In Sweden haloperidol has been reported in wild fish and treated wastewater exposed fish at levels around therapeutic concentrations in humans.This is supported by the fat solubility of the substance and measured concentrations in surface waters. Mechanism-based efficacy data is lacking.
Haloperidol is included in the Stockholm County Council's table of pharmaceuticals with a negative environmental impact according to the environmental programme 2017–2021. Haloperidol has been detected in treated wastewater and fish in Stockholm County in the last five years (2012–2016).
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 haloperidol
The risk classification insignificant, according to Fass.se, is based on total sold amount (kg) of haloperidol in Sweden during the year 2013 and the toxicity of the substance, i.e. consideration has not been given to measured levels in the environment.
Author: Health and Medical Care Administration, Region Stockholm