Pharmaceuticals and Environment
Here you can find information about the environmental impact of human pharmaceuticals. You can search for a substance name. The environmental risk refers to the use of a pharmaceutical. The knowledge support is based on three sources:
- environmental information from the European Medicines Agency's (EMA's) European Public Assessment Reports (EPARs) with risk assessed from a European perspective
- environmental information on Fass.se and risk based on the total sales of an active substance in Sweden during a given year
- environmental risk assessments for certain substances based on concentrations measured in the environment in Sweden and effect studies.
Based on the two first-mentioned sources, environmental information is missing for many medicinal products. The database is based on Region Stockholm's work in Sweden and may mean, for example, that information about the Wise list, the formulary of recommended essential medicines for the entire Stockholm healthcare region, has been included.
The knowledge support Pharmaceuticals and Environment applies its own environmental criteria, which differ from the formal ERA system used by EMA/CHMP, and therefore cannot be directly applied in regulatory authorisation processes.
Information about the classification
In a document there is information about the classification of the environmental hazard and the environmental risk. The classification of the risk is usually based on theoretical calculations of the risk. For more information see Classification.
For some substances there is also a risk assessment made on the basis of concentrations measured in the environment in Sweden and efficacy studies with high quality. These assessments are presented in the documents for the substances and are made by independent ecotoxicological expertise. Continuous work is underway to provide more substance documents with this type of environmental information and also present comparisons of environmental risk between substances intended for the same indication. Based on this type of risk assessment, a table of environmentally hazardous drugs pdf, 41 kB. was developed within the framework of Region Stockholm's environmental program 2017–2021.
News
2025
Villén J. Pharmaceuticals in the environment – perspectives on drug utilisation and mitigation strategies. Uppsala: Acta Universitatis Upsaliensis; 2025. 66 p. (Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Pharmacy; 390). ISBN: 978‑91‑513‑2648‑1. ISSN: 1651‑6192.
Salehi E, Ljungberg Persson C, Håkonsen H. Green pharmacy practice – a multi method study of environmental sustainability measures implemented in Swedish pharmacies. J Pharm Policy Pract. 2025;18(1):2512983. doi:10.1080/20523211.2025.2512983.
Yu Z, et al. Antibiotic resistance selection and deselection in municipal wastewater from 47 countries. Nat Commun. 2025;16:9698. doi:10.1038/s41467-025-65670-7.
Christina Ljungberg Persson, Sebastian Aronsson, Helle Håkonsen. The impact of policy changes on the sales of the environmentally harmful drug diclofenac in Sweden, International Journal of Pharmacy Practice, 2025; riaf092, https://doi.org/10.1093/ijpp/riaf092
Coderre M, Fortin AS, Morency LD, Roy J, Sirois C. Pharmaceuticals in drinking water: a scoping review to raise pharmacists' public health and environmental awareness on contamination in groundwater, surface water, and other sources. Int J Pharm Pract. 2025 Jul 24;33(4):360−368. doi:10.1093/ijpp/riaf038. PMID: 40448951.
Michael G Bertram, Jack A Brand, Eli SJ Thoré, Daniel Cerveny, Erin S McCallum, Marcus Michelangeli, Jake M Martin, Jerker Fick, Tomas Brodin. Slow-Release Pharmaceutical Implants in Ecotoxicology: Validating Functionality across Exposure Scenarios. ACS Environ. Au 2025, 5, 69−75.
Brand, JA, Martin JM, Michelangeli M, Thoré ESJ, Sandoval-Herrera N, McCallum ES, Szabo D, Callahan DL, Clark TD, Bertram MG, Brodin T. Advancing the Spatiotemporal Dimension of Wildlife−Pollution Interactions. Environ. Sci. Technol. Lett. 2025, 12, 358−370.
Mathilda Andreassen, Christina Rudén, Marlene Ågerstrand, Mapping chemicals across EU’s legal frameworks towards a ‘one substance, one assessment’ approach, Environment International, Volume 199, 2025, 109460, ISSN 0160-4120, https://doi.org/10.1016/j.envint.2025.109460.
Sandoval Herrera N, McCallum ES, Baktoft H, Brönmark C, Cerveny D, Hansson LA, Hellström G, Hulthén K, Nilsson PA, Brodin T. 2025. Impacts of an anxiolytic drug on fish behaviour and habitat use in a natural landscape. Proc. R. Soc. B 292: 20251443.
Lampi E, Carlsson F, Jacobsson G, et al. Willingness to pay for antibiotic pollution control. Ecological Economics, Volume 239, 2026, 108780, ISSN 0921-8009, https://doi.org/10.1016/j.ecolecon.2025.108780.
Water pollution: Council and Parliament reach provisional deal to update priority substances in surface and ground waters
European Council, Council of the European Union
2025-09-23
Osena G, Fick J, Flach C-F, et al. Evaluating wastewater surveillance for estimating pharmaceutical use. Environment International.Volume 204, 2025, 109807, ISSN 0160-4120, https://doi.org/10.1016/j.envint.2025.109807.
Villén J, Ljungdahl N, Wettermark B, et al. “We throw away an incredible amount of unused medicines“: Community pharmacy staff perspectives on environmental responsibility. Exploratory Research in Clinical and Social Pharmacy, Volume 20, 2025, 100662, ISSN 2667-2766, https://doi.org/10.1016/j.rcsop.2025.100662.
Harrison, S., Barnett, C., Short, S. et al. Continuous improvement towards environmental protection for pharmaceuticals: advancing a strategy for Europe. Environ Sci Eur 37, 128 (2025). https://doi.org/10.1186/s12302-025-01180-z
Jane J. Pappas, Natasha DesRochers, Bindu Tuteja, et al. Ecotoxicological implications of increased antidepressant concentrations in the Laurentian Great Lakes Basin, 2018–2023, Science of The Total Environment, Volume 981, 2025, 179331, ISSN 0048-9697, https://doi.org/10.1016/j.scitotenv.2025.179331.
Villén J, Laux J, Wettermark B, Sporrong SK, Nekoro M, Håkonsen H. Towards greener prescribing? Swedish general practitioners' support for policies to reduce pharmaceutical pollution. Br J Clin Pharmacol. 2025 Apr 27. doi: 10.1002/bcp.70066. Epub ahead of print. PMID: 40289270.
Brand JA, Michelangeli M, Shry SJ, et al. Pharmaceutical pollution influences river-to-sea migration in Atlantic salmon (Salmo salar). Science, 10 Apr 2025, Vol 388, Issue 6743, pp. 217–222, DOI: 10.1126/science.adp7174.
Martin JM, Michelangeli M, Bertram MG, et al. Evidence of the impacts of pharmaceuticals on aquatic animal behaviour (EIPAAB): a systematic map and open access database. Environmental Evidence (2025) 14:4 https://doi.org/10.1186/s13750-025-00357-6.
Fork ML, Fick J, Reisinger AJ, et al. Environmental conditions explain variabilityin concentrations of nutrients butnot emerging contaminants. Ecosphere. 2025;16:e70225. DOI: 10.1002/ecs2.70225.
Ella D. van Vliet, Nynke M. Kannegieter, Caroline T.A. Moermond, Teresa Leonardo Alves, Keystones in the implementation of greener pharmaceuticals: A scoping review, Sustainable Chemistry and Pharmacy, Volume 44, 2025, 101938, ISSN 2352–5541, https://doi.org/10.1016/j.scp.2025.101938.
Niemi L, Anderson C, Arakawa N, et al. Do you think medicines can be prescribed in a more eco-directed, greener way? A qualitative study based on public and prescriber focus groups on the impact of pharmaceuticals in Scotland’s water environment. BMJ Open 2025;15:e088066. doi:10.1136/bmjopen-2024-088066
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