SINGAPORE: Worried high blood pressure patients crowded polyclinics on Friday (Mar 29), a day after three medicine brands used to treat the disease were recalled, but doctors said there is no cause for alarm.
Among the concerned patients at a SingHealth Polyclinic in Bukit Merah was Madam Yoke Chan, 70.
"I was worried because the risk is cancer," she said.
Her hypertension medication, which she has been taking for about three years, was indeed affected, and changed to one called Lisinopril.
She said that she was attended to quickly, in about 20 minutes, after she went to a “Losartas Review Counter” that was set up specially to attend to patients like herself.
She consulted a doctor and was able to have her medicines changed. She said she did not want to have to wait till her next appointment in April, and therefore showed up.
On Thursday, the Health Sciences Authority (HSA) announced that it was recalling three brands of medicine that contain a lorsartan ingredient, losartan potassium. The brands are Losartas, Hyperten and Losagen. This is because these brands were found to contain unacceptable amounts of nitrosamine impurity, a substance which is possibly carcinogenic, or has the potential to cause cancer.
About 137,000 patients in Singapore are using the three recalled brands of losartan medicine, of whom about 130,000 patients have been prescribed Losartas at the public healthcare institutions, the Ministry of Health said.
Hypertension patients, both those who were affected and unaffected, told Channel NewsAsia that they received text messages from their polyclinics advising them not to stop taking their blood pressure medication.
Since the end of last month, several losartan medicines were recalled overseas due to the presence of such impurities, HSA said. In Singapore, seven other medicines that also contain losartan are not affected, HSA added.
Another worried patient who went to the polyclinic is Mr Yee Kam Chuen, 68. He did not have an appointment on the day, but also walked in as he was concerned after reading that the medicine could increase the risk of cancer.
“It’s better to change, in case there’s any problem, It's our body, we have to take care of it,” he told Channel NewsAsia.
Others Channel NewsAsia spoke to also had their medicines swapped when they turned up for their regular appointments.
NO CAUSE FOR ALARM: DOCTORS
Despite the worry and flurry, doctors said that there is no cause for alarm. Dr Elly Sabrina, who manages two clinics, in Jurong and in Woodlands, has had patients check with her, although her clinics do not prescribe the affected medicines.
She noted that the impurity that was found in the affected medicines is found in other products which are not as tightly controlled as medicines, like processed meat and cigarettes.
“If people are worried about their medicines, they should also worry about smoking and having these foods,” she said.
Dr Elly pointed to a circular given to medical professionals that said that there is a risk of cancer, even when the ingredient is within acceptable amounts. The risk is 1 in 100,000 for exposure over a lifetime, or more than 70 years.
Dr Lye Tong Fong, who runs a clinic in Pasir Ris, also said there is no cause for alarm. The recall is more to err on the side of safety, he added.
HSA also said that the added cancer risk from an additional six-month exposure is estimated to be less than 0.0002 per cent.
Cardiologist in the National Heart Centre Professor Ding Zee Pin, who is also on HSA’s Expert Panel on nitrosamines, advised that there is no immediate health risk associated with taking the affected medicines.
“Patients are advised not to stop or change treatment on their own. As losartan is used to treat high blood pressure, stopping the medicine without replacement of other equivalent medication can increase the risk of poor control of blood pressure,” she cautioned.
Group chairman of SingHealth's medical board Professor Terrance Chua, said that following the recall, SingHealth Polyclinics there was a 9 per cent week-on-week increase in patients on Friday.
Patients whose appointments are on or after Jul 1 will be contacted for a consultation at a dedicated review clinic set up for the losartas recall, he added.
Chief operating officer of National Healthcare Group Polyclinics Dr Simon Lee said that patient turnout at the group's clinics was normal, and that that most patients turned up as they had appointments scheduled.
He added that all affected patients had been contacted via text message, and that those without mobile numbers will be sent letters.