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  Specific waste: Inhalers

Inhalers come in a variety of forms. The most commonly seen are either aerosol metered-dose inhalers, which contain a chemical propellant, or a dry powder inhaler. The aerosol metered-dose inhalers with chloro-fluorocarbons (CFC) as the propellant are being phased out of production by the US FDA by the end of 2013, 21 CFR Part 2.

Unused inhalers: Discontinued, outdated or unused and unopened, the product should be returned to the pharmacy to determine if it can be returned for credit with the Reverse Distributers. If it can’t be returned for credit, it is a non-viable pharmaceutical waste inhaler.

Partially used inhalers: When products have been opened and only partially used they become a non-viable pharmaceutical waste.

Empty inhalers: Empty inhalers contain no product and no pressure. For designation and waste management, please see Specific Wastes: Empty containers

Designation of waste inhalers

RCRA hazardous inhaler waste: Includes any non-viable formulations that designate under the RCRA Characteristics of Ignitability, Corrosivity, Reactivity or Toxicity (Chapter 173-303-090 WAC). Please see Pharmaceutical Designation Flowchart

  • Metered-Dose Inhalers (MDIs): Metered-dose inhalers use chemical propellants to expel the medication from the inhaler. To administer the medication, the patient may either use direct inhalation or squeeze the inhaler's canister. Some examples include:
    • Atrovent, Azmacort, Nasacort, Proventil, QVAR.
  • Non-viable MDIs are a RCRA hazardous waste because the propellant designates as a RCRA hazardous waste for ignitability (D001).
    • This includes those using CFCs as the propellant. Examples include:
      • Tilade, Alupent, Azmacort, Intal (Off the market by 12/31/10)
      • Aerobid, Combivent, Maxair (Phased out by 12/21/13)
  • Epinephrine inhalers: Inhalers containing only epinephrine or epinephrine and salts as the sole active ingredient designate as a P042 RCRA hazardous waste. Please see Special Waste: Epinephrine

State-only dangerous waste: You can assume any non-viable inhalers that are not RCRA hazardous waste are State-only dangerous waste. To determine it is not a State-only dangerous waste, you must know the concentration of all the constituents as well as the acute toxicity information of those ingredients, Chapter 173-303-100 WAC. Please see Pharmaceutical Designation Flowchart

  • Dry Powder Inhalers (DPIs): Dry powder inhalers release the medication via rapid inhalation instead of using chemical propellants. Some examples include:
    • Advair, Albuterol, Alupent, Combivent, Cromolyn, Flovent, Maxair, Nasonex, Pulmicort, Salbutamol, Symbicort, Ventolin.
  • Non-viable DPIs commonly designate as state-only dangerous waste due to the acute toxicity of the pharmaceutical constituent, (WT02).

Management of waste inhalers

Viable inhalers: inhalers that are eligible for credit from a manufacturer, wholesaler, or reverse distributor are a viable pharmaceutical and not considered waste. Viable pharmaceuticals include any unused and/or unopened pharmaceutical that receive a credit. Items not receiving a credit must be managed as a non-viable waste.

RCRA hazardous waste: Dispose as a dangerous waste at a RCRA-permitted facility.

State-only dangerous waste: Dispose as either a dangerous waste at a RCRA-permitted facility or as excluded waste at an incinerator meeting the criteria of the conditional exclusion Chapter 173-303-071(3)(nn) WAC.

Note: It is a violation of the Dangerous Waste Regulations to dispose of these pharmaceuticals in the sewer, in a sharps container, or in a regulated medical waste container destined for landfill.

Resources:

The USDA Center for Drug Evaluation and Research, Metered Dose Inhalers

The Food and Drug Administration (FDA) Final Rule, 21 CFR Part 2, to remove CFCs from Inhalers