This summary information on persistence, bioaccumulation and toxicity comes from Fass. The risk comes from the report by Goodpoint.
Persistence. The potential for persistence cannot be excluded due to lack of data.
Bioaccumulation. Haloperidol has the potential to bioaccumulate in aquatic organisms.
Toxicity. Haloperidol has high acute toxicity.
Risk. See the report by Goodpoint.
Fass environmental information
Fass environmental information for Haldol (haloperidol) from Janssen (downloaded 2020-11-04).
Persistence: No data.
Bioaccumulation: Log Dow = 4.76 (pH = 3).
Toxicity: There are data for 3 trophic levels, most sensitive fish (Brachydanio rerio) LC50 96 timmar = 1.4 mg/L (OECD 203).
PEC/PNEC is based on sales data in Sweden in year 2016. PEC/PNEC = 0.00122849 which gives the risk insignificant.
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 Region Stockholm'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 in Region Stockholm.
Suggestions on how to reduce the emissions of haloperidol
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. (The Wise list is the drug formulary of essential medicines for common diseases in Region Stockholm from the Drug and Therapeutics Committee.) However, for such pharmaceuticals, there may be measures that could reduce the environmental impact.
Concrete proposal for haloperidol
- Haloperidol is not recommended in the Wise list.
- An option for introduction into patients with schizophrenia may be aripiprazole (recommended in the Wise list and is better from an environmental point of view than haloperidol).
- Fass.se för vårdpersonal
- Goodpoint. Prioritering av läkemedel med miljörisk inom SLL. Stockholm: Goodpoint; 2016. Rapport LS 2016–0634.
- 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. Pharmaceuticals.
- 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.
- Furuhagen S, Liewenborg B, Breitholtz M, Gorokhova E. Feeding activity and xenobiotics modulate oxidative status in Daphnia magna: implications for ecotoxicological testing. Environ Sci Technol. 2014;48:12886-92.
- Provtagningar av läkemedelsrester i vatten, sediment och fisk för Region Stockholm.
- Region Stockholm. Förteckning över miljöbelastande läkemedel med åtgärdsförslag framtagen inom ramen för Region Stockholms miljöprogram 2017–2021.
Author: Health and Medical Care Administration, Region Stockholm