No, it does NOT have to be flushed out first. The 2 are completely compatable. The only difference is that once Dexcool is contaminated with green coolant, it no longer has the "silicate free" properties of Dexcool. Think of Dexcool as sterile and once mixed with green, it has only the properties of green. You WILL have to thoroughly flush all the green out if you ever want the benefits of Dexcool again.