Clear out expired and unused medicines regularly; dispose of them with packaging in hazardous-waste bins, not at home

10. Clear out expired and unused medicines regularly; dispose of them with packaging in hazardous-waste bins, not at home

Cost: No cost. Sort the medicine cabinet once a year — about ten minutes.

In plain terms: Nearly half of unsupervised pediatric medication ingestions involve prescription tablets. About three in ten of those prescriptions belong to grandparents. Removing unused drugs removes one thing a child can find. Put discarded medicines in hazardous-waste bins with original packaging, or hand them to pharmacies that collect old drugs.

Benefit: U.S. emergency-department surveillance estimated that from 2004 to 2013, children under 6 took medicines without adult supervision about 640,000 times (estimate 640,161 ED visits). In 2013 alone about 59,000 visits (59,092). From 2010 to 2013 the most common form was oral prescription tablets, 45.9% of cases. Among prescriptions, opioids (13.8%) and benzodiazepines (12.7%) were most common. In 2017 five U.S. poison centers surveyed callers: for prescription ingestions, 30.7% involved grandparents’ medicines. More than half (51.5%) of prescription drugs had been removed from original packaging before the child accessed them. China’s National Catalogue of Hazardous Wastes (2025 edition) classifies household discarded medicines and their packaging as hazardous waste in domestic refuse. Shanghai’s sorting guide puts waste medicines in hazardous waste, including expired drugs, capsules, tablets, and inner packaging — “discard medicines preferably with packaging.” Shanghai also requires pharmacies collecting household expired medicines to use temporary transfer points set by district market-supervision departments. The U.S. FDA states the best disposal for expired and unwanted medicines is take-back programs.

Evidence grade: B

Sources: Lovegrove MC, Weidle NJ, Budnitz DS (2015). Trends in Emergency Department Visits for Unsupervised Pediatric Medication Exposures, 2004-2013. Pediatrics, 136(4):e821-e829. <https://doi.org/10.1542/peds.2015-2092>; Agarwal M, Lovegrove MC, Geller RJ, et al. (2020). Circumstances Involved in Unsupervised Solid Dose Medication Exposures among Young Children. Journal of Pediatrics, 219:188-195.e6. <https://doi.org/10.1016/j.jpeds.2019.12.027>; et al. (2024). National Hazardous Waste Inventory (2025 Edition), Appendix "Hazardous Waste Exemption Management List" Item 1. <https://www.gov.cn/gongbao/2025/issue_11906/202503/content_7011162.html>; Shanghai Greening and City Appearance Administration (2024). Shanghai Domestic Waste Classification and Disposal Guidelines (2024 Edition) (Shanghai Lvrong [2024] No. 278). <https://www.shanghai.gov.cn/gwk/search/content/40b9feaa-53db-472f-8a6b-2c3cf0465def>; Shanghai Greening and City Appearance Administration, Shanghai Environmental Protection Bureau, Shanghai Food and Drug Administration (2018). Notice on standardizing the full management of hazardous waste classification for domestic waste. <https://www.shanghai.gov.cn/nw12344/20200813/0001-12344_57440.html>; U.S. Food and Drug Administration (2025). Where and How to Dispose of Unused Medicines. <https://www.fda.gov/consumers/consumer-updates/where-and-how-dispose-unused-medicines>

Notes: Local waste-sorting rules differ; follow the directory posted at your building’s waste room. In Shanghai, traditional Chinese medicine dregs go in wet waste, not hazardous. Keep remaining drugs in original boxes, not pill organizers or other bottles, out of children’s reach — see Section 13, item 20 (accidental ingestion). Do not self-treat with leftover antibiotics — item 7 in this section. When no U.S. take-back exists, FDA allows mixing with coffee grounds or cat litter before sealing in trash; a few strong painkillers may be flushed — that is U.S. practice; in China follow local sorting. Rated B because U.S. figures are registry counts without studies on how much cabinet cleanouts reduce ingestions. Benefit rated small: numbers are ED visits, not deaths, and the effect of cleaning cannot be calculated from them.