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Risperidone

Hazard 5 P 3 B 0 T 2 Risk See below

Information

Concentrations found in wild fish in Sweden correspond to therapeutic concentrations in human, which seem reasonable due to the liposolubility of risperidone and concentrations detected in wastewater treatment plants.

Risperidone is included in the Stockholm County Council's table of pharmaceuticals with risk for negative environmental impact according to the environmental program 2017–2021. Risperidone has been detected in treated wastewater in Stockholm County in the last five years (2012–2016).

Is recommended in The Wise list. Environmental classification of pharmaceuticals is taken into consideration, sometimes with other environmental aspects, when selecting pharmaceuticals for the Wise list. When comparable pharmaceuticals are equivalent to medical effects, safety and pharmaceutical efficacy, environmental impact and price are considered.

Suggestions on how to reduce the release of risperidone

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 risperidone

  • Risperidone is recommended in the Wise list.
  • An option for new administration to patients with schizophrenia may be aripiprazole (recommended in the Wise list and is better from an environmental point of view than risperidone).
  • Only recommended as short term treatment in case of psychotic symptoms or severe aggression to the elderly.
  • Starter pack of certain strengths is available within the reimbursement system.

The risk classification insignificant, according to Fass.se, is based on total sold amount (kg) of the substance in Sweden during the year 2010 and the toxicity of the substance, i.e. consideration has not been given to measured levels in the environment.

Author: The Pharmaceutical unit of Region Stockholm