To Flush Or Not To Flush: Drug Patch Disposal

To Flush Or Not To Flush: Drug Patch Disposal

Hospitals across the country continue to struggle with the issue of how to dispose of medication patches in a manner that is both safe for patients and families and convenient for caregivers.

Advocacy campaigns, including SMARxT Disposal* have attempted to enlighten caregivers and the public about the potential impact that discarded drugs can have on the environment. The White House’s Office of National Drug Control Policy has also issued general guidelines on the disposal of prescription drugs for consumers and professionals. Yet, regulatory agencies have few regulations applicable to hospitals regarding the disposal of medication patches.

Meanwhile, emerging information suggests that some medication patches are being misused and even abused. Lingering and unpredictable levels of medications are still contained in medication patches at the time of scheduled removal, and they can represent a risk to patients or caregivers if not disposed of properly. In addition, medication patches containing pain control substances hold a potential for abuse, adding further importance to the issue of properly securing medication patches upon removal.

Some hospitals have implemented home-like policies, such as disposal of patches in trash receptacles. Others have implemented policies for disposal of patches in medical sharps bins, which are later incinerated. This strategy holds unknown risks for individuals involved in the disposal process. Flushing patches down the toilet – another disposal option – sends medications into the municipal waste system with little-known effects.

In short, there is no certain best practice that applies to hospitals.

To provide some clarity, the following table has been compiled to assist organizations in establishing a policy that meets manufacturer’s recommendations for the most common patches used in hospitals.

Drug Directions
Duragesic®
(Fentanyl)
Use: Pain
DaytranaTM
(methylphenidate)
Use: ADD
Habitrol 21
Use: Smoking cessation
  • Fold in half.
  • Place in the disposal tray provided in the package.
  • Source/More Info
Transdermal nitroglycerin
Use: Angina
ORTHO EVRA ®
Use: Hormone replacement
  • Fold in half.
  • Place in a sturdy container, preferably with a child-resistant cap, and throw the container in the trash.
  • DO NOT flush down the toilet.
  • Source/More Info
CombiPatch
Use: Hormone replacement
Catapres-TTS® (clonidine)
Use: Hypertension
Androderm
Use: Hormone replacement
Exelon Patch
Use: Dementia, Alzheimers
  • Fold in half.
  • Return the used patch to its original pouch and discard.
  • Source/More Info
General
Flector® Patch
Use: NSAID
  • Fold in half.
  • Dispose.
  • DO NOT flush down the toilet unless instructed to do so.
  • Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.
  • Source/More Info
Lidoderm
Uses: Neuralgia

To provide some clarity, the following table has been compiled to assist organizations in establishing a policy that meets manufacturer’s recommendations for the most common patches used in hospitals. Please follow the “Source/More Info” links for further information. If your server disables links, visit www.hospital-accreditation.com, to explore this table further.