Medicines are essential to human health but can also
impact the
aquatic and terrestrial environment after use by patients and release
via excreta into wastewater. We highlight the need for a GREENER approach
to identify and meet important environmental criteria, which will
help reduce the impact of medicinal residues on the environment. These
criteria include effect reduction by avoiding nontarget effects or
undesirable moieties, exposure reduction via lower emissions or environmental
(bio)degradability, no PBT (persistent, bioaccumulative, and toxic)
substances, and risk mitigation. With all of these criteria, however,
patient health is of primary importance as medicines are required
to be safe and efficacious for treating diseases. We discuss the feasibility
of including these criteria for green by design active pharmaceutical
ingredients in the process of drug discovery and development and which
tools or assays are needed to accomplish this. The integrated GREENER
approach can be used to accelerate discussions about future innovations
in drug discovery and development.