Small quantities of solid and semi-solid pharmaceuticals, typically not more than 1% of the total daily waste, can be disposed of directly in a landfill with large volumes of municipal solid waste, if no other suitable method is available. The figure of 1% is based on expert opinion rather than scientific evidence. It is further postulated that in emergencies and situations where the stockpile is large (many hundreds of tons), then 5-10% of the total daily municipal waste would be an acceptable daily disposal figure, where disposal of municipal waste is greater than 50 metric tons per day. In this case the landfill should be well managed and the disposal should be for a fixed period of time.
The pharmaceutical solid waste should be disposed of at the base of the working face of the landfill and covered immediately by fresh municipal waste. Security measures to prevent scavenging should be in place. Pharmaceuticals classed as readily biodegradable organic material in the solid or semi-solid form, e.g. vitamins, can also be disposed of in a landfill.
Large quantities of solid and semi-solid pharmaceuticals are best destroyed by high temperature incineration as previously described. Medium temperature incineration is however widely practiced for solid form pharmaceuticals, provided that the pharmaceuticals are "diluted" in large quantities of municipal waste. Many countries however do not have access to either high or medium temperature incineration plants, and the use of the encapsulation method represents an acceptable, but not always feasible, method of disposal for large quantities of pharmaceuticals.
Solids, semi-solids and powders should be removed from their outer packaging but remain in their inner packaging and placed in clean plastic or steel drums, for treatment according to the encapsulation method. Removing outer packaging dramatically reduces the volume for disposal for methods such as encapsulation. Small quantities of pharmaceuticals still within their packaging may be discharged into a landfill as described above. They should be immediately covered with municipal waste. Outer packaging should be disposed of as non-drug, non-chemical materials by recycling or burning.
The separation of materials should be as follows:
• tablets and capsules in plastic/foil blisters should be removed from all outer packaging but not from blisters;
• tablets and capsules in bottles should be removed from outer packaging but not bottles;
• tablets and effervescents in tubes should be removed from outer packaging but not from tubes;
• powders in sachets or bottles should be removed from outer packaging but not from sachets or bottles.
Any large quantities of a single type of drug should be checked by the supervising pharmacist to ensure that the drug is not an anti-infective drug, antineoplastic or controlled substance. If the drug is an antineoplastic, it should be treated according to the procedure for antineoplastics outlined in Section 4.6. Controlled substances should be treated as normal solids, but with supervision according to local regulations. See Sections 4.3 and 4.4 for treatment of anti-infective drugs. Very large quantities of loose tablets should be mixed with other medicines in several different steel drums to avoid very high concentrations of a single drug in any one drum.