Concentrations measured in Swedish surface water are estimated to accumulate in fish at therapeutic concentrations. Relevant effect studies are lacking, however, as the analytical method for studying levels in fish is not sensitive enough. Mechanism-based data is missing.
Flupentixol is included in the Stockholm County Council's table of pharmaceuticals with risk for negative environmental impact according to the environmental programme 2017–2021.
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 advice. 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 flupentixol
The risk assessment can not be excluded, according to Fass.se, is due to persistence and toxicity studies being incomplete, why a risk calculation has not been possible. It is voluntary for manufacturers to provide information on the environmental impact. In The Wise list substances with little or moderate environmental impact are recommended before substances that are completely missing or have incomplete environmental data if the substances are medically equivalent.
Author: Health and Medical Care Administration, Region Stockholm