The purpose of this document is to provide the procedures Coast Guard units should follow for the management of pharmaceutical waste. This document outlines the federal regulatory requirements promulgated in Title 40 of the Code of Federal Regulations (CFR) Part 266 Subpart P, Management Standards for Hazardous Waste Pharmaceuticals and Amendment to the P075 Listing for Nicotine, effective on August 21, 2019, and provides the necessary measures to attain compliance with this rule. This regulation is stricter than previous rules, and according to the provisions of the U.S. Resource Conservation and Recovery Act (RCRA) all authorized states and U.S. Territories are required to adopt this rule. However, states may promulgate rules that are even stricter than this federal rule. Due to the infancy of this rule at the time of publication of this document, specific state-only requirements are not included; however, references to state environmental agency websites are provided. Units are encouraged to frequently monitor state environmental agency websites for updates to state-specific regulations regarding pharmaceutical waste management in their respective state. This document also provides guidance regarding delegation of roles and responsibilities of host and tenant commands. The coordination of pharmaceutical waste management should comply with Coast Guard policy relating to Host/Tenant agreements. The information in this document is not a substitute for the regulations, and all units are responsible for maintaining compliance with all applicable laws and regulations and Coast Guard policy.