Pharmacists Can Adopt Climate-Conscious Practices

From medication optimization to waste management and sustainable procurement, pharmacists have more tools than they know to reduce pharmacy’s environmental footprint. New research from the International Journal of Pharmacy Practice shows that pharmacists can make an environmental impact through addressing climate-related health outcomes and disasters, energy, infrastructure and inventory management, and more.¹

“Pharmacists are experts in medicines and their safe and effective use,” wrote the Royal College of Pharmacy.² “This is particularly important as medicines are the most common intervention in health care. They have 3 major impacts on the environment: the chemical effects of the active pharmaceutical ingredients (APIs) themselves, the large carbon footprint involved in manufacture and distribution, and pharmaceutical waste.”

To address these environmental impacts, community pharmacists are increasingly looking toward clinical mitigation strategies that align daily patient care with broader environmental stewardship. Rather than simply focusing on back-office operational changes, practitioners are leveraging their clinical expertise through targeted medication optimization.¹

READ MORE: Heat and Pregnancy: What Pharmacists Need to Know

Optimizing Medication to Protect Patients and the Planet

At the heart of this movement is deprescribing, the systematic review of a patient's medication regimen to safely reduce or stop therapies that are no longer beneficial. In many cases, patients are started on drugs for acute problems, only to remain on them indefinitely.^1,3

By actively deprescribing unnecessary medications, such as long-term sleeping pills that pose a high risk of adverse effects, pharmacists can drastically reduce chemical waste and lower the carbon footprint of health care delivery.^2,3

Furthermore, pharmacists can champion antimicrobial stewardship and prioritize prescribing environmentally preferred alternatives. For instance, shifting patients from older, high-carbon propellant inhalers to dry-powder alternatives provides the same clinical benefits for asthma management while dramatically cutting greenhouse gas emissions.^1,3

Some pharmacies are also embracing social prescribing, encouraging physical and community activities to improve health outcomes and reduce overall drug consumption.^1,2

Adapting Community Pharmacy to Extreme Climate Events

Although mitigation efforts aim to reduce health care's overall footprint, community pharmacists must simultaneously adapt to the immediate health threats posed by climate change. Extreme climate events, such as severe heat waves, intensifying wildfires, and floods, place an immense burden on public health and disrupt the operational capacity of health facilities.^1,4

These natural disasters also trigger massive supply chain shocks, such as the severe nationwide shortages of intravenous saline that occurred after Hurricane Maria damaged manufacturing plants in Puerto Rico. On the front lines of community care, extreme heat events now cause more weather-related deaths than hurricanes, tornadoes, and floods combined.^4,5

Pharmacists are uniquely positioned to protect vulnerable groups from heat-related illness, including infants, pregnant women, and older adults with chronic conditions.^4-6

Utilizing tools like the CDC's HEAT questionnaire, pharmacists can assess patient risk based on housing conditions, emergency preparedness, health risk awareness, and temperature exposure. They can guide patients on proper hydration, sunscreen use, and the location of community cooling centers.^5,6

Furthermore, extreme heat alters the stability and safety of medications. High temperatures can degrade drug delivery devices like transdermal patches and inhalers, while power outages threaten the cold chain for vital products like insulin and vaccines.⁶

Certain drugs also increase patient vulnerability to heat; medications with anticholinergic activity, antidepressants, and antipsychotics can impair the body’s ability to sweat and regulate its temperature. Dehydration can also alter drug pharmacokinetics, causing narrow therapeutic index drugs like lithium to accumulate to toxic levels.

Pharmacists must actively collaborate with health care teams to create specialized hot-weather medication plans.^5,6

Building Sustainable Infrastructure and Systemic Support

On an operational level, community pharmacies have numerous actionable opportunities to build climate-resilient practices. Sustainable procurement practices allow pharmacy managers to optimize ordering and delivery schedules, minimizing transport-related emissions.¹

Waste management can be revolutionized by digitizing workflows to create paperless operations and encouraging patient participation in structured drug disposal programs to prevent active pharmaceutical ingredients from contaminating local water tables.^1,2

Innovative community partnerships, such as drop-off programs that send empty medication blister packaging to organizations like Terracycle for polymer recycling, offer tangible solutions to complex waste challenges. Some clinics have even established successful repeat-prescription ordering systems that require patients to discuss and confirm their medication needs before an order is placed, significantly reducing stockpiling and unnecessary waste.²

However, implementing these clinical and operational changes is incredibly challenging for busy, under-funded, and resource-constrained primary care teams. Qualitative research reveals that in fast-paced clinics, long-term climate initiatives are often deprioritized to address acute patient emergencies.^1,3

Experts emphasize that the full burden of climate-conscious practice should not fall solely on individual, overburdened practitioners. True transformation requires the mobilization of a system-wide coalition.

Licensing and regulatory bodies must establish legal mandates for sustainable practices, universities must embed planetary health into curricula, and professional associations must provide clear, algorithm-driven guidelines to make climate-conscious choices seamless and routine for frontline professionals.³

“This multi-methods study identified actionable considerations available for community pharmacists who are interested in climate-conscious pharmacy practice,” concluded the authors.¹ “Considerations for practice change were both clinical and operational in nature and comprised of 5 topics: addressing climate-related health impacts and disasters, energy, infrastructure and inventory management, medication optimization, sustainable procurement, and waste management.”

READ MORE: Heat and Older Adults: What Pharmacists Need to Know

REFERENCES

1. Park JY, Semchism S, Moyana CV, et al. Exploring climate-conscious pharmacy: considerations for community pharmacists. IJPP. 2025;34(2):147-153. doi:10.1093/ijpp/riaf095

2. Pharmacy’s role in climate action and sustainable healthcare. Royal College of Pharmacy. June 11, 2026. Accessed August 27, 2026. https://www.rcpharm.org/campaigns/pharmacys-role-in-climate-action-and-sustainable-healthcare/

3. Austin Z, Gregory P. Climate change adaptation and mitigation opportunities and strategies in primary health care: perspectives of pharmacists in Ontario, Canada. Climate. 2026;14(2):29. doi:10.3390/cli14020029

4. Seervai S, Gustafsson L, Abrams MK. The impact of climate change on our health and health systems. The Commonwealth Fund. May 4, 2022. Accessed August 27, 2026. https://www.commonwealthfund.org/publications/explainer/2022/may/impact-climate-change-our-health-and-health-systems

5. Mager ND, Mager J. Heat and human health: what pharmacists need to know. Drug Topics. May 6, 2026. Accessed August 27, 2026. https://www.drugtopics.com/view/heat-and-human-health-what-pharmacists-need-to-know

6. D’Souza MS, Mager ND. Heat and medications: what pharmacists need to know. Drug Topics. May 20, 2026. Accessed August 27, 2026. https://www.drugtopics.com/view/heat-and-medications-what-pharmacists-need-to-know