Two more blood pressure drugs recalled for potential cancer risk

[CountAllVotes]

Source: USA TODAY

Teva Pharmaceuticals has launched a voluntary recall into two drugs used to treat high blood pressure as yet more medications face concerns over a possible cancer risk.

In a statement from Teva posted by the Food and Drug Administration, the recall affects all lots of combination tablets featuring the drugs amlodipine and valsartan and another combo drug featuring amlodipine, valsartan, and hydrochlorothiazide.

The drugs could contain an impurity called N-nitroso-diethylamine (NDEA), which has been classified as a possible human carcinogen, the FDA said.

Patients taking either drugs should contact their doctor or pharmacist for advice or alternative treatments. Stopping the drugs immediately with no comparable alternative could pose a greater risk to patients' health, said Teva.


Read more: https://www.usatoday.com/story/news/health/2018/11/30/blood-pressure-drugs-two-more-medications-recalled-cancer-risk/2159850002/

[Siwsan]

1. Why don't doctors have patients 'self monitor' to rule out white coat hypertension, first?

Home blood pressure monitors can be calibrated and are easy to use.

Oh, wait. I know why. Big Pharma wouldn't realize a long term profit.

[CaliforniaPeggy]

3. First of all, it's not that simple.

High blood pressure has a number of causes, only one of which is white coat hypertension. Not everyone has that.

Responsible doctors do have their patients monitor their BP at home. They want their patients to be well, more than anything else.

[Siwsan]

8. I wish I believed that about physicians. My experience has been otherwise

But I know it's my experience, and not shared by everyone.

When I was in the military, they did not recognize 'white coat' hypertension and put me on medication. My BP was fine when the corpsmen took it and jumped when the physician checked it. It caused me no end of problems, not the least was losing over 30 lbs. I am 5'6 and weighed 130, before they got a hold of me.

My Aunt died as a result of over-prescribing of BP medications. She went into prescription related delirium and when we discovered the problem, the doctor upped the dosages. The nurse at the assisted living center was furious. My aunt was 97 years old and it was obvious the condition was causing her to spiral so I signed paperwork to just keep her comfortable. She died a day later.

Oh, and my father was 'misdiagnosed' with MS when he actually had a brain tumor. The medication they gave him was, in effect, an Immunosuppressant that killed him far faster than the tumor, on its own, would have.

And that's just the tip of my medical horror stories.

[Aristus]

15. I'm a Physician Assistant, not a physician. But I manage a lot of hypertension.

Beefing up Big Pharma is nowhere near our reasons for treating. Not the least of which reasons is because a lot of us despise the pharmaceutical companies for keeping so many important and necessary medication priced out of the reach of the patients who need them the most.

Also, regarding treating hypertension, the vast majority of drugs out there for managing high blood pressure are dirt-cheap and generic. So no one single pharmaceutical company can get fat on a $4 per month medication.

I prescribe only generics for my patients, which insurance companies will readily pay for. And if the patient doesn't have insurance, $4 a month per medication is usually acceptible to the patient.

Finally, regarding 'white coat hypertension': in the absence of any other evidence, home b/p monitoring or not, we have to treat the blood pressure reading we see in clinic. If we don't, and the patient dies of a condition secondary to hypertension, we are liable, and can get sued. Plus; dead patient, which none of us want.

[Siwsan]

18. Well, like I wrote - treating my non-existent hypertension nearly erased me

They saw my weight dropping. I had to go in every week for a blood draw to check potassium levels. And they blamed me for my diminishing appetite when that was one of the side effects of the medication. Of course, THEY didn't warn me about that. I checked a PDR when couldn't get through the night without 3 or 4 marathon trips to the bathroom. I knew the medication would have a diuretic effect, but this was ridiculous. They were pushing me to eat bananas, every day. I checked and found a list of other foods high in potassium and committed the sacrilege of mentioning them to the physician. Who promptly insisted I stop contradicting him and stick to bananas. Honestly, that I ever went to see another doctor is a miracle because my faith was deeply shaken by their steady attempt to kill me.

I don't know any other way to differentiate white coat from any other BP condition, unless it is checked AWAY from the doctor. Mine was - normal when the corpsmen took it (a lot of us were friends) but spiked when the physician did. Yet, they insisted on poisoning me.

Sorry - I do have what most people see as an unreasonably harsh attitude toward medicine. But my experiences have, more often than not, been very detrimental to my health.

[Grasswire2]

37. I have learned that I have to be my own advocate.

A certificate in medical terminology and a bunch of years as a unit clerk in a CCU and doing telephone triage for an internal medicine practice at least allow me to understand the literature.

I get medical care at a neighborhood clinic that is part of a world-class teaching university teaching hospital. I have to stay on top of things all the time. All the time. And when I don't agree with cookie cutter medicine, I resist.

Are you checking your BP at home? It's really a good thing to do. Feet on the floor, arm resting on something so it's about the level of your heart, relax. Keep a journal. And don't trust the first taking; repeat it after a moment. The difference is sometimes stunning.

[Siwsan]

41. I'm an old hand at the whole bp thing

And you are right about being your own advocate. I worked in healthcare, both in the military and as a civilian. And one thing I learned by being the 'medical advocate' for a number of family members is to do research and ask questions. Lots and lots of questions.

My gut told me the diagnosis they gave my Dad was wrong. What 68 year old man develops MS. I guess it can happen, but, strangely, when I took him to another neurosurgeon, he had NO trouble recognizing that brain tumor in the scan.

When my Aunt went into the pharmaceutical induced delirium and we took her to the hospital, I was actually told they didn't know what was wrong with her and I needed to see what I can figure out. NO, I'm not kidding. So I did some sign/symptom research and that led me to suggesting they might want to check her medication levels. Turns out, among other things, her potassium level was bottoming out!

Then the doctor asked me what I thought was going on. Honestly, it was surreal. After I told him what I thought, he dismissed my suggestion, went on a 5 minute dissertation that ended up with him confirming my diagnosis. Again - surreal.

Then he upped her BP medication and sent her back to the assisted living center, where she died, the next day.

[Grasswire2]

42. Ya gotta wonder, sometimes.

I wonder if there's a note in my chart saying "non-compliant" ...LOL Might be. I question authority and do my own research.

[womanofthehills]

64. "Non-compliant" is definitely in my chart

I've even brought in research articles on topics and nothing changes her mind. Hello, here is the latest from Langone Med center drs - only to be told it's all wrong. Only she knows best.

[Grasswire2]

66. Oh I do that, too.

And any doctor who would suggest that I start a statin drug would be fired pronto.

Can you change doctors?

[Brainstormy]

76. same here!

not quite the same effects but I had serious problems. Turns out that my medication was one of those recalled. I'm pretty much a latrophobe. Lot of things may take me out, but medical malpractice won't be one of them. I stay away.

[sdfernando]

77. There are a lot of arrogant doctors out there.

I've had my experiences with some. God forbid you mention homeopathy or any alternative treatment as even a consideration. A friend experienced the same...he is very smart and outspoken and will challenge for specifics. Some doctors don't like that. One ever threatened him with being non-compliant, so he fired the doctor and found a new one.

[volstork]

22. As a physician,

I agree 100% with your post. Of course there are bad doctors, just like there are bad lawyers and bad chefs and bad insurance agents; however, most of us are deeply invested in our patients' wellbeing.

[at140]

79. It is $4 for pills and $30-120 for office visit...nt

[Aristus]

80. Not where I work.

In community health, fees are placed on a sliding scale according to the patients' income level. Of course, the best solution would be a national health insurance program. But until that day (and Godspeed the day!...), the sliding scale is what we use. Many of my patients without an income of any kind don't pay a visit fee, which is instead covered by funds from a grant.

[at140]

81. Good for you to do that ..

just for curiosity do you depend on patients being honest about income?

[Aristus]

82. I'm not the one who registers them.

Once they're in the exam room, I don't care about anything except why they are there. I practice medicine, and let someone else worry about the money stuff.

Anyway, most of my patients are homeless. The 'why-don't-they-just-go-get-a-job?' types might be astonished to learn that many homeless people actually have jobs. So while many of my patients earn an income, my primary concern is taking care of their health.

[at140]

78. Me and my ex-wife both have white coat hypertension

as many as 30 points difference!

[CountAllVotes]

5. I'm trying to do that right now

Very sick at the moment with a UTI.

They want me taking hydrochlorothiazide!

I DO NOT HAVE HIGH BLOOD PRESSURE!

However, when I get around the medical people I must deal with it goes up. It is called White Coat Syndrome, a problem I've had my entire life.

I am not taking any more of these pills and wow are they angry with me for going up against them.

And to think, cancer is now part of this picture.

[Siwsan]

11. I've got the same thing and refuse to take prescriptions for a transient, situational problem

I've seen mention of a couple of studies mentioned that are looking to link the over-prescribing and long term use of BP medications to the increase in Alzheimer’s and dementia.

I take a lot of raw garlic. I know - sounds horrible but I grow my own, peel and bruise the smaller cloves, swallow them whole with a glass of water or diluted/sweetened cider/vinegar.

[mr_lebowski]

12. Hydrochlorothiazide is a diuretic, not a 'BP medication'.

Yes, it's MIXED IN with certain 'true' BP medications, to make a combination medication, because it has a complimentary effect, but in and of itself ... it is a diuretic.

And this article is not saying that pills of pure Hydrochlorothiazide are a risk, only one particular combination pill, made by Teva Pharma, that happens to include it.

[d_r]

17. It is a diuretic

I take it for high blood pressure

[mr_lebowski]

19. My point is I wouldn't NOT take it if Rx'd to me for a UTI ...

Simply on the basis that it can help with lowering blood pressure, but I don't have high blood pressure ... as the person I responded to ... appears to be deciding.

Diuretics have many legitimate uses, and it's inaccurate to conclude one should NOT take a diuretic ... UNLESS their BP is high.

Just MHO

[d_r]

21. oh I see nt

[mr_lebowski]

48. I guess i misunderstood CAV, actually ...

It would make sense possibly that a diuretic might be Rx'd to assist with a UTI, but now the poster clarified it's specifically being given as BP meds ... unrelated to the UTI they originally spoke of ...

Glad it's cleared up.

I take that drug in combo with Lisinopril for my BP, myself. Seems to work pretty well, though I tend to pee more at night ... no other negative effects I've noticed.

[d_r]

53. I pee more all the time

But it is enough to keep my bp down I hope to get to a point not to need it

[CountAllVotes]

20. I know!

I have taken it on occasion for swelling.

I found out it is now for high blood pressure for me.

I don't have high BP and I have to prove it to them *again*.

And now this.

[Grasswire2]

43. you could talk to the doctor.

Explain your worry. I think you will be reassured. And there are alternatives to hydrocholorothiazide. One is called "lasix" -- a diuretic.

[still_one]

57. diuretics are not only used for hypertension. You indicated you have occasional edema.

You should consult with your physician as others have suggested. A political forum is not the best place for medical advice, which many times is anecdotal, and one size does not fit all

[Siwsan]

25. Well, ok then.

[treestar]

58. Those machines can make even higher readings

And the readings are all over the place.

[Siwsan]

59. Of course you need to check the calibration

Mind did the swing within minutes, right in the office, and depending on who took it. And the numbers were consistent. Always normal when the corpsmen took it and always spiked when the physician did. I'm not sure what other proof I'd need.

Don't those new fitness wrist bands monitor things like that? If you bp is within normal range but spikes when you go to the doctor, to my simple mind that should be proof, enough.

[RobinA]

72. Sorry

to disappoint you, but my doctor did exactly this. Alas, my blood pressure remained in need of some adjustment.

[ck4829]

75. Good question

[mucifer]

2. wow Amlodipine is VERY common.

Oy vey!

[ChiTownDenny]

4. +1

[still_one]

26. Yes, it is a very common Calcium Channel Blocker, and if someone is taking Amlodipine that is

manufactured from TEVA, they need to contact there doctor and physician for a substitute manufacturer of amlodipine that don't have this issue. There are a lot of them.

It also would NOT be advisable to just stop taking Amlodipine, without a replacement. Several days is not going to realistically change anything, and stopping this completely without a replacement can put someone in danger depending what the Amlodipine is being prescribed for. It is prescribed for more than just BP, as is Valsartan. Heart failure and other cardio vascular issues use these medications

[forkol]

45. From what I can tell...

I don't think it's Amlodipine itself, my guess is that it's the valsartan that is with the HBP combinations. It seems any of the combinations with Valsartan made in China are the culprit. There has been a recall for Valsartan for a couple of months now from certain manufacturers.

But if in doubt, always best to check with the pharmacy.

[still_one]

46. I read it that way too. Also the pharmacy for those impacted should be able to tell them

[RainCaster]

6. Uh oh- I'm on Irbesartan which was recalled last month

My insurance company never told me!

UPDATE: spent a long time on the phone and found out my supply was not involved in the recall.

[still_one]

27. That is what you do. You should be able to contact the pharmacy where it was dispensed to find out,

which I assume is what you did, and I assume it was through a mail-order which was why it took a long time on the phone.

[RainCaster]

49. That's exactly what I did

In case anyone else has to buy their drugs by email, please check it out.

[Maxheader]

7. Clonidine for me...

Makes me kinda sleepy but keeps the bp down around the 130s...

Hypertension is the diagnosis for my high bp...The question from me
to the docs...What is causing the hypertension?
They don't know...

[Grasswire2]

30. Let's talk.

There is something called "secondary hypertension" and it can be resistant to the meds usually prescribed for HBP because there's an underlying cause of some kind. I have been fighting it for 26 months now. My PCP kept adding (trying to) more and more classes of meds. I suffered spikes every day as high as 246 systolic. (My diastolic is very low always; diastolic dysfunction.) I am hard to treat because I have sinus bradycardia of 46-52, and BP meds often take the pulse down a few points.

An ER doc treated me with Clonidine nearly three years ago for a spike, and I researched to find that there is a Clonidine patch. Doctors don't consider Clonidine to be the first resort for hypertension. It's short-acting. Works immediately, but it's short-acting except for pediatric patients who can get a long-acting variety. It took me about eight months to convince my PCP to prescribe a Clonidine patch while we tried to pin down the cause of the secondary hypertension. The three common causes are kidney-related, thyroid-related, or pulmonary artery-related. All of those ruled out for me.

And so every fricking day I fight spikes several times. And suffer. Wearing a 0.2 patch, and taking 0.I tablet prn SBP>175. I take my BP when I wake up in the night, several times. Sometimes I have to take a Clonidine tab then. I also take atenolol (for many years to control SVT), Losartan, and HCTZ (for many years). Other BP meds were prescribed that either were awful or did nothing.

I've been referred to a specialist in secondary hypertension; two more months til appt. Here is how it affects my daily life. A signal that a spike is coming on is increased tinnitus (ear ringing) and painful tingling in my fingers. If I am out and about and feel that coming, I guess at whether or not I need some Clonidine because I can't always be in a place where I can take my BP. If a spike comes, I often feel very crummy until it is gone. Chilled, maybe shaky, anxious. It is very tiresome and wearing.

So check out the concept of secondary hypertension. Read about it, and ask for a referral to a specialist. The adding of pill upon pill is not always the best solution. I hope my experience informs someone else.

[CountAllVotes]

35. Thank you for the info.

I for one appreciate it.

Lots of good info. in your post!

[Grasswire2]

39. best of luck

I am so grateful to have Clonidine available. I'd otherwise likely have had a stroke by now.

Well, Trumpy doesn't help us manage our BP, does he?

Feel free to PM me about your experiences finding a remedy.

[Grasswire2]

40. Okay mom. LOL

[still_one]

47. No problem, i'll self delete.

[Maxheader]

60. I was under the impression the clonidine

worked with those areas in the brain that control heart beat?

Hypertension, as far as I am aware...pushes up the bp..I also
have kidney disease..A result , according to my primary
doc., of the high bp. Last visit to the nephrologist says I'm
looking better. Clonidine..twice a day...And exercise,

[Grasswire2]

65. Clonidine does affect the pulse rate, yes

And so does the atenolol that I have taken for many years to control arrhythmia.

Both of those are a consideration for me because I have a sinus bradycardia (slow heart rate). If my pulse is 45, I adjust the timing of the atenolol until it is 49, at which time I might take just half a dose. (with doctor's okay about this.) I wear a clonidine patch and also take 0.1 tablet as needed for systolic greater than 175. A person could take up to 24 0.1 doses of Clonidine in 24 hours, according to the pharmacology, but of course no one would do that. The most I have had to take in one day is 5 tablets, and that was unusual. Maybe something to do with Trump.

A pulse of 45 might sound scary, but I have no bad effect from it. Doesn't bother me at all. I'd rather have that than arrhythmia.

But I am looking forward to seeing a specialist to see if he can find a cause of the secondary hypertension. I'm tired of unexplained blood pressure spikes.

Good news that you are looking better! Hooray!

[Maxheader]

68. May your health remain stable and

your need for the meds be reduced...At least thats what I am
hoping for in my case...I don't care for the Clonidine, it takes my
"get up and go" down a few notches...

[Grasswire2]

69. I don't like the dry mouth.

That's a pain. But if the alternative is stroking out......

[TreasonousBastard]

9. We're probably going to see more of this. The BP drug I use, losartan, had a recall...

last month for several lots with NDEA contamination, although not all of it. I haven't heard the supply I have is recalled.

The problem seems to be with Chinese producers using contaminated water in the production of some ingredients.

[CountAllVotes]

10. Contaminated water from China

Holy hell!

Don't you just feel like throwing those stupid pills at them and tell them where to put them?

I know I do!

[Mr. Ected]

13. Damn, I take Amlodipine and Losartan daily

I already hated taking this stuff, but reading this article just raised my blood pressure about 35 points.

[TreasonousBastard]

14. Sucks, don't it?

[still_one]

54. That is an incorrect statement. It did not come from China. Sandoz is the generic manufactuer of

the Losartan in question, and their generics come from India, as do most of the generics

[TreasonousBastard]

61. Not this one...

https://www.webmd.com/a-to-z-guides/news/20181119/drug-recalls-put-spotlight-on-drug-supply-chain

And in early November, Sandoz had to pull back a similar medication, losartan potassium-hydrochlorothiazide, after discovering NDEA in it. Losartan, the active ingredient in the pills, was also made by Zhejiang Huahai.

Regardless of where they come from, the problem of tainted drugs being imported is a large one. Other sources mention the FDA is opening testing facilities in China and India to try to keep up.

[still_one]

62. Absolutely.

[virgogal]

16. Wow,thanks for posting this.

I take HBP drugs----and will check this out.

[localroger]

23. Amlodipine is a dangerous drug

I had what was very obvoiusly an allergic reaction to it. It seems to sensitize you, like fiberglass resin. You can handle it somewhat until you have too much, and then you can't have any more. I was on 5 mg/day for two years and my doctor decided I needed more BP control so he increased it to 10 mg/day, and I started to gain weight, be very itchy, and lose my appetite. Amlodipine builds up in your system so it was the last thing I tried to figure out what was causing my problem and even now that I've stopped taking it, two more years later I'm not back to normal.

[Grasswire2]

31. I reacted badly to amlodipine as well.

It's on that list of four worst BP meds, FWIW.

I nearly fell off a curb and into traffic. And then I fired that PCP.

[still_one]

56. Norvasc is NOT listed as the worst BP medication. That is false information. Catapress on the

other hand is rarely prescribed for hypertension any more except in cases where BP cannot be controlled by other BP medications, and there are good reasons for that

[Grasswire2]

67. you haven't told us what your credentials are

Just wondering.

The idea that you are sternly critical of the medication that my doctors, my pharmacist and I have found to be the only current help for my situation is beginning to bug me.

[YOHABLO]

36. I was recently put on Valsartan and Amlodipine as a replacement for a more expensive Edarbi.

Seems the insurance co. didn't want to pay for the Edarbi .. too expensive. Worked great however. Now this shit

[Grasswire2]

44. the contaminated meds are just from certain designated provider.

Just check with your pharmacy. They will give you the correct info you need.

[YOHABLO]

50. Thanks for the info.

[RobinA]

73. I Believe

all generic valsartan is recalled. I was switched from valsartan to losartan because of the recall. Now one manufacturer’s losartan is recalled, which is how the valsartan recall started, so I’m just waiting. I despise the generic drug scam and would pay out of pocket for the branded stuff if I could. My insurance punishes me for using branded by making me pay a penalty over just the difference between the generic and branded prices.

[gopiscrap]

51. shit I am on amlodapine

[Grasswire2]

63. the contaminated meds are just from a certain provider.

check with your pharmacist. You're probably fine.

[duhneece]

70. I did. You're right

My pharmacist said that they get their from another manufacturer.

[still_one]

55. You are absolutely right. There is a lot of misinformation being spewed in this thread. Most of

Last edited Sat Dec 1, 2018, 01:51 PM - Edit history (2)

the generics as you said come from India. The recall in the OP came from TEVA whose generics come from Israel, South America, North America, and Europe.

There are some trying to blame it on China, and while it may be convenient to blame China for all are problems, most generic drugs here in the U.S. are coming from India.

The Losartan recall a month or so ago was from Sandoz

The advice you gave is very sound, people should do their due dilligence.

Dr. Reddy, a generic maker in India has had FDA issues with its generics for issues you just stated.

Even non-generics one needs to be aware of where they are manufactered, and contaminent issues

[EllieBC]

71. Is it hydrochlorothiazide solo or the combo?

I’m on 30 mg adalat XR and a 25 mg HCTZ.

[ck4829]

74. Kick