Send Orders for Reprints to reprints@benthamscience.net Current Drug Safety, 2020, 15, 000-000 1 REVIEW ARTICLE 1574-8863/20 $65.00+.00 © 2020 Bentham Science Publishers Poor and Unsatisfactory Disposal of Expired and Unused Pharmaceuticals: A Global Issue Sunil Nepal a , Anil Giri b , Ramesh Bhandari c , Sharad Chand d , Sudip Nepal e , Santosh Aryal f , Pukar Khanal g , Jeet Bahadur Moktan h and C. S. Shastry i,* a Department of Clinical Pharmacy, School of Health and Allied Sciences, Pokhara University, Nepal, b Assistant Professor, Department of Clinical Pharmacy, School of Health and Allied Sciences, Pokhara University, Nepal; c Assistant Professor, Department of Pharmacy Practice, KLE College of Pharmacy, Belagavi, KLE Academy of Higher Education and Research (KAHER), Belagavi, India; d Research Scholar, Department of Pharmacy Practice, NGSM In- stitute of Pharmaceutical Sciences, NITTE (Deemed to be University), Paneer, Deralakatte, Mangaluru, Karnataka, India- 575018; e District Coordinator-The Leprosy Mission Nepal, Rupandehi, Butwal, Nepal; f District Coordinator-The Leprosy Mission Nepal, Morang, Biratnagar, Nepal; g Department of Pharmacology and Toxicology, KLE College of Pharmacy, Belagavi, KLE Academy of Higher Education and Research (KAHER), Belagavi, India; h Department of Pharmacy Practice, Sri Adichunchanagiri College of Pharmacy, Adichunchanagiri University, B.G. Nagara-571448; i Department of Pharmacy Practice, NGSM Institute of Pharmaceutical Sciences, NITTE (Deemed to be University), Paneer, Deralakatte, Mangaluru, Karnataka, India Abstract: Pharmaceuticals are beneficial to humankind and emerged as crucial arms to treat/manage multiple disease pathogenesis in the present era. In analogous, these medicines/ medi- cal devices should be used cautiously as they possess a potential threat to induce multiple undesired effects that may be related to human health or the environment. Daunting effects may arise due to the improper disposal of unused/expired medicines. Hence, to minimize such harm, there should be adequate knowledge and practice among the population regarding the safe disposal of un- used/expired medicines or related pharmaceutical devices. The lack of approved information re- garding safe disposal of such substances may invite serious concerns like environmental pollution, which may induce immediate health hazards to the present population and upcoming future genera- tions. There are numerous ways to dispose of, or manage the unused and expired pharmaceutical substances. Sharing the medicines among siblings, friends, and family members are never free from serious health risks. Storing the unused and expired medicines in the home increases the risk of in- tentional or accidental ingestion of such substances and may create a health emergency. Disposing medicines like household and municipal waste may lead to environmental pollution and harm to humans and animals. The present review finds the multiple unsafe ways of disposal of unutilized medications/tools. Furthermore, it also summarizes the disposal pattern of unutilized medications among the few developed and undeveloped nations. A R T I C L E H I S T O R Y Received: January 29, 2020 Revised: April 27, 2020 Accepted: May 29, 2020 DOI: 10.2174/1574886315666200626164001 Keywords: Expired pharmaceuticals, health hazards, leftover medicines, outdated medicines, pharmaceutical pollution, unused medicines. 1. INTRODUCTION The pharmaceutical drug disposal practice of unused and expired medicines is a global problem and a neglected issue that is growing day by day and needs attention [1]. Quality use of medicine means selecting medicines appropriately, using them safely and effectively, and disposing of them as per standards [2]. Pharmaceutical products are an inevitable *Address correspondence to this author at the Department of Pharmacy Practice, NGSM Institute of Pharmaceutical Sciences, NITTE (Deemed to be University), Paneer, Deralakatte, Mangaluru, Karnataka, India; E-mail: drcshastry@gmail.com and integral part of health as they help in restoring health from various ailments and illnesses. Health is a dynamic state and may deter at any point in time; hence the pharma- ceuticals are always a wiser and effective tool to regain health. However, the complex nature of pharmaceuticals and the lack of degradability of such pharmaceuticals has always been a threat to living beings. The improper and unsafe dis- posal of such pharmaceuticals causes various health and en- vironmental concerns due to their toxic emissions [3, 4]. Being in a state of complete health for a lifetime is not pos- sible for an individual; hence, the pharmaceuticals help in improving the quality of life and minimize the discomfort