
important for<BR>fighting HIV and other
infections.</FONT></SPAN></FONT><BR></FONT><FONT color=#000000><FONT size=2>Oral
solution (for children): ZERIT for Oral Solution is taken twice a day (every
12<BR>hours). If your child will be taking ZERIT, the doctor should give you
written<BR>instructions on how to give this medicine. Before measuring each
dose, shake the<BR>bottle well. Store ZERIT for Oral Solution in a tightly
closed container in a<BR>refrigerator and <STRONG>throw away any unused portion
after 30 days.</STRONG></FONT></FONT></DIV>
<LI>
<DIV><FONT color=#000000 size=2>This medicine was prescribed for your particular
condition. Do not use ZERIT for another<BR>condition or give it to others. Keep
ZERIT and all other medicines out of the reach of children.<BR>Throw away ZERIT
when it is outdated or no longer needed by flushing it down the toilet
or<BR>pouring it down the sink.<BR></FONT></DIV>
<LI>
<DIV><SPAN class=504271601-07112007></SPAN><FONT color=#000000
size=2>9</FONT><SPAN class=504271601-07112007><FONT color=#000000 size=2>.
Meperidine HCl Tablets - morphine like substance - for pain
relief</FONT></DIV>
<OL>
<LI>
<P class=First><FONT color=#000000 size=2>Patients should be advised that if
they have been receiving treatment with meperidine for more than a few weeks
and cessation of therapy is indicated, it may be appropriate to taper the
meperidine dose, rather than abruptly discontinue it, due to the risk of
precipitating withdrawal symptoms. Their physician can provide a dose schedule
to accomplish a gradual discontinuation of the medication.</FONT></P>
<LI>
<P class=First><FONT color=#000000><FONT size=2>Patients should be instructed
to keep meperidine in a secure place out of the reach of children. When
meperidine is no longer needed, the unused tablets should be destroyed by
flushing down the toile<SPAN class=504271601-07112007>t.
</SPAN></FONT></FONT></P></LI></OL>
<P class=First><FONT color=#000000 size=2><SPAN class=504271601-07112007>10.
percocet - Percocet (Oxycodone and Acetaminophen)
narcotic pain relief - flush</SPAN></FONT></P></SPAN>
<LI><SPAN class=504271601-07112007>
<P class=First><FONT color=#000000 size=2><SPAN class=504271601-07112007>When
PERCOCET tablets are no longer needed, the unused tablets should be destroyed
by<BR>flushing down the toilet.<BR>4. Patients should be
advised</SPAN></FONT></P></SPAN><SPAN class=504271601-07112007>
<P class=First><FONT color=#000000 size=2><SPAN class=504271601-07112007>11.
Xyrem - Xyremâ (sodium oxybate) is a central nervous system depressant with
anti-cataplectic activity in<BR>patients with narcolepsy<BR>Your doctor has
determined that you may benefit<BR>from taking Xyrem. Xyrem has been shown
to<BR>reduce excessive daytime sleepiness and<BR>cataplexy in patients with
narcolepsy.<BR></SPAN></FONT></SPAN></FONT><FONT face=Arial size=2> When
you can no longer draw medication<BR>out of the bottle with the measuring
device,<BR>it is time to throw the bottle away. Use a<BR>marker or pen to deface
the bottle label<BR>so someone else cannot use it for illicit<BR>purposes. Pour
any unused Xyrem®<BR>down the drain. Place the empty bottle<BR>in the trash so
it is not used for illegal<BR>purposes.</FONT></P>
<P class=First><SPAN class=504271601-07112007></SPAN><FONT face=Arial><FONT
size=2>1<SPAN class=504271601-07112007>2. Fentora - Flush Yes - FENTORA is
a prescription medicine that contains the medicine
fentanyl.</SPAN></FONT></FONT></P>
<P class=First><FONT size=2><FONT size=+0><SPAN
class=504271601-07112007> Patients and caregivers should be advised that if
they have been receiving treatment<BR>with FENTORA and the medicine is no longer
needed they should flush any<BR>remaining product down the toilet, and if they
then need further assistance, contact<BR>Cephalon at 1-800-896-5855.<BR>Disposal
of Unopened FENTORA Blister Packages When No Longer Needed<BR>Patients and
members of their household must be advised to dispose of any unopened<BR>blister
packages remaining from a prescription as soon as they are no longer
needed.<BR>To dispose of unused FENTORA, remove FENTORA tablets from blister
packages and<BR>flush down the toilet. Do not flush the FENTORA blister packages
or cartons down the<BR>toilet. (See SAFETY AND HANDLING.)<BR>Detailed
instructions for the proper storage, administration, disposal, and
important<BR>instructions for managing an overdose of FENTORA are provided in
the FENTORA<BR>Medication Guide. Patients should be encouraged to read this
information in its entirety<BR>and be given an opportunity to have their
questions answered.<BR>In the event that a caregiver requires additional
assistance in disposing of excess unusable<BR>tablets that remain in the home
after a patient has expired, they should be instructed to<BR>call the Cephalon
toll-free number (1-800-896-5855) or seek assistance</SPAN></FONT><BR><SPAN
class=504271601-07112007><FONT
face=Arial> </FONT></SPAN></FONT></P></LI></BODY></HTML>