Curbside ConsultNitrosamine Impurities in Angiotensin Receptor BlockersShephard, Emily A. PharmD*; Nawarskas, James J. PharmD†Author Information From the *Department of Pharmacy, University of New Mexico Hospitals, Albuquerque, NM †Department of Pharmacy Practice and Administrative Sciences, University of New Mexico College of Pharmacy, Albuquerque, NM. Disclosure: The authors declare no conflict of interest. Correspondence: James J. Nawarskas, PharmD, College of Pharmacy, University of New Mexico, 2502 Marble Ave NE, Albuquerque, NM 87131. E-mail: [email protected]. Cardiology in Review: September/October 2020 - Volume 28 - Issue 5 - p 262-265 doi: 10.1097/CRD.0000000000000323 Buy Metrics Abstract Nitrosamines are known carcinogens which have been recently discovered in several angiotensin receptor blockers (ARBs). This led to the recall of valsartan in the United States in 2018, and afterward, the recall of other ARBs as well as unrelated medications (e.g., ranitidine). The presence of nitrosamine in ARBs was likely a result of changes in the manufacturing process, although nitrosamine contamination is believed to occur by different mechanisms with other medications. The United States Food and Drug Administration has since taken steps to identify products affected by nitrosamine contamination and mitigate this concern going forward. Despite the contamination of some drug products, studies estimate that the overall risk to patients is low enough to not necessitate changes in prescribing patterns at this time. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.