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<p class="MsoNormal">Good morning,<o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal">I’ve gotten the occasional question from hospital workers here in Ohio about policies to rinse Schedule IV drugs down the drain. As I generally work with the residential side of things, I’m not as well-versed on hospital practices. However,
it seems to me there is a serious disconnect between the message from the environmental folks (like my agency, Ohio EPA) and the FDA. The FDA’s most recent guidance still suggests flushing a lengthy list of pharms (see below). Has anyone had any experience
with hospitals making it a policy to NOT flush pharmaceuticals? As far as I know, it is still legal to flush the pharmaceuticals that FDA advises. But I guess I’d like to see some sort of solution that involves incinerating ALL pharms, even the ones that
have historically been flushed. Do any of you have any suggestions I could pass on to Ohio hospitals?<o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal">Thanks,<o:p></o:p></p>
<p class="MsoNormal">Deb <o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<table class="MsoNormalTable" border="0" cellpadding="0" summary="layout">
<thead>
<tr>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal" align="center" style="text-align:center"><em><b><span style="font-family:"Calibri","sans-serif"">Medicine</span></b></em><b><span style="font-size:12.0pt"><o:p></o:p></span></b></p>
</td>
<td style="padding:.75pt .75pt .75pt .75pt">
<h5 align="center" style="text-align:center"><em>Active Ingredient</em><o:p></o:p></h5>
</td>
</tr>
</thead>
<tbody>
<tr>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal"><a href="http://www.fda.gov/downloads/Drugs/DrugSafety/UCM239930.pdf"><strong><span style="font-family:"Calibri","sans-serif";color:blue">Abstral
</span></strong>(PDF - 1M)</a><strong><span style="font-family:"Calibri","sans-serif"">,
</span></strong>tablets (sublingual)<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal">Fentanyl<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
</tr>
<tr>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal"><a href="http://www.fda.gov/downloads/Drugs/DrugSafety/UCM085817.pdf"><strong><span style="font-family:"Calibri","sans-serif";color:blue">Actiq
</span></strong>(PDF - 251KB)</a>, oral transmucosal lozenge <strong><span style="font-family:"Calibri","sans-serif"">*</span></strong><span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal">Fentanyl Citrate<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
</tr>
<tr>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal"><a href="http://www.fda.gov/downloads/Drugs/DrugSafety/UCM311346.pdf"><strong><span style="font-family:"Calibri","sans-serif";color:blue">Avinza
</span></strong>(PDF - 51KB)</a>, capsules (extended release)<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal">Morphine Sulfate<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
</tr>
<tr>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal"><strong><span style="font-family:"Calibri","sans-serif"">Buprenorphine Hydrochloride</span></strong>, tablets (sublingual)
<strong><span style="font-family:"Calibri","sans-serif"">*</span></strong><span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal">Buprenorphine Hydrochloride<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
</tr>
<tr>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal"><strong><span style="font-family:"Calibri","sans-serif"">Buprenorphine Hydrochloride; Naloxone Hydrochloride</span></strong>, tablets (sublingual) *<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal">Buprenorphine Hydrochloride; Naloxone Hydrochloride<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
</tr>
<tr>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal"><a href="http://www.fda.gov/downloads/Drugs/DrugSafety/UCM219146.pdf"><strong><span style="font-family:"Calibri","sans-serif";color:blue">Butrans</span></strong> (PDF - 388KB)</a>, transdermal patch system<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal">Buprenorphine<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
</tr>
<tr>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal"><a href="http://www.fda.gov/downloads/Drugs/DrugSafety/UCM088581.pdf"><strong><span style="font-family:"Calibri","sans-serif";color:blue">Daytrana</span></strong> (PDF - 281KB)</a>,<strong><span style="font-family:"Calibri","sans-serif"">
</span></strong>transdermal patch system<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal">Methylphenidate<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
</tr>
<tr>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal"><strong><span style="font-family:"Calibri","sans-serif"">Demerol</span></strong>, tablets *<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal">Meperidine Hydrochloride<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
</tr>
<tr>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal"><strong><span style="font-family:"Calibri","sans-serif"">Demerol</span></strong>, oral solution *<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal">Meperidine Hydrochloride<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
</tr>
<tr>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal"><strong><span style="font-family:"Calibri","sans-serif""><a href="http://www.accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm?fuseaction=Search.Overview&DrugName=DIASTAT" target="_blank">Diastat/Diastat AcuDial</a></span></strong>,
rectal gel [for disposal<br>
instructions: click on link, then go to "Label information"<br>
and view current label] <span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal">Diazepam<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
</tr>
<tr>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal"><strong><span style="font-family:"Calibri","sans-serif"">Dilaudid</span></strong>, tablets *<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal">Hydromorphone Hydrochloride<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
</tr>
<tr>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal"><strong><span style="font-family:"Calibri","sans-serif"">Dilaudid</span></strong>, oral liquid *<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal">Hydromorphone Hydrochloride<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
</tr>
<tr>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal"><a href="http://www.fda.gov/downloads/Drugs/DrugSafety/UCM311370.pdf"><strong><span style="font-family:"Calibri","sans-serif";color:blue">Dolophine Hydrochloride</span></strong> (PDF - 48KB)</a>, tablets *<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal">Methadone Hydrochloride<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
</tr>
<tr>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal"><a href="http://www.fda.gov/downloads/Drugs/DrugSafety/UCM088584.pdf"><strong><span style="font-family:"Calibri","sans-serif";color:blue">Duragesic</span></strong> (PDF - 179KB)</a>, patch (extended release)
<strong><span style="font-family:"Calibri","sans-serif"">*</span></strong><span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal">Fentanyl<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
</tr>
<tr>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal"><a href="http://www.fda.gov/downloads/Drugs/DrugSafety/UCM179172.pdf"><strong><span style="font-family:"Calibri","sans-serif";color:blue">Embeda</span></strong> (PDF - 39KB)</a>, capsules (extended release)<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal">Morphine Sulfate; Naltrexone Hydrochloride<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
</tr>
<tr>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal"><a href="http://www.fda.gov/downloads/Drugs/DrugSafety/UCM204267.pdf"><strong><span style="font-family:"Calibri","sans-serif";color:blue">Exalgo</span></strong> (PDF - 83KB)</a>, tablets (extended release)<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal">Hydromorphone Hydrochloride<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
</tr>
<tr>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal"><a href="http://www.fda.gov/downloads/Drugs/DrugSafety/UCM088597.pdf"><strong><span style="font-family:"Calibri","sans-serif";color:blue">Fentora</span></strong> (PDF - 338KB)</a>, tablets (buccal)<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal">Fentanyl Citrate<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
</tr>
<tr>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal"><a href="http://www.fda.gov/downloads/Drugs/DrugSafety/UCM311373.pdf"><strong><span style="font-family:"Calibri","sans-serif";color:blue">Kadian</span></strong> (PDF - 135KB)</a>, capsules (extended release)<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal">Morphine Sulfate<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
</tr>
<tr>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal"><strong><span style="font-family:"Calibri","sans-serif"">Methadone Hydrochloride</span></strong>, oral solution *<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal">Methadone Hydrochloride<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
</tr>
<tr>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal"><strong><span style="font-family:"Calibri","sans-serif"">Methadose</span></strong>, tablets *<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal">Methadone Hydrochloride<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
</tr>
<tr>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal"><strong><span style="font-family:"Calibri","sans-serif"">Morphine Sulfate</span></strong>, tablets (immediate release) *<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal">Morphine Sulfate<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
</tr>
<tr>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal"><a href="http://www.fda.gov/downloads/Drugs/DrugSafety/UCM199333.pdf"><strong><span style="font-family:"Calibri","sans-serif";color:blue">Morphine Sulfate</span></strong> (PDF - 282KB)</a>, oral solution *<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal">Morphine Sulfate<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
</tr>
<tr>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal"><a href="http://www.fda.gov/downloads/Drugs/DrugSafety/UCM311374.pdf"><strong><span style="font-family:"Calibri","sans-serif";color:blue">MS Contin</span></strong> (PDF - 433KB)</a>, tablets (extended release) *<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal">Morphine Sulfate<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
</tr>
<tr>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal"><a href="http://www.fda.gov/downloads/Drugs/DrugSafety/UCM270268.pdf"><strong><span style="font-family:"Calibri","sans-serif";color:blue">Nucynta ER</span></strong> (PDF - 38KB)</a>, tablets (extended release)<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal">Tapentadol<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
</tr>
<tr>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal"><a href="http://www.fda.gov/downloads/Drugs/DrugSafety/UCM285397.pdf"><strong><span style="font-family:"Calibri","sans-serif";color:blue">Onsolis
</span></strong>(PDF - 297KB)</a>, soluble film (buccal)<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal">Fentanyl Citrate<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
</tr>
<tr>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal"><strong><span style="font-family:"Calibri","sans-serif"">Opana</span></strong>, tablets (immediate release)<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal">Oxymorphone Hydrochloride<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
</tr>
<tr>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal"><a href="http://www.fda.gov/downloads/Drugs/DrugSafety/UCM283820.pdf"><strong><span style="font-family:"Calibri","sans-serif";color:blue">Opana ER</span></strong> (PDF - 56KB)</a>, tablets (extended release)<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal">Oxymorphone Hydrochloride<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
</tr>
<tr>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal"><strong><span style="font-family:"Calibri","sans-serif"">Oxecta</span></strong>, tablets (immediate release)<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal">Oxycodone Hydrochloride<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
</tr>
<tr>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal"><strong><span style="font-family:"Calibri","sans-serif"">Oxycodone Hydrochloride</span></strong>, capsules<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal">Oxycodone Hydrochloride<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
</tr>
<tr>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal"><a href="http://www.fda.gov/downloads/Drugs/DrugSafety/UCM289880.pdf"><strong><span style="font-family:"Calibri","sans-serif";color:blue">Oxycodone Hydrochloride</span></strong> (PDF - 100KB)</a>, oral solution<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal">Oxycodone Hydrochloride<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
</tr>
<tr>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal"><a href="http://www.fda.gov/downloads/Drugs/DrugSafety/UCM208530.pdf"><strong><span style="font-family:"Calibri","sans-serif";color:blue">Oxycontin</span></strong> (PDF - 417KB)</a>, tablets (extended release)<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal">Oxycodone Hydrochloride<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
</tr>
<tr>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal"><strong><span style="font-family:"Calibri","sans-serif"">Percocet</span></strong>, tablets *<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal">Acetaminophen; Oxycodone Hydrochloride<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
</tr>
<tr>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal"><strong><span style="font-family:"Calibri","sans-serif"">Percodan</span></strong>, tablets *<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal">Aspirin; Oxycodone Hydrochloride<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
</tr>
<tr>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal"><strong><span style="font-family:"Calibri","sans-serif""><a href="http://www.fda.gov/downloads/Drugs/DrugSafety/UCM225677.pdf">Suboxone</a></span></strong><a href="http://www.fda.gov/downloads/Drugs/DrugSafety/UCM225677.pdf"> (PDF - 83KB</a><a href="http://www.fda.gov/downloads/Drugs/DrugSafety/UCM225677.pdf">)</a>, film
(sublingual)<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal">Buprenorphine Hydrochloride; Naloxone Hydrochloride<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
</tr>
<tr>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal"><a href="http://www.fda.gov/downloads/Drugs/DrugSafety/UCM089830.pdf"><strong><span style="font-family:"Calibri","sans-serif";color:blue">Xyrem</span></strong> (PDF - 185KB)</a>, oral solution<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal">Sodium Oxybate<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
</tr>
<tr>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal"><a href="http://www.fda.gov/downloads/Drugs/DrugSafety/UCM362203.pdf"><strong><span style="font-family:"Calibri","sans-serif";color:blue">Zubsolv
</span></strong>(PDF - 354KB)</a>, tablets (sublingual)<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
<td style="padding:.75pt .75pt .75pt .75pt">
<p class="MsoNormal">Buprenorphine Hydrochloride; Naloxone Hydrochloride<span style="font-size:12.0pt"><o:p></o:p></span></p>
</td>
</tr>
</tbody>
</table>
<p class="MsoNormal"><o:p> </o:p></p>
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