Safe Disposal of — Unused Cancer Medicines

No. Flushing is one of the most harmful disposal routes for cancer medicines. These compounds are not fully removed by standard sewage treatment, and they have been found in rivers and water sources at levels that affect aquatic life. The safe route is always to return them to the hospital pharmacy.

No. Household rubbish is handled by people who do not know what it contains. Cancer medicines are cytotoxic, meaning they can cause harm through skin contact or through inhaling dust from broken tablets. A waste worker, a child, or an animal could be exposed without any warning. Return them to the pharmacy where they were dispensed.

Treat them exactly like any other cancer medicine — return them to the hospital pharmacy in their original packaging. Do not crush, open, or break capsules before returning them. Intact packaging lets the pharmacist identify and log the medicine safely. If a capsule has already broken, seal everything in a zipper bag and tell the pharmacist when you hand it in.

Keep them in their original sealed packaging, in a cool dry place out of reach of children and pets. Do not transfer them to a different container. If the medicine requires refrigeration, continue to refrigerate it until you can return it. Tell your care team if you cannot get to the centre promptly — they can advise on the safest interim arrangement.

It is good practice to call ahead, especially for larger quantities. This gives the pharmacy time to have the right staff member available to receive and log a hazardous return. For a small number of tablets or a partially used pack you can usually bring them in without prior notice, but calling first avoids any delay at the counter.

Yes. Expired cancer medicines should be returned to the hospital pharmacy in exactly the same way as unused ones. Expiry does not make a cytotoxic medicine safe to bin or flush — it is still potentially harmful to handle. The hospital pharmacy will dispose of it as hazardous waste regardless of the expiry date.

The same principle applies: return them to the hospital or cancer centre pharmacy rather than binning or flushing them. Targeted therapies and immunotherapy medicines are biologically active compounds. While their hazard profile differs from traditional cytotoxic chemotherapy, they should not be treated as ordinary household medicines. If you are unsure about a specific medicine, ask your pharmacist before doing anything else.

Do not touch the spilled contents with bare hands. Put on gloves if you have them, or use a damp disposable cloth to contain the spill without spreading it. Place everything — the cloth, any broken packaging, and the remaining medicine — into a sealed bag. Wash your hands thoroughly with soap and water afterwards. Tell your care team what happened before you bring it in for disposal, so they can guide you on what to bring and how to hand it over safely.