The FDA's recall of the blood pressure drug prazosin has raised concerns about the safety of older generic medications. But here's where it gets controversial: While the recall is due to elevated levels of cancer-causing chemicals called nitrosamines, it's not just about prazosin. The FDA has identified nitrosamine contamination in various widely used drugs, including blood pressure, diabetes, heartburn, antibiotic, and smoking cessation medications. This has led to questions about the safety of older generics, particularly those made overseas. And this is the part most people miss: The FDA doesn't disclose which manufacturing plants companies use, making it difficult to compare the safety records of generic drugs made in the U.S. and abroad. So, what should people who take prazosin do? If you have Teva Pharmaceuticals' prazosin, look for the abbreviations MFG or MFR on your prescription label. If it says 'MFG Teva' or 'MFR Teva,' that means Teva supplied the medication. You can also check the first four numbers of a National Drug Code (NDC) on the label. If your product has been recalled, your pharmacy may have other generic versions of prazosin in stock that are not part of this recall. The FDA has given the recall a Class II status, meaning the medication could cause temporary or medically reversible adverse health consequences. If no other prazosin version exists at your pharmacy, do not stop taking your drug without talking with your physician first. The risk of temporarily taking tablets with an elevated amount of nitrosamines may be less than the risk of suddenly stopping this medication. Your physician may also be able to prescribe an alternative treatment such as clonidine or trazodone. Do older generics made overseas pose higher risks? Recent research suggests that generics made in India have a 54.3% higher risk of serious adverse events compared to those made in the United States. The longer a drug has been available in generic form, the greater the difference in safety risk between its U.S.- and India-made forms. This raises concerns about the quality of generic drugs produced in developing countries, where manufacturers may prioritize lower prices over quality.
