43A waste-based alternative activated carbon (AAC) was produced from paper mill sludge 44 under optimized conditions. Aiming its application in tertiary wastewater treatment, 45 AAC was used for the removal of carbamazepine, sulfamethoxazole and paroxetine 46 from biologically treated municipal wastewater. Kinetic and equilibrium adsorption 47 experiments were run under batch operation conditions. For comparison purposes, they 48 were also performed in ultrapure water and using a high-performance commercial AC 49 (CAC). Adsorption kinetics was fast for the three pharmaceuticals and similar onto 50 AAC and CAC in either wastewater or ultrapure water. However, matrix effects were 51 observed in the equilibrium results, being more remarkable for AAC. These effects were 52 evidenced by Langmuir maximum adsorption capacities (qm, mg g -1 ): for AAC, the 53 lowest and highest qm were 194 ± 10 (SMX) and 287 ± 9 (PAR), in ultrapure water, and 54 47 ± 1 (SMX) and 407 ± 14 (PAR), in wastewater; while for CAC, the lowest and 55 highest qm were 118 ± 7 (SMX) and 190 ± 16 (PAR) in ultrapure water, and 123 ± 5 56 (SMX) and 160 ± 7 (CBZ) in wastewater. It was found that the matrix pH played a key 57 role in these differences by controlling the surface electrostatic interactions between 58 pharmaceutical and AC. Overall, it was evidenced the need of adsorption results in real 59 matrices and demonstrated that AAC is a promising option to be implemented in tertiary 60 wastewater treatments for pharmaceuticals' removal. 61 62 63 64 65 66 67 68 69