Promoting sustainable pharmacy for tackling environmental pharmaceutical pollution

Pharmaceuticals are essential for health but are increasingly impacting the environment, affecting ecosystems and human health, and contributing to biodiversity loss, antimicrobial resistance, and climate change. Active pharmaceutical ingredients designed for stability and biological activity, along with excipients and packaging materials, contaminate air, soil, and water globally. To address the issue of pharmaceutical pollution, the establishment of a sustainable pharmacy framework is required, beginning with drug development and the education of future professionals. In this article, we present a critical overview of initiatives already implemented and those emerging that aim to achieve a more sustainable pharmacy. We followed a cradle-to-grave life-cycle approach to identify the role of pharmacy professionals, including drug developers, in enabling mitigation measures for pharmaceutical pollution. Some of the emerging initiatives for reducing pharmaceutical pollution that were identified include a benign-by-design approach for drug development, the adoption of a One Health approach in healthcare systems, and advancing regulatory frameworks and education of healthcare professionals.