This summary information comes from Fass. The risk is also confirmed by the assessment from Goodpoint.
Persistence. Ciprofloxacin is potentially persistent.
Bioaccumulation. Ciprofloxacin has low potential for bioaccumulationn.
Toxicity. Ciprofloxacin has a very high acute toxicity.
Risk. The use of ciprofloxacin (sales data Sweden 2016) has been judged to entail a risk high of environmental impact.
Fass environmental information for Ciloxan (ciprofloxacin) from Novartis (downloaded 2020-10-12).
Persistence: "Not readily degradable (28 days; Measurement of biological oxygen demand according to the guidelines published by OECD) (Halling-Sørensen, 2000)."
Bioaccumulation: "Log Kow = 1.24 (estimated with ACD Log P software (Advanced Chemical Development, Toronto, Canada (Halling-Sørensen, 2000)."
Toxicity: There are data for 3 trophic levels, most sensitive cyanobacteria Mycrocystis aeruginosa EC50 = 5 microg/L.
PEC/PNEC is based on sales data in Sweden in year 2016. PEC/PNEC = 79 which gives the risk high.
Report Goodpoint 2016 and pharmaceuticals residues in the aquatic environment
Due to the risk of ecotoxicity of ciprofloxacin in water, the substance is monitored within the framework of EU water legislation to "improve knowledge of the occurrence and spread of antimicrobials in the environment".
Measurements have shown that ciprofloxacin is present in the Swedish wastewater treatment plants at levels posing risk of selection of resistant bacteria.
The substance is included in Region Stockholm's table of pharmaceuticals with risk for negative environmental impact according to the environmental programme 2017–2021. Ciprofloxacin has been detected in treated wastewater in Region Stockholm.
Studies have shown that even low concentrations of antibiotics in the environment may trigger antibiotic resistance and therefore measures should be taken to ensure that as little as possible ends up in our environment.
Ciprofloxacin is recommended in the Wise list. Environmental classification of pharmaceuticals is taken into consideration, sometimes with other environmental aspects, when selecting pharmaceuticals for the Wise list. When comparable pharmaceuticals are equivalent to medical effects, safety and pharmaceutical efficacy, environmental impact and price are considered.
Concrete proposals on how to work to reduce emissions of environmentally harmful pharmaceuticals on the list have been developed in close cooperation with the Stockholm Drug and Therapeutics Committee's expert groups. The action proposals were developed from an environmental perspective. The patient's best always goes first and several pharmaceuticals on the list are also included in the Wise list. However, for such pharmaceuticals, there may be measures that could reduce the environmental impact.
Concrete proposal for ciprofloxacin
Author: Health and Medical Care Administration, Region Stockholm