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Guide Health: Drug contamination

As drug standards get stricter, recalls will become more common

Whether it’s a prescription drug or nonprescription remedy, when you take a medication, you would like to think that it will be effective and not cause you more problems. While adverse effects or even interactions with other drugs or foods are by far the most common reason for problems, drug contamination has recently been mentioned more often.

Ranitidine, a drug used for heartburn, was recently found to contain the potentially carcinogenic N-nitrosodimethylamine or NDMA, and all formulations were recalled. More recently the blood pressure medication losartan was discovered to have been contaminated with N-methylnitrosobytric acid or NMBA, another cancer-causing substance. It, too, was recalled.

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You may be relieved that these unacceptable contaminants didn’t end up in your medicine cabinet, but if you depended upon either drug, you may be worried about your health.

Besides contamination, another reason for recalls is a health hazard. For example, the non-steroidal anti-inflammatory drug refecoxib was recalled because it was associated with an unacceptable, increased risk for coronary heart disease. Then its manufacture was discontinued.

As well, mislabelling, a manufacturing defect, or even discontinuation due to low profits can cause a drug recall.

In fact, if it seems to you that there are more recalls currently than in previous decades, you are correct.

More stringent testing, both pre- and post-market, plus more labelling requirements mean drugs are always undergoing evaluation. And there are also more systems in place to identify and report factors like contamination.

Many drugs today are manufactured using raw ingredients from a single source, which means that if the source is contaminated, then all drugs manufactured regardless of the pharmaceutical manufacturer will be potentially contaminated.

Even if a drug is not recalled, it may be in short supply and you may not be able to fill your prescription or purchase a non-prescription drug product.

A manufacturer usually uses the same manufacturing “line” to produce its many products, and they make projections as to how much of any one drug may be sold over a specific time period.

Thus, they manufacture what they believe is enough of drug “X” to last, say, for six months. Then they change over the production schedule and manufacture drugs “A” through “W.” The next slot for “X” is six months down the road. and there is very little the manufacturer can do to get “X” back into the cycle until then, even if the drug gets recalled.

Health Canada has a web page,, which actually tracks these shortages.

Recalls and shortages can mean that you may not be able to fill your prescription, but do not panic. There may be a different manufacturer with a good supply of your drug, even though the tablets or capsules may look different. You may be able to take a half tablet or two tablets, or even a different formulation that will give you the same dose.

Another option may be to change to another member of the same group, for example another angiotensin receptor blocking agent besides losartan, or alternatively change to another drug group altogether, for example a proton pump inhibitor like omeprazole for indigestion rather than ranitidine.

Regardless of what medications you may take, it is important to keep up to date with recalls and shortages. Asking your physician, nurse or pharmacist is all it takes, and if one of your drugs is not available, then work with them to find an alternative that will work for you.

So here is one last word. When everyone goes to all this effort to secure a good supply of an effective medication for you, remember to take them!

About the author


Marie Berry is a lawyer/pharmacist interested in health and education.



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