Michael Demian ^1,2*

• ¹ Université de Bordeaux, Bordeaux, France
• ² Master's student, Alexandria, Egypt

Background: While extensive safety and toxicology studies typically explore the adverse effects on human and animal health, the potential environmental implications of pharmaceuticals are little understood and have only lately drawn attention from researchers globally and in the Middle East (ME). Objectives: Our objectives are to describe the scope of ecoPharmacovigilance (EPV) worldwide, assess the concept of ecoPharmacovigilance in the ME, and to investigate the ways the consequences of ecoPharmacovigilance could be minimized worldwide in general and in the ME. Methods: We conducted this scoping review according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Checklist. Studies were eligible if they assessed ecopharmacovigilance scope, if they addressed the concept of ecoPharmacovigilance in the ME, and if studies investigated the ways the consequences of EcoPharmacovigilance could be minimized worldwide in general and in the ME. Non-English studies were excluded for the fear that inappropriate translation could alter the study's context. Results: In total, 616 records were retrieved from the electronic database search. After removing 49 duplicates and applying automation tools, the total was 567 records. We screened the records by title and abstract, 506 sources were assessed for eligibility. The records initially eligible were assessed by full text. Reports sought for full text retrieval were 61 records. The final number of studies included in the review was 32 studies. None of the included studies was conducted in the ME. Most included studies were conducted in European countries (e.g. Sweden, Germany, UK and Chile), Brazil, South Africa, and China. Key obstacles involve inadequate knowledge and insufficient advice from the dispensers concerning safe disposal practices, the absence of regulations regarding the disposal of drugs in some countries, and lack of pharmaceutical waste management teamwork. Opportunities for change include a collaborative effort to address EPV by each of the legislative authorities, pharmaceutical companies and patients.