International Journal of Clinical Pharmacy

, Volume 38, Issue 4, pp 822–828 | Cite as

Investigating the disposal of expired and unused medication in Riyadh, Saudi Arabia: a cross-sectional study

  • Fatma Al-Shareef
  • Sarah Abu El-Asrar
  • Lamyaa Al-Bakr
  • Maisam Al-Amro
  • Fulwah Alqahtani
  • Fadilah Aleanizy
  • Sarah Al-Rashood
Research Article


Background Improper disposal of medication has several possible consequences such as childhood poisoning, environmental pollution, a negative impact on wildlife, and antibiotic resistance. The number of studies conducted to characterize pharmaceutical disposal practices is limited, particularly in the Middle East. Objective The aim of this cross-sectional study was to examine the behaviour of individuals with respect to the disposal of expired and unused medications. Furthermore, we aimed to identify the best methods of education regarding appropriate, safe disposal of medication. Setting The study was carried out in King Khalid University Hospital (KKUH), and King Saud University (KSU), during a 3-month period from February 2015 to April 2015. Method Twelve hundred patients were randomly selected from KKUH and KSU. Participants were invited to complete paper-based questionnaire with self enumeration. Pilot testing was conducted and involved 50 randomly selected participants. Main outcome measures The proportion of expired medications present in the home and their therapeutic groups, disposal methods of expired and unused medications, and preferred educational methods regarding safe and proper disposing of medications. Results A substantial proportion (79.15 %) of respondents disposed of unwanted medication via household waste, while a small proportion (1.70 %) returned unwanted medication to a pharmacy. Although currently practised disposal methods are undoubtedly unsuitable, 70.20 % of respondents considered finding appropriate, safe methods via which to dispose of unwanted medication their responsibility, and 78.6 % expressed an interest in receiving information concerning the correct disposal of unwanted medication. Conclusion We have demonstrated that a low percentage of respondents have ever received information regarding correct medication disposal. Moreover, the results have shown that over half of the respondents store antibiotics in their households. Additionally, respondents weren’t aware of the consequences of keeping expired medication at home. It is quite clear that the awareness of proper and safe drug disposal among the Saudi population is quite low making it a priority of concerned authorities to implement educational programs.


Medication disposal Medication waste Saudi Arabia Unused medications 



We would like to thank Amir S. Marzouk from KKUH, College of medicine research centre for his help in statistical analysis.


The authors acknowledge the Research Centre of the Science and Medical studies Departments at King Saud University for financial support.

Conflicts of interest

The authors report no conflicts of interest.

Supplementary material

11096_2016_287_MOESM1_ESM.pdf (232 kb)
Supplementary material 1 (PDF 231 kb)
11096_2016_287_MOESM2_ESM.pdf (106 kb)
Supplementary material 2 (PDF 106 kb)


  1. 1.
    Kinch MS, Haynesworth A, Kinch SL, Hoyer D. An overview of FDA-approved new molecular entities: 1827–2013. Drug Discov Today. 2014;19(8):1033–9.CrossRefPubMedGoogle Scholar
  2. 2.
    USFDA. How to dispose of unused medicines. 2013 [updated 2013 Dec 4; cited 2015 Apr 1].
  3. 3.
    PSNCP. Disposal of unwanted medicines. 2015 [updated 2015 Jan 1; cited 2015 Aug 1].
  4. 4.
    Limited TNRaDoUM. Return unwanted medicines (The RUM Project) Australia. 2011 [updated 2011 Feb 1; cited 2015 Aug 1].
  5. 5.
    Bergen PJ, Hussainy SY, George J, Kong DC, Kirkpatrick CM. Safe disposal of prescribed medicines. Aust Prescr. 2015;38(3):90–2.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Gracia-Vasquez SL, Ramirez-Lara E, Camacho-Mora IA, Cantu-Cardenas LG, Gracia-Vasquez YA, Esquivel-Ferrino PC, et al. An analysis of unused and expired medications in Mexican households. Int J Clin Pharm. 2014;37(1):121–6.CrossRefPubMedGoogle Scholar
  7. 7.
    Kusturica MP, Sabo A, Tomic Z, Horvat O, Solak Z. Storage and disposal of unused medications: knowledge, behavior, and attitudes among Serbian people. Int J Clin Pharm. 2012;34(4):604–10.CrossRefPubMedGoogle Scholar
  8. 8.
    Monteiro SC, Boxall AB. Occurrence and fate of human pharmaceuticals in the environment. Rev Environ Contam Toxicol. 2010;202:53–154.PubMedGoogle Scholar
  9. 9.
    Kummerer K. Resistance in the environment. J Antimicrob Chemother. 2004;54(2):311–20.CrossRefPubMedGoogle Scholar
  10. 10.
    Hoeger B, Kollner B, Dietrich DR, Hitzfeld B. Water-borne diclofenac affects kidney and gill integrity and selected immune parameters in brown trout (Salmo trutta f. fario). Aquat Toxicol. 2005;75(1):53–64.CrossRefPubMedGoogle Scholar
  11. 11.
    Ozanne-Smith J, Day L, Parsons B, Tibballs J, Dobbin M. Childhood poisoning: access and prevention. J Paediatr Child Health. 2001;37(3):262–5.CrossRefPubMedGoogle Scholar
  12. 12.
    Paparella SF. A serious threat to patient safety: the unintended misuse of FentaNYL patches. J Emerg Nurs. 2013;39(3):245–7.CrossRefPubMedGoogle Scholar
  13. 13.
    Vellinga A, Cormican S, Driscoll J, Furey M, O’Sullivan M, Cormican M. Public practice regarding disposal of unused medicines in Ireland. Sci Total Environ. 2014;15(478):98–102.CrossRefGoogle Scholar
  14. 14.
    Tong AY, Peake BM, Braund R. Disposal practices for unused medications in New Zealand community pharmacies. J Prim Health Care. 2011;3(3):197–203.PubMedGoogle Scholar
  15. 15.
    Law AV, Sakharkar P, Zargarzadeh A, Tai BW, Hess K, Hata M, et al. Taking stock of medication wastage: unused medications in US households. Res Social Adm Pharm. 2015;11(4):571–8.CrossRefPubMedGoogle Scholar
  16. 16.
    Bound JP, Voulvoulis N. Household disposal of pharmaceuticals as a pathway for aquatic contamination in the United kingdom. Environ Health Perspect. 2005;113(12):1705–11.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Glassmeyer ST, Hinchey EK, Boehme SE, Daughton CG, Ruhoy IS, Conerly O, et al. Disposal practices for unwanted residential medications in the United States. Environ Int. 2009;35(3):566–72.CrossRefPubMedGoogle Scholar
  18. 18.
    Abou-Auda HS. An economic assessment of the extent of medication use and wastage among families in Saudi Arabia and Arabian Gulf countries. Clin Ther. 2003;25(4):1276–92.CrossRefPubMedGoogle Scholar
  19. 19.
    SFDA. Saudi Arabia pharmaceutical country profile. WHO; 2012 [updated 2012 Apr 18; cited 2015 Apr 1].
  20. 20.
    WHO. Chronic diseases are the major cause of death and disability worldwide. 2015 [updated 2015 Jan 1; cited 2015 Apr 1].
  21. 21.
    Ruwailia NA, Balushia AA, Alharfb A, AlShaharanib H, Eldalic A. Do parents in Saudi Arabia store medications safely? Int J Pediatr Adolesc Med. 2014;1(1):21–5.CrossRefGoogle Scholar
  22. 22.
    Abahussain EA, Ball DE, Matowe WC. Practice and opinion towards disposal of unused medication in Kuwait. Med Princ Pract. 2006;15(5):352–7.CrossRefPubMedGoogle Scholar
  23. 23.
    Abahussain E, Waheedi M, Koshy S. Practice, awareness and opinion of pharmacists toward disposal of unwanted medications in Kuwait. Saudi Pharm J. 2012;20(3):195–201.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Tong AY, Peake BM, Braund R. Disposal practices for unused medications around the world. Environ Int. 2011;37(1):292–8.CrossRefPubMedGoogle Scholar
  25. 25.
    Persson M, Sabelstrom E, Gunnarsson B. Handling of unused prescription drugs—knowledge, behaviour and attitude among Swedish people. Environ Int. 2009;35(5):771–4.CrossRefPubMedGoogle Scholar
  26. 26.
    Belkina T, Al Warafi A, Eltom EH, Tadjieva N, Kubena A, Vlcek J. Antibiotic use and knowledge in the community of Yemen, Saudi Arabia, and Uzbekistan. J Infect Dev Ctries. 2014;8(4):424–9.CrossRefPubMedGoogle Scholar
  27. 27.
    Bawazir SA. Prescribing pattern at community pharmacies in Saudi Arabia. Int Pharm J. 1992;6(5):222–4.Google Scholar
  28. 28.
    Langmia K, Tyree T, O’Brien P, Sturgis I. Social media: pedagogy and practice. Lanham: University Press of America; 2013.Google Scholar

Copyright information

© Springer International Publishing 2016

Authors and Affiliations

  • Fatma Al-Shareef
    • 1
  • Sarah Abu El-Asrar
    • 2
  • Lamyaa Al-Bakr
    • 2
  • Maisam Al-Amro
    • 2
  • Fulwah Alqahtani
    • 3
  • Fadilah Aleanizy
    • 3
  • Sarah Al-Rashood
    • 4
  1. 1.Saudi Medication Safety Centre, Ministry of National Guard, Health AffairsRiyadhSaudi Arabia
  2. 2.College of PharmacyKing Saud UniversityRiyadhSaudi Arabia
  3. 3.Department of Pharmaceutics, College of PharmacyKing Saud UniversityRiyadhSaudi Arabia
  4. 4.Department of Medicinal Chemistry, College of PharmacyKing Saud UniversityRiyadhSaudi Arabia

Personalised recommendations