Little information exists on the occurrence and the ultimate fate of pharmaceuticals in the water bodies in India despite being one of the world leaders in pharmaceutical production and consumption. This paper has reviewed 19 published reports of pharmaceutical occurrence in the aquatic environment in India [conventional activated sludge wastewater treatment plants (WTPs), hospital WTPs, rivers, and groundwater]. Carbamazepine (antipsychoactive), atenolol (antihypertensive), triclocarban and triclosan (antimicrobials), trimethoprim and sulfamethoxazole (antibacterials), ibuprofen and acetaminophen (analgesics), and caffeine (stimulant) are the most commonly detected at higher concentrations in Indian WTPs that treat predominantly the domestic sewage. The concentration of ciprofloxacin, sulfamethoxazole, amoxicillin, norfloxacin, and ofloxacin in Indian WTPs were up to 40 times higher than that in other countries in Europe, Australia, Asia, and North America. A very few studies in Indian rivers reported the presence of ciprofloxacin, enoxacin, ketoprofen, erythromycin, naproxen, ibuprofen, diclofenac and enrofloxacin. Similar compounds were reported in rivers in China, indicating a similar usage pattern in both of these developing countries. In a study reported from an open well in southern India, the groundwater showed the presence of cetirizine, ciprofloxacin, enoxacin, citalopram and terbinafine, which was close to a WTP receiving effluents from pharmaceutical production.
