This past Friday, the US Food and Drug Administration (FDA) recalled certain medications containing the drug Valsartan because it contains a chemical that poses a potential cancer risk.
Valsartan is commonly used to control blood pressure and help prevent heart failure.
The recall is due to the presence of the impurity, N-nitrosodimethylamine (NDMA). NDMA is an organic chemical that is in a family of potent carcinogens. It has been used to make liquid rocket fuel, softeners and lubricants, among other products. It can also be unintentionally produced through certain chemical reactions and is a byproduct from rubber tire and some pesticide manufacturing.
Animal studies have shown that NDMA can be toxic and cause tumors in the liver, kidney and respiratory tract. Exposure to high levels can cause liver damage and is a probable human carcinogen, according to the US Department of Health and Human Services.
Valsartan is off patent and is used as a component of other generic medicines, but not all medicines containing the ingredient are involved, according to the FDA. The US recall includes the versions of valsartan that are made by Major Pharmaceuticals, Solco Healthcare and Teva Pharmaceuticals Industries as well as valsartan/hydrochlorothiazide sold by Solco Healthcare and Teva Pharmaceuticals Industries.
“We have carefully assessed the valsartan-containing medications sold in the United States, and we’ve found that the valsartan sold by these specific companies does not meet our safety standards. This is why we’ve asked these companies to take immediate action to protect patients,” said Dr. Janet Woodcock, director of the FDA’s Center for Drug Evaluation and Research.
A Deeper Dive
In Europe and Asia, Novartis, the company that originally developed the drug, said Sandoz valsartan and valsartan/HCT film-coated tablets are being recalled because they “do not meet our high-quality standards.” Novartis spokesman Eric Althoff said after the initial recall last week that products sold in the US were not affected by this recall, but the FDA’s ongoing review and laboratory tests found otherwise. “The presence of NDMA was unexpected and is thought to be related to changes in the way the active substance was manufactured,” the FDA release said.
“The amounts of NDMA found in Valsartan API are much lower than the cumulative endogenous production and usual external exposure of NDMA,” Althoff wrote in an email July 6. “There is no certainty as to how much this contaminant may potentially increase cancer risk in humans. Thus, the amount of NDMA found in the Valsartan API would not represent a significantly increased risk to the patients taking of Sandoz Valsartan and Sandoz Valsartan HCT Film coated tablets.”
“The FDA is committed to maintaining our gold standard for safety and efficacy. That includes our efforts to ensure the quality of drugs and the safe manner in which they’re manufactured,” Commissioner Dr. Scott Gottlieb said Friday. “When we identify lapses in the quality of drugs and problems with their manufacturing that have the potential to create risks to patients, we’re committed to taking swift action to alert the public and help facilitate the removal of the products from the market. As we seek the removal of certain drug products today, our drug shortages team is also working hard to ensure patients’ therapeutic needs are met in the United States with an adequate supply of unaffected medications.” The FDA’s investigation into the drug will continue.
If you are taking any valsartan-containing medications, please talk with your doctor as soon as possible.
Please be advised that you should not discontinue taking any medication without your doctor’s permission. Going off your medication without supervision could be dangerous, according to the American Heart Association (AHA).