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The detection of pharmaceutical compounds, their ecological threat, and water quality was evaluated at six points along the Cauca River, Colombia's second most important river. The detected compounds included diclofenac, ibuprofen, naproxen, and paracetamol, with the latter presenting maximum concentrations of up to 4.20\u03bcg\/L. Domestic wastewater discharges impacted the river's water quality, increasing the frequency and concentration of pharmaceutical contaminants. Ibuprofen and paracetamol were identified as high-risk compounds for aquatic biota, with Hazard Quotient (HQ) values between 190 and 250 in areas near urban wastewater discharges. This finding also indicated a high ecological risk due to the mixture of these pharmaceuticals. No single removal technology proved completely effective, highlighting the need for complementary treatments to conventional systems to ensure safe discharge into water bodies. Moreover, given the presence of these compounds in surface waters, drinking water treatment systems must be adapted to minimize health risks in distributed water. Finally, the study underscores the need for regulatory measures and continuous wastewater monitoring to protect both aquatic ecosystems and public health.<\/jats:p>","DOI":"10.2166\/wst.2025.151","type":"journal-article","created":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T14:00:46Z","timestamp":1760709646000},"page":"1187-1204","update-policy":"https:\/\/doi.org\/10.2166\/iwapcrossmarkpolicypage","source":"Crossref","is-referenced-by-count":3,"title":["Impact of therapeutic pharmaceuticals on water bodies: diagnosis, ecological threat, and removal strategies"],"prefix":"10.2166","volume":"92","author":[{"given":"Diana","family":"S\u00e1nchez","sequence":"first","affiliation":[{"name":"a Grupo de Ciencia e Ingenier\u00eda en Sistemas Ambientales, Facultad de Ingenier\u00eda Civil, Universidad del Cauca, Carrera 2# 15N, Popay\u00e1n 190002, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Velasco","sequence":"additional","affiliation":[{"name":"a Grupo de Ciencia e Ingenier\u00eda en Sistemas Ambientales, Facultad de Ingenier\u00eda Civil, Universidad del Cauca, Carrera 2# 15N, Popay\u00e1n 190002, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nasly","family":"Delgado","sequence":"additional","affiliation":[{"name":"a Grupo de Ciencia e Ingenier\u00eda en Sistemas Ambientales, Facultad de Ingenier\u00eda Civil, Universidad del Cauca, Carrera 2# 15N, Popay\u00e1n 190002, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9605-377X","authenticated-orcid":false,"given":"Eliana","family":"M. 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