Valsartan Recall

It must be slightly ironic that an email arrived this morning from the HPRA giving us a list of interchangeable Valsartan medicines.  All the more so since none of them are available or likely to be available for the foreseeable future.  It was best summed up on a pharmacy forum.

The following is a summary of the handling by the state quangos of the Valsartan withdrawal saga:

1) The Chinese are saying there’s an issue with one of their manufacturing plants processes. We know they definitely make ingredients for a few generic companies version of valsartan on the Irish market. Let’s announce on the airwaves that people using any of the generics listed should bring back their medicines to their pharmacy to be replaced with one of the ones that aren’t on the list.
2) We better tell the doctors and pharmacists about this as well , now that we put it on the news.
3) One of the generics that we thought wasn’t on the list might be affected as well now. We better quarantine that stock until they can prove otherwise.
4) We better say that other products may be added in the coming days as the picture becomes clearer(good thinking…that will cover our asses)
5) Excellent ..job well done.
6) Hmmm….pharmacies are reporting to us that there is no alternate “safe” stock available…interesting. Perhaps quarantining the stock we said was safe has contributed to this…hard to say
7) We better say that we never meant for anyone to bring back their tablets for switching , and clarify that we wanted them to bring the tablets with them for a show and tell day.
8)It’s now ok for patients to keep taking the contaminated possibly cancer causing tablets , but it’s not ok for pharmacies to keep supplying them….but if you have them already , keep taking them.
9) Wait, medicine management says to switch to candesartan.
10) The HPRA is now closed for the weekend, please call back Monday.

As for alternatives
Now the Medicines Management Programme have weighed in with their advice to switch to Candesartan, except post-MI, when specialist advice should be sought, as if making work for GPs and pharmacists isn’t enough.…nce-for-prescribers-on-valsartan-shortage.pdf
I would predict a Candesartan shortage, because I’m guessing they didn’t check if there were sufficient stocks to treat 25,000 additional patients, but given how much attention doctors usually pay to their advice (like simvastatin being the preferred statin) it might be premature to stockpile
Better batten down the hatches.