REGULATORY AFFAIRS – NITROSAMINES: WHICH STEPS SHOULD BE TAKEN?
In June 2018, N-nitrosodimethylamine (NDMA) and similar compounds known as nitrosamines, classified as probable human carcinogen based on animal studies, were unexpectedly found in several blood pressure medicines known as sartans leading to some recalls and resulting in new manufacturing requirements and stricter limits for nitrosamines for these medicinal products. Traces of NDMA have also been found in the active substance pioglitazone hydrochloride; however, considering that the levels of this impurity were within the temporary limits set after the review of sartans, no action was taken about the products on the market. In September 2019, EMA started an EU-wide review of ranitidine medicines after tests showed that some of these products too contained the impurity NMDA. Considering the above-mentioned events, as a precaution, the Committee for Medicinal Products for Human Use (CHMP) asked to all Marketing Authorization Holders (MAHs) to review the medicinal pro