Relationship between antihypertensive drugs and cancer : Doubts and controversies.
In the daily attention of my practice I have seen with care an important concern among my patients with arterial hypertension who must permanently receive antihypertensive medication with drugs such as Losartan, Valsartan, and Olmesartan, because at the end of 2018 the FDA (Food and Drugs Administration) in the United States responsible for the approval and monitoring of drugs consumed in that country, presents its first notification about the existence of an impurity called NDMA (N-nitrosodimethylamine) in a large lot of Valsartan made in the Republic of China, At the same time, the Ministry of Health of Spain confirms this finding and raises the notification to the regulatory body of drugs in the European community, which also manifests and suggests the withdrawal of batches of the drug from China..
In the month of January, the Ministry of popular power for health in Venezuela takes the measures of the case withdrawing the entire existence of Valsartan from the market for review, however none of the pharmaceutical companies in Venezuela acquire this drug from China.
But until now the controversy has continued and again the FDA has obtained traces of a compound called NMBA (N-nitroso N-methyl 4 aminobutyric acid) also within the list of compounds carcinogenic in Losartan made in India.
What controversies on the subject exist today?
The dilemma is now centered in the fact of clarifying definitively the suspension or not of these drugs, because neither the FDA nor other drug surveillance agencies in the world have established in their alerts the suspension of said antihypertensive drugs definitively.
My opinion about this situation.
After the analysis that this requires and its application in clinical practice during the prescription, I have observed some aspects that I would like to point out here:
- In spite of the reliability of the detection methods for these elements, it is not known if the amounts found are high enough to produce cancer of any kind.
- It is unknown until now if there are cases of cancer attributable to drugs with these impurities.
For these questions I consider that there are more doubts that remain than what we can resolve the issue and establish clearly.
Recomendations for patients
In view of the fact that the FDA and the rest of pharmacovigilance organisms have never declared the suspension of these drugs, the best thing will always be caution, no antihypertensive medication should be stopped abruptly because of the implications it has on the generation of other diseases such as stroke or myocardial infarction, for this reason it is very important to consult with your treating doctor and discuss this issue before self-medication or take any decision without medical supervision.
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