By Douglas Main New research suggests that fluorinated pharmaceuticals — a category that includes well-known medications such as Prozac and Flonase — are showing up in the water supply of millions of people. These drugs and their breakdown products are technically classified as being per- and polyfluoroalkyl substances (PFAS), also known as “forever chemicals,” which as a chemical class is the subject of worldwide health concern. A study published January 6 in Proceedings of the National Academy of Sciences found that the bulk of PFAS entering and exiting wastewater treatment plants is made up of these fluorinated drugs. Notably, the researchers determined that the pharmaceuticals were largely not removed from the water by conventional wastewater treatment practices. This pharmaceutical material “doesn’t get treated in the wastewater treatment plant, and it doesn’t break down,” said Bridger Ruyle, study co-author and researcher at New York University. “And we know can be re-entering drinking water supplies.” The study estimates that this material contaminates the water supply of around 23 million Americans, Ruyle said. These drugs enter wastewater after being excreted by people. About 50% of drinking water utilities are located downstream of a wastewater outflow plant and regularly use varying amounts of this water. A slight majority of this material was made up of only four drugs and one of their metabolites: the arthritis medication Celecoxib (Celebrex); flecainide (Tambocor), prescribed for arrhythmia; maraviroc (Selzentry), and one of its metabolites, used to treat HIV; and sitaglipt (Januvia), a diabetes drug. “We don’t know that much about what the exposures or health risks are” for those drinking small concentrations of this material, Ruyle said.