Pharmaceutical wastewater biological treatment plants are stressed with multi-component wastewater and unexpected variations in wastewater flow, composition and toxicity. To avoid operational problems and reduced wastewater treatment efficiency, accurate monitoring of influent toxicity on activated sludge microorganisms is essential. This paper outlines how to predict highly toxic streams, which should be avoided, using measurements of biochemical oxygen demand (BOD), if they are made in a wide range of initial concentration. The results indicated that wastewater containing multivalent Al3+ cations showed a strong toxic effect on activated sludge biocenosis irrespectively of dilutions, while toxicity of phenol and formaldehyde containing wastewater decreased considerably with increasing dilution. Activated sludge microorganisms were not sensitive to wastewater containing halogenated sodium salts (NaCl, NaF) and showed high treatment capacity of saline wastewater. Our findings confirm that combined indicators of contamination, such as chemical oxygen demand (COD), alone do not allow evaluating potential toxic influence of wastewater. Obtained results allow identifying key inhibitory substances in pharmaceutical wastewater and evaluating potential impact of new wastewater streams or increased loading on biological treatment system. Proposed method is sensitive and cost effective and has potential for practical implementation in multiproduct pharmaceutical wastewater biological treatment plants.