F. Disposal of Abandoned or Expired Medications

When a resident’s medication has been discontinued but has not expired, the medication should be returned to the resident (if safe) or the resident’s representative/guardian, OR the facility may centrally store the medication for future use of the resident.

When centrally storing discontinued medications for residents, remember that only medications which have not expired may be kept. These medications must:

  • Be stored separately from medications in current use. [For example, in a separate drawer.]
  • The medication must be kept in a separate area which is marked “Discontinued Medication.” Remember, do not alter or write on the medication label when a medications is discontinued. In addition, when strong discontinued medications, write the date the medication was discontinued and the name of the health care provider who gave the order to discontinue the medication on the medication observation record and keep a copy of this information with the discontinued medication together: For example, in a plastic bag, with the residents name clearly marked on the bag, in the area marked “Discontinued Medications.”If a medication which was previously discontinued, but has not yet expired, is re-prescribed, it may be used in lieu of having a new prescription filled. However, ALF staff must be sure that they are using the right medication and strength by checking with a pharmacist or the prescribing physician.

BEST PRACTICE: To reduce the risk of making a dangerous mistake, follow the best practice for retrieving re-prescribed, discontinued, medication as described below.

  1. When a medication is ordered for a resident, check to see if the resident has previously been prescribed the medication and if there’s medication left which may be used. (Check with the resident’s representative or guardian or in the discontinued medication area.)In other words, if you have an hand Mrs. Brown’s discontinued Haldol, you may only use the Haldol for Mrs. Brown’s if it i re-prescribed for her. You may not use it for Mr. Brown, or for any other resident.
  2. Verify the name and strength of the drug. To avoid any dangerous medications errors, only use the discontinued medication if it is the same strength as the present order. For example, if the current prescription is for 15 mg of Restoril and the discontinued medication on hand is 30 mg of Restoril, you must obtain a new supply of medication in the correct strength of Restoril from the pharmacy rather than use the wrong strength.
  3. Enter the medication information on the MOR.
  4. Remove the medication from the discontinued medication area and return it to the resident’s current medications.
  5. Have another staff member trained in assistance with medication, or a nurse, review the health care provider’s order, the MOR, and verify the medication label. Check to ensure that the medication is for the:
  • RIGHT resident and is the
  • RIGHT Medication and the
  • RIGHT dosage (strength) and the
  • RIGHT time is recorded on the MOR and the
  • RIGHT route is indicated.

6. Verify that medication isn’t expired and won’t expire while the medication is to be taken. For example, if there’s enough medication for three weeks, but it expires.