The data for bioaccumulation is based on previous environmental information. Environmental information is missing on fass.se (2019-11-28). It is voluntary for manufacturers to provide information about environmental impact on fass.se. Risk see the report Goodpoint 2019.
Cetirizine has previously been found in purified wastewater, surface water and drinking water in Stockholm County (2005–2012). Cetirizine is not among the pharmaceuticals analyzed in recent years. Studies from Stockholm's wastewater treatment plants have shown low degree of purification of cetirizine.
Comparative assessment of environmental risk when using the antihistamines desloratadine, cetirizine, loratadine, ebastine, clemastine and fexofenadine from a Swedish perspective (Report Goodpoint 2019).
Summary assessment based on (expected) water exposure in relation to toxicity and interaction with targets. Use of clemastine (Tavegyl) is considered to pose a risk of impact on aquatic organisms. It is supported by the fact that measured concentrations in the environment are in good agreement with predicted levels, these levels, although very low, are considered to be able to accumulate in fish to therapeutic concentrations given its high fat solubility (for which there is a reasonable consensus assessment), and finally have levels above Cmax been detected in wild fish. Studies on effects on aquatic organisms are lacking for clemastine, so the assessment is based entirely on the above. Thus, what kind of pharmacological effect can be expected from clemastine through its effect on the histamine receptors, and how severe these are, has not been investigated. The risk of impact is significantly lower, but not negligible, for fexofenadine. The other studied antihistamines pose a low risk based on expected exposure and the likelihood of accumulation in biota to near therapeutic concentrations, at the same time the assessment is uncertain due to insufficient efficacy data. An exchange of clemastine with one of the other studied antihistamines is recommended from an environmental point of view.
Author: Health and Medical Care Administration, Region Stockholm