Kommersiellt obunden läkemedelsinformation riktad till läkare och sjukvårdspersonal

Ketoprofen

Hazard 4* P 3 B 0 T 1* Risk See below

Information

The T-value in the PBT index refers to acute toxicity.

Large margin between concentrations in the environment and the concentration that affects the environment. However, ketoprofen appears to accumulate more in fish if exposure is effected through wastewater. The possibility is that the risk is underestimated.

Ketoprofen has been detected in treated wastewater in Stockholm County in the last five years (2012–2016).

According to Fass.se, the lack of sufficient ecotoxicological data makes the environmental risk impossible to calculate. Therefore, risk of environmental impact can not be ruled out.

Report Goodpoint 2018

Comparative assessment of environmental risk when using diclofenac, naproxen, ibuprofen, ketoprofen, etoricoxib, and paracetamol in Sweden.

Log P for diclofenac from PubChem is reported to be 3.9–4.51. Available data clearly indicate that diclofenac represents the highest risk of the NSAID/analgesics investigated. The NSAIDs (ibuprofen, ketoprofen and naproxen) + paracetamol recommended in the Wise List are all better from an environmental point of view than diclofenac. Paracetamol is a very safe alternative from an environmental point of view. The others are also expected to cause a low environmental risk, somewhat elevated to ketoprofen.

References

  1. Goodpoint. Prioritering av läkemedel med miljörisk inom SLL. Stockholm: Goodpoint; 2016. Rapport LS 2016–0634.
  2. SLL. Sammanställning av läkemedelsprovtagningar - Bearbetning av regional försäljningsstatistik av läkemedel samt datamaterial från Stockholms läns landstings mätprogram för läkemedelssubstanser i vattenmiljö, 2012–2016.
  3. 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, B 2014 Pharmaceuticals.
  4. 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.
  5. Fick J, Lindberg RH, Tysklind M, Larsson DG. Predicted critical environmental concentrations for 500 pharmaceuticals. Regul Toxicol Pharmacol. 2010;58:516-23.
  6. Fick J, Lindberg RH, Parkkonen J, Arvidsson B, Tysklind M, Larsson DG. Therapeutic levels of levonorgestrel detected in blood plasma of fish: results from screening rainbow trout exposed to treated sewage effluents. Environ Sci Technol. 2010;44:2661-6.
  7. Harada A, Komori K, Nakada N, Kitamura K, Suzuki Y. Biological effects of PPCPs on aquatic lives and evaluation of river waters affected by different wastewater treatment levels. Water Sci Technol. 2008;58:1541-6.
  8. Fass.se för vårdpersonal
  9. Goodpoint. Jämförande bedömning av miljörisk vid användning av diklofenak, naproxen, ibuprofen, ketoprofen, etoricoxib samt paracetamol. Stockholm; Goodpoint; 2018.

Author: Department of Strategic Careers, Stockholm County Council.