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Fluconazole

Summary

Environmental information is available on fass.se for Diflucan (2021-09-21) but with information that data is missing.It is voluntary for manufacturers to provide information on environmental impact on fass.se. Data on bioaccumulation comes from previous environmental information on fass.se. Fluconazole is monitored within the framework of EU water legislation.

 

Persistence. It cannot be excluded that fluconazole is persistent, due to the lack of data.
Bioaccumulation. Fluconazole has low potential for bioaccumulation.
Toxicity. It cannot be excluded that fluconazole is toxic, due to the lack of data.
Risk. Risk of environmental impact cannot be excluded, due to lack of environmental toxicity data.

Detailede information

Fass environmental information for Fluconazol Villerton from Mylan Hospital (downloaded 2019-02-15)

Hazard

Persistence: The potential for persistence of fluconazole cannot be excluded due to lack of data.

Bioaccumulation: Log Kow= 0.25 at neutral pH (estimated data).

Toxicity: It cannot be excluded that fluconazole is toxic, due to the lack of data.

Risk

Risk of environmental impact of flucanozole cannot be excluded, since no ecotoxicity data are available.

Fass environmental information for Diflucan (flukonazol) from Pfizer (downloaded 2021-09-21)

Hazard

Persistence: It cannot be excluded that fluconazole is persistent, due to the lack of data.

Bioaccumulation: It cannot be excluded that fluconazole bioaccumulates, due to the lack of data.

Toxicity: It cannot be excluded that fluconazole is toxic, due to the lack of data.

Risk

Risk of environmental impact of flucanozole cannot be excluded, due to the lack of environmental toxicity data.

Report Goodpoint 2016

The ecotoxicology of fluconazole is poorly researched, but existing data indicate a low risk of environmental impact.

Pharmaceuticals in the aquatic environment in Stockholm Region

Fluconazole has been detected in treated wastewater, surface water and drinking water in Region Stockholm 2012–2016 and also in treated wastewater and drinking water in 2017.

Fluconazole has been found in spiders

Fluconazole was one of the top 5 most frequently detected pharmaceuticals in spiders (article Richmond et al. 2018).

EU water legislation

Fluconazole is monitored within the framework of EU water legislation. "Substances for which doubt exists about their toxicity, or for which the sensitivity, reliability or comparability of the available monitoring methods are not adequate, should not be included in the watch list. The sulfonamide antibiotic sulfamethoxazole and the diaminopyrimidine antibiotic trimethoprim, the antidepressant venlafaxine and its metabolite O-desmethylvenlafaxine, a group of three azole pharmaceuticals (clotrimazole, fluconazole and miconazole) ... The inclusion of the various pharmaceuticals is consistent with the EU Strategic Approach to Pharmaceuticals in the Environment, and the inclusion of the two antibiotics is also consistent with the European One Health Action Plan against Antimicrobial Resistance (AMR), which supports the use of the watch list to ‘improve knowledge of the occurrence and spread of antimicrobials in the environment’."

References

  1. Fass.se för vårdpersonal
  2. Goodpoint. Prioritering av läkemedel med miljörisk inom SLL. Stockholm: Goodpoint; 2016. Rapport LS 2016–0634.
  3. IVL Swedish Environmental Research Institute Ltd. Fick J, Lindberg RH, Kaj L, Brorström-Lundén E. Results from the Swedish National Screening Programme 2010. Subreport 3, B 2014 Pharmaceuticals.
  4. IVL Swedish Environmental Research Institute Ltd Fick J, Lindberg RH, Fång J, Magnér J, Kaj L, Brorström-Lundén E. Screening 2014. Analysis of pharmaceuticals and hormones in samples from WWTPs and receiving waters. Rapport C 135.
  5. Chen ZF, Ying GG, Jiang YX, Yang B, Lai HJ, Liu YS et al. Photodegradation of the azole fungicide fluconazole in aqueous solution under UV-254: kinetics, mechanistic investigations and toxicity evaluation. Water Res. 2014;52:83-91.
  6. Provtagningar av läkemedelsrester i vatten, sediment och fisk för Region Stockholm.
  7. Stockholm County Council. The Wise List 2015.
  8. Richmond EK, Rosi EJ, Walters DM, Fick J, Hamilton SK, Brodin T et al. A diverse suite of pharmaceuticals contaminates stream and riparian food webs. Nat Commun. 2018;9(1):4491.
  9. Bengtsson-Palme J, Larsson DG. Concentrations of antibiotics predicted to select for resistant bacteria: Proposed limits for environmental regulation. Environ Int. 2016;86:140-9.
  10. Official Journal of the European Union. Commission implementing decision (EU) 2020/1161 of 4 August 2020.
  11. Official Journal of the European Union. Commission implementing decision (EU) 2022/1307 of 22 July 2022.

Author: Health and Medical Care Administration, Region Stockholm