Abstract
Nonsteroidal anti-inflammatory drugs are widely utilised to alleviate pain and reduce inflammation in both human and veterinary medicine. Despite their therapeutic benefits, NSAIDs pose environmental concerns due to their possible ecotoxicity. NSAIDs can enter aquatic ecosystems through wastewater discharge as it is very difficult to extract NSAIDs by conventional wastewater treatment, thus affecting aquatic life. These drugs induce cytotoxic and genotoxic effects, affect the functioning of endocrine systems, influence behavioural changes, and impair reproduction in fish and other aquatic organisms. This review article also discusses the use of bioindicators such as fish, bivalves, and crustaceans, to estimate NSAIDs exposure in aquatic ecosystems. It emphasises the importance of monitoring these organisms to evaluate potential risks linked with NSAIDs in aquatic environments. Addressing the environmental consequences of NSAIDs requires an inclusive strategy, including regulatory measures, public awareness, and the development of environmentally friendly alternatives to mitigate the risks caused by these widely used pharmaceuticals in aquatic environments.