Large margin between concentrations in the environment and the concentration that affects the environment. The primary source is shampoo for dandruff.
Ketoconazole has not been detected in treated wastewater and raw water in Stockholm County in the last five years (2012–2016).
Information from assessment report for Ketoconazole HRA, 25 September 2014, EMA/CHMP/534845/2014: Ketokonazole is a potential endocrine disruptor.
The risk classification low, according to Fass.se, is based on total sold amount (kg) of the substance in Sweden during the year 2013 and the toxicity of the substance.
Author: The Pharmaceutical unit of Region Stockholm