Although pharmaceutical pollution is a global environmental concern, much remains unknown about the transformation of pharmaceuticals in the wild and their effects on wildlife. In the environment, pharmaceuticals typically transform to some extent into different, structurally related compounds. Pharmaceutical transformation products resulting from exposure to sunlight (i.e., ultraviolet radiation) in surface waters are of particular concern; these products can be more hydrophobic, persistent, and toxic than their parent compounds. In the present study, naproxen, a widely used nonsteroidal anti‐inflammatory drug, and its phototransformation products were studied to assess the overall persistence and photochemical fate of naproxen. Southern toad (Anaxyrus terrestris) larvae were used as model aquatic vertebrates to evaluate the acute toxicity of naproxen and its phototransformation products singly and in mixtures. The phototransformation products were observed to be more persistent and more toxic than naproxen itself. The slower phototransformation of the phototransformation products relative to naproxen suggests a greater potential to accumulate in the environment, particularly when naproxen is continually released. Mixtures of naproxen and its phototransformation products, in ratios observed during phototransformation, were more toxic than naproxen alone, as predicted by the model of concentration addition and the greater toxicity of the phototransformation products. Together, these results indicate that the ecological risk of naproxen may be underestimated by considering environmental levels of naproxen alone. Environ Toxicol Chem 2019;38:2008–2019. © 2019 SETAC.