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CDSCO lists 17 drugs safe to flush to prevent harm from misuse at home

The Central Drugs Standard Control Organisation (CDSCO) has released a list of 17 medicines—including opioids such as fentanyl, tapentadol and buprenorphine—permitting the general public to flush them down the sink or toilet to prevent harm to people and pets in the home. The list is part of the central drug regulator's draft guidance document for the safe disposal of unused or expired drugs, aimed at preventing antimicrobial resistance (AMR) and other public health risks. 'There is a small number of medicines that may be especially harmful and, in some cases, fatal with just one dose if they are used by someone other than the person for whom the medicine was prescribed,' the CDSCO stated in a guidance document dated 26 May. The CDSCO added that the objective of the guidance document is to provide clear and comprehensive instructions, in accordance with the Drugs and Cosmetics Act and other applicable laws, for the safe disposal of expired and unused drugs. Unscientific disposal of unused or expired medicines is considered one of the primary sources of environmental pollution, with carelessly discarded antibiotics seeping into soil and water bodies and eventually affecting human life. 'In an effort to tackle the unsafe disposal of unused drugs, state governments, in coordination with local bodies, may establish the methodology and facilities for the collection and disposal of unused or expired drugs according to the provisions of the Biomedical Waste Management Rules, 2016,' the document added. The draft guidance also details methods for the collection, storage, transport and disposal of 11 other types of expired or unused drug dosages and packaging, with separate instructions for manufacturers, wholesalers, retailers, hospitals and other stakeholders. These include anti-infectives, antineoplastics, radioactive drugs, and medicines in packaging such as ampoules, aerosol canisters and PVC materials, among others. The draft proposal for the safe disposal of unused and expired medicines comes five years after it was first placed at the 58th meeting of the Drugs Consultative Committee (DCC) of the CDSCO in July 2020. The committee had recommended constituting a sub-committee to examine the issue and prepare the guidance document.