Available online: https://pub.norden.org/temanord2020-502/ Abstract [en] The present study has investigated and collected sales statistics of pharmaceuticals in Sweden, Norway and Iceland. A literature review of waste water treatment plants (WWTP) and the efficiency of different WWTP techniques was conducted and combined with a literature review of metabolization of pharmaceuticals in humans. These data have been linked and used for calculations of the amount of pharmaceuticals and their metabolites that actually reaches the aquatic recipient. A future recommendation is to include metabolites of pharmaceuticals in environmental impact studies to be able to assess and account for the chemicals that actually pass through a WWTP to the aquatic environment. No large differences regarding pharmaceuticals used were observed, and many were common in both Sweden, Iceland and Norway.