During the last decades, it has become evident that some active pharmaceutical ingredients (API) have harmful environmental impacts on aquatic ecosystems. Therefore, there is a need to decrease the amount of pharmaceutical residues that end up in the environment. Information gaps related to increased awareness of the environmental impacts of pharmaceuticals in the health care sector and the promotion of sustainable consumption of pharmaceuticals have been identified in the Status Report on Pharmaceuticals in the aquatic environment of the Baltic Sea Region (BSR) published by UNESCO and HELCOM in 2017. The aim of the current report is to fill in some of the identified knowledge gaps identified in the HELCOM report, specifically increasing awareness about the environmental impacts of pharmaceuticals. In Sweden, there are good practices for healthcare professionals about how to consider the environmental impacts of medications already at the prescription phase, as well as guidelines for how to make the environmental information available and accessible to healthcare professionals and the public. The Swedish practices are described and evaluated, and the measures that can be implemented in the other BSR countries are formulated as recommendations. Eight recommendations were formulated through dialogues with stakeholders in Sweden. The recommendations are divided into four main areas i.e. education, databases and guidelines, dissemination of information to public, and collaboration among stakeholders. Some recommendations might be implemented without any large challenges or financial costs while other recommendations require large changes such as economic investments and changes in legislation. This report also contains information about existing practices in other countries in the Baltic Sea region (BSR), provided by the project partners in the CWPharma project. The countries in the BSR are currently at different levels when it comes to management of pharmaceuticals and their residues in the environment. Public awareness of the environmental impacts of pharmaceuticals differs, as do the systems for returning leftover medications. Basic education for health care personnel regarding the environmental consequences of different medications and pharmaceutical compounds exists in most of the BSR countries but the scope and content differs. One recommendation in the report is that environmental impacts of APIs should be compiled in a national, or ideally an EU level, database. As a first step, the Baltic Sea countries could investigate the possibility to establish national interfaces to the Swedish databases “Pharmaceutical and environment” (Janusinfo) or FASS. Although the data in “Pharmaceutical and environment” and FASS are not complete, they are existing platforms which provide valuable information and gather criteria important for classification. In Sweden, there are several channels for the dissemination of information about the environmental consequences of pharmaceuticals with the aim to raise public awareness regarding this subject. Examples of actions to be considered by other countries are information campaigns driven by pharmacies for returning unused and left over medications (Germany and Finland have similar campaigns), and distribution of leaflets with information about the environmental impacts of pharmaceuticals, which have proven to be efficient in raising awareness among pharmacists, doctors and the public. The collaboration of different stakeholders is one of the foremost reasons for the progress that has been made regarding pharmaceuticals in the environment in Sweden. The Swedish Medical Production Agency has set up a Knowledge Centre for Pharmaceuticals in the Environment, providing a platform for different actors to discuss environmental issues connected to pharmaceuticals. Among these actors there is a sense of a shared environmental vision with common goals. Hence, one recommendation for the BSR countries is to investigate the possibilities of establishing similar national knowledge centers within medicine agencies, or to use existing networks as a starting point to also involve other environmental issues related to pharmaceuticals and to find new collaboration possibilities. Finally, collaboration between the EU countries is crucial to successfully implement environmental aspects in the lifecycle of the pharmaceuticals.