Yet another blood pressure medication is being recalled due to the presence of impurities that could cause cancer. (Photo: Getty)
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Whitesnake came out with the song “Here I Go Again” in 1982. Well, it’s now 2025, and here we go again with yet another recall of a commonly used blood pressure medication due to too high levels of a chemical that could cause cancer. This time it’s Teva Pharmaceuticals USA Inc., recalling 580,844 bottles of its prazosin hydrochloride capsules, according to a Food and Drug Administration enforcement report.
If this sounds like déjà vu all over again, it kind of is. I’ve written for Forbes about blood pressure medication recalls for cancer concerns nearly every year over the past seven years, like in 2018, 2019, 2021 and 2022. These recalls have spanned different blood pressure medications from different manufacturers and different impurities over different Presidential administrations. That’s the mark of a recurring problem that has yet to be fully addressed.
The main difference this time around is that while the FDA had issued press releases for many of the medication recalls prior to 2025, for this recall, the rather brief FDA enforcement report simply indicated, “Press Release Not Issued For This Recall.” It didn’t state why there hasn’t been a press release. If you recall, the lack of a press release has been the case for a number of other recalls this year. One does have to wonder how much of this has to do with the Trump administration making all sorts of cuts of and shifts in FDA personnel over the past eight months.
The Recall Is Due To A N-nitroso Prazosin Impurity C
The FDA enforcement report does indicate that the impurity of concern is something called a N-nitroso Prazosin impurity C. N-nitroso is short for N-Nitrosamines, a class of chemical compounds with an N–N=O structure. In this case, the N stands for nitrogen and the O stands for oxygen. The N–N=O notation may look like the type of “no” uttered by Luke Skywalker when he found out that Darth Vader was his father. Regardless, it’s a big no-no to have too much “N-nitrosamines” in your blood pressure medications. That’s because the 15th Report on Carcinogens from the National Toxicology Program lists 15 different “N-nitrosamines” as being “reasonably anticipated to be a human carcinogen” or the like.
Being told that something is “reasonably anticipated to be a human carcinogen” is sort of like being told that your date is “reasonably anticipated to cause you big problems.” It may be difficult to tell exactly how much exposure may tip you over to the uh-oh range. Therefore, it’s best to avoid the stuff as much as you can.
Now, it’s not as if manufacturers put impurities into medications just to mess with you. Manufacturing processes can inadvertently introduce various impurities at various stages along the way. As a result, expecting zero impurities in a medication can be sort of like expecting expecting any human to have zero impure thoughts.
Therefore, the FDA has established limits as to what levels of different impurities are acceptable. The FDA expects manufacturers to routinely test for levels of such impurities and report on any excursions above what’s deemed acceptable. The FDA enforcement report does indicated that there have been “CGMP Deviations-Test results for N-nitroso Prazosin impurity C that are above the Carcinogenic Potency Categorization Approach (CPCA) acceptable intake limit for the above specified lots.”
The Recall Is Of Prazosin Hydrochloride
To understand how prazosin hydrochloride works, find a hot dog and wrap your fingers around it. Imagine your fingers to be the smooth muscle in the walls of a blood vessel and the hot dog to be the blood flowing through the blood vessel. The smooth muscle has many alpha-1 adrenergic receptors. Activating these receptors will then cause the smooth muscle to contract, which would be like tightening your fingers around the hot dog. This will end up squeezing the hot dog harder, which would be akin to raising your blood pressure.
Prazosin hydrochloride acts by blocking these alpha-1 receptors so that they can’t be stimulated. This allow the smooth muscle to in the words of Frankie Goes To Hollywood, relax, your blood vessels to expand and thus your blood pressure to drop. This would be analogous to relaxing your grip on the hot dog so that it can move more freely through your hands. Similarly, when your blood vessels are less tight, your blood can move much more easily through your blood vessels.
High blood pressure isn’t the only reason you might be on prazosin hydrochloride. You have alpha-1 receptors in other parts of your body such as your prostate (if you have one), urethra, iris in your eyes and brain (if you have one). That makes prazosin a possible treatment for other conditions such as benign prostatic hyperplasia and PTSD-associated nightmares.
How To Determine If Your Medication Is Part Of The Recall
Of course, just because you are on prazosin doesn’t necessarily mean that your medications are part of the recall. The recall includes capsules from Teva of three different doses: 1, 2 and 5 mg. If you are taking prazosin hydrochloride for any reason, you should first the origin of your medication. If it is from Teva, then check whether the medication’s National Drug Code (NDC) and the expiration date match any of those listed in the FDA enforcement report. The recall began on October 7.
If you are still not sure or need assistance in locating the NDC and expiration date, contact the pharmacy from where you got the medication. If the pharmacy for some reason doesn’t help you, remind them that they are a freaking pharmacy, and it’s their job to provide you with such services.
How Concerned Should You Be About The Recall
Now, this isn’t a if-you-took-some-of-these-medications-you-will-explode type of recall. The FDA has deemed this a “Class II” recall, which means the product “may cause temporary or medically reversible adverse health consequences.” Teva USA has determined that the overall harm to the patient population will be “medium,” according to a memo from the Califonia Board of Pharmacy Having limited exposure to relatively small amounts of a carcinogen over a short amount of time may have little effect. However, the risk of getting cancer does increase as you get exposed to more and more of the carcinogen over longer and longer periods of time.
Therefore, it is important to heed any warnings about such carcinogens. Don’t immediately stop taking any blood pressure medications, though, without first talking to your doctor. That could be like immediately not wearing any pants after your pants have been recalled. There could be significant risk in going uncovered. Your doctor may instead want to switch you to a different blood pressure medication.
A broader concern is why there continues to be recalls of different blood pressure medications for too high levels of impurities and what the U.S. government has been doing about this problem. Consumers rely on the FDA to make sure that medications are safe to take. Yet, there’s been little talk over the past seven years from the U.S. government about what changes will be enacted to deal with this what’s-in-your-medication issue. And the concern is that all this current eagerness to slash FDA personnel, funding and regulations may further trump safety.
That could end up adversely affecting a lot of people including yourself. If you recall, nearly half of adults in the U.S. have high blood pressure, with many not even realizing that their blood pressure is to high, according to the American Heart Association. Not getting proper treatment for high blood pressure can to all lots of big problems such as heart attacks, stroke and kidney issues. Therefore, it would make sense to have the U.S. government apply more pressure on companies to make sure that their blood pressure medications are safe for all Americans to use.