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Another ARB Recall Translates into Bad BP Control

Have you lost count of all the blood pressure medicine recalls? Sorry, here is yet another ARB recall. This time it is for losartan from Legacy. Enough!

Yup, you guessed it. The FDA has issued another ARB recall. This time it is for losartan…again. On March 15, 2019 and again on March 19, 2019 the FDA announced that Legacy Pharmaceutical Packaging, LLC, was recalling 25 mg, 50 mg and 100 mg lots of losartan because of the impurity NMBA (N-Nitroso N-Methyl 4-amino butyric acid). This probable carcinogen is just the latest nitrosamine that has been found in angiotensin receptor blockers (ARBs) that treat high blood pressure. Other drugs in this class include valsartan and Irbesartan. One reader has shared his problems with yet another ARB recall.

ARB Recall Makes it Harder to Control Blood Pressure:

Q. I am very concerned about all the recalls of blood pressure pills. When valsartan was first recalled, my doctor put me on losartan. Before long, that was also recalled. In the meantime, my blood pressure was not well controlled.

I’m back on valsartan now, but I have no confidence that it is safe to take it. I can’t afford the brand name, Diovan, because it is so expensive. I guess I have an unacceptable choice: Do I die from cancer or a heart attack or stroke?

An Unpleasant Choice:

A. Since July millions of blood pressure pills have been recalled because of nitrosamine impurities. The drugs include irbesartan, losartan and valsartan. We are not totally convinced that there won’t be a different ARB recall down the road.

According to the FDA, the risk of cancer is very low even though the recalled medicines have been contaminated with suspected carcinogens for four years or longer. The company announcement posted on the FDA’s website states:

“NMBA is a potential human carcinogen. To date, Legacy has not received any reports of adverse events related to this recall.”

Right. How would anyone even know whether a particular cancer was related to a particular recall, especially since it can take many years for cancer to develop. The FDA says the risk is low. That may be true, but most people would prefer to avoid potential cancer-causing chemicals in their medicines. We will likely never know how many people developed cancer as a result of the widespread contamination.

Doctors Weigh In on the ARB Recall:

A perspective published in the New England Journal of Medicine (March 13, 2019) points out that doctors may find it challenging to switch patients from one medication such as valsartan to another, such as losartan.  There aren’t good studies to guide them on how to adjust the dosages.

The average retail price for a month’s supply of brand name Diovan (160 mg) is $320, according to GoodRx.com. That organization offers coupons that can lower the price to $260.

Canadian online pharmacies offer Diovan at around $45 for a four-week supply. There have been no reports of contamination with this brand. You can learn more about Canadian online pharmacies in our eGuide to Saving Money on Medicines.

Are you fed up with another ARB recall. Share your thoughts in the comment section below.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.”.
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