Environment and pharmaceuticals / Environmentially classified pharmaceuticals / C Cardiovascular system

Environmentally classified pharmaceuticals

Two substances may have the same risk values but different PBT values, but the risk assessment can also be different even if the PBT values are the same. When assessing a medication's environmental impact, consideration should be given to both environmental risk and environmental hazard since bioaccumulation and persistence are not included in the risk assessment.

The Swedish Association of the Pharmaceutical Industry conducted the environmental risk assessment, beginning in 2005.

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Last updated: 2010-06-11

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C Cardiovascular system

Substance	Risk	PBT	P	B	T	Volume in DDD	ATC
Cardiac therapy							C01
glyceryl trinitrate	insignificant	-	-	-	3	1 300 691	C01D A02
isosorbide monitrate	cannot be excl	4 N.B.	3 N.B.	0	1 N.B.	7 246 153	C01D A14
amiodarone	cannot be excl	7 N.B.	3	3	1 N.B.	154 711	C01B D01
adrenaline	cannot be excl	-	-	-	-	141 834 C 0	C01C A24 N01B B02 N01B B51 N01B B52 N01B B53 N01B B58
digoxin	cannot be excl	-	-	-	-	1 852 240	C01A A05
fishoil	none					135 453	C01 B05B A02 B05B A10
lidocaine	isigni- ficant	3	3	0	0	44 C, E 1 027 747	C05A A01 C01B B01 D04A B01 H02A B04 J01D D54 N01B B01 N01B B02 N01B B20 N01B B52 R02A D02 S01J A51
milrinone	cannot be excl	4 N.B.	3	0	1 N.B.	392	C01C E02
disopyramide	cannot be excl	4 N.B.	3 N.B.	0	1 N.B.	225 556	C01B A03
etilefrine	cannot be excl	8 N.B.	3	3 N.B.	2 N.B.	46 308	C01C A01
alprostadil	cannot be excl	-	-	-	-	136 731	C01E A01 G04B E01
dopamine	cannot be excl	-	-	-	-	163	C01C A04
Antihypertensives							C02
doxazosin	cannot be excl	6 N.B.	3	0	3 N.B.	933 734	C02C A04
moxonidine	isigni- ficant	4	3	0	1	71 230	C02A C05
hydralazine	isigni- ficant	5 N.B.	3	0	2 N.B.	14 650	C02D B02
clonidine	cannot be excl	6 N.B.	3	0	3 N.B.	24 081	C02A C01
methyldopa	cannot be excl	-	-	-	-	3 150	C02A B01
Diuretics							C03
furosemide	isigni- ficant	4	3	0	1	22 421 131	C03C A01
hydrochlor- thiazide	isigni- ficant	4 N.B.	3	0	1 N.B.	2 734 590 C 21 756 857	C03A A03 C09B A02 C09B A03 C09B A05 C09B A06 C09B A08 C09B A09 C09B A15 C09D A01 C09D A02 C09D A03 C09D A04 C09D A06 C09D A07 C03E A01
bendro- flumethiazide	cannot be excl	4 N.B.	3 N.B.	0	1 N.B.	6 035 920 C 175 200	C03A A01 C03A B01
amiloride	cannot be excl	-	-	-	-	363 646 C 9 434 005	C03D B01 C03E A01
spironolactone	cannot be excl	-	-	-	-	2 131 869	C03D A01
torasemide	isigni- ficant	4	3	0	1	54 889	C03C A04
eplerenone	isigni- ficant	6	3	0	3	63 676	C03D A04
bumetanide	cannot be excl	4 N.B.	3	0	1 N.B.	70 279	C03C A02
Peripheral vasodilators							C04
ginkgo biloba	none						C04
Vasoprotectives							C05
horse-chestnut	none						C05
lidocaine	insigni- ficant	3	3	0	0	44 C, E 1 027 747	C05A A01 C05A A08 C01B B01 H02A B04 J01D A13 J01D A63 J01D D54 D04A B01 N01B B02 N01B B20 N01B B52 R02A D02 S01J A51
hydrocortisone	cannot be excl	1 N.B.	0	0	1 N.B.	370 169 C, E 15 859 355	C05A A01 D07A A02 D07A B02 A07E A02 H02A B09 D01A C20 D07A C16 D07C A01 D07X A01 S01B A02 S03C A04
esculoside	cannot be excl	-	-	0	-	-	C05A A01
framycetin	cannot be excl	-	-	0	-	-	C05A A01 S03C A01
cincocaine	cannot be excl	-	-	3	-	-	C05A A01 C05A A04 S01H A06
heparinoid	cannot be excl	-	-	-	-	-	C05B A01
prednisolone	cannot be excl	-	-	-	-	4 158 325	A07E A01 C05A A04 H02A B06 S01B A04
Beta blocking agents							C07
metoprolol	isigni- ficant	4	3	0	1	15 765 438 C 661 541	C07A B02 C07F B02
labetalol	cannot be excl	6 N.B.	3 N.B.	0	3 N.B.	41 618	C07A G01
pindolol	isigni- ficant	4	3	0	1	132 518	C07A A03
carvedilol	isigni- ficant	9	3	3	3	770 746	C07A G02
propranolol	moderate	3	0	0	3	1 080 624	C07A A05
atenolol	cannot be excl	4 N.B.	3 N.B.	0	1 N.B.	5 173 238	C07A B03
sotalol	cannot be excl	6 N.B.	3	0	3 N.B.	1 002 406	C07A A07
esmolol	cannot be excl	-	-	-	-	-	C07A B09
Calcium channel blockers							C08
amlodipine	isigni- ficant	6	3	0	3	12 366 352 C 70 336	C08C A01 C09B B05
isradipin	isigni- ficant	9	3	3	3	331 244	C08C A03
felodipine	low	9	3	3	3	15 157 616 C 84 994	C08C A02 C07F B02
nifedipine	cannot be excl	5 N.B.	3	0	2 N.B.	321 770	C08C A05
diltiazem	cannot be excl	6 N.B.	3	0	3 N.B.	778 724	C08D B01
Agents acting on the renin-angiotensin system							C09
losartan	isigni- ficant	3	3	0	0	5 981 664 C 3 668 565	C09C A01 C09D A01
enalapril	isigni- ficant	3 N.B.	3	0	0 N.B.	22 724 553 C 3 055 402	C09A A02 C09B A02
ramipril	isigni- ficant	6	3	3	0	15 418 731 C 303 032	C09A A05 C09B A05
candesartan	cannot be excl	4 N.B.	3	0	1 N.B.	12 928 855 C 2 671 131	C09C A06 C09D A06
eprosartan	isigni- ficant	3	3	0	0	100 604 C 71 862	C09C A02 C09D A02
cilazapril	isigni- ficant	4	3	0	1	25 682 C 22 946	C09A A08 C09B A08
irbesartan	isigni- ficant	4	3	0	1	1 971 844 C 928 928	C09C A04 C09D A04
valsartan	isigni- ficant	4	3	0	1	1 589 170 C 1 300 664	C09C A03 C09D A03
fosinopril	isigni- ficant	4 N.B.	3	0	1 N.B.	18 041	C09A A09 C09B A09
telmisartan	isigni- ficant	5	3	0	2	444 668 C 160 482	C09C A07 C09D A07
trandolapril	isigni- ficant	6 N.B.	3	0	3 N.B.	- C 5 124	C09A A10 C09B B10
lisonopril	cannot be excl	3 N.B.	3	0	0 N.B.	969 034 C 169 649	C09A A03 C09B A03
captopril	cannot be excl	4 N.B.	3	0	1 N.B.	534 574	C09A A01
quinapril	cannot be excl	-	-	-	-	60 107 C 98 946	C09A A06 C09B A06
Lipid modifying agents							C10
simvastatin	insigni- ficant	4	3	0	1	26 120 131	C10A A01 C10B A02
atorvastatin	isigni- ficant	4	3	0	1	5 976 176	C10A A05
fluvastatin	isigni- ficant	4	3	0	1	144 945	C10A A04
pravastatin	isigni- ficant	4	3	0	1	1 296 468	C10A A03
rosuvastatin	isigni- ficant	4	3	0	1	1 977 620	C10A A07
bezafibrate	isigni- ficant	5	3	0	2	118 486	C10A B02
ezetimibe	isigni- ficant	6 N.B.	3	0	3 N.B.	1 293 568	C10A X09 C10B A02
gemfibrozil	low	5	3	0	2	297 228	C10A B04
cholestyramine	cannot be excl	6 N.B.	3	0	3 N.B.	114 834	C10A C01
fenofibrate	cannot be excl	-	-	-	-	138 020	C10A B05
colestipol	cannot be excl	-	-	-	-	21 191	C10A C02