Practice Alerts and Guidelines

Avoiding Medication Waste and Ensuring Continuity of Care


The State Board of Pharmacy has received numerous inquiries regarding the release of properly dispensed medications to patients upon discharge from hospitals and nursing homes. In particular, special concern has been expressed regarding specific dosage forms such as inhalers, insulin, and insulin injectors. Concerns have been increasing in response to a desire to reduce environmental contamination by unused medications, continuity of care and as a means of controlling drug costs. This guideline is intended to address this issue.

It is important to note that we are guided first and foremost by the need to protect the public. We also note that New York State was among the first to define clear circumstances wherein many solid dosage forms (e.g. tablets and capsules) may be returned to a pharmacy for re-use. Thus, this guideline does not alter or otherwise address such medications.

Products such as inhalers and insulin vials and injectors often contain significantly more medication than required for the average hospital stay. These products are also clearly labeled by the manufacturer regarding brand and generic names, quantity and other important information. Institutions routinely add patient names and other identifiers. Finally, patients and care-givers are provided complete instructions and counseling in use/administration of these critical medications, often by several health professionals such as registered nurses, pharmacists and respiratory therapists.

Providing that institutional policies and procedures are developed to ensure labeling as discussed above and documentation of patient education, it is our opinion that medications such as those referenced above may be provided to patients upon discharge into the community rather than being wasted and causing environmental harm.

This Guideline does not apply to controlled substances.

(November 2009)

Last Updated: July 19, 2011