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Friday 30 November 2018

Losartan. Is this the silent end for this anti-hypertensive drug?

Losartan is a well known, and frequently prescribed antihypertensive drug. It is supposed to treat hypertension, high blood pressure, and we are told it can prevent illnesses such as stroke and myocardial infarction.

Yet over the years it has also been associated with causing cancer, although typically this has never been accepted by the conventional medical establishment.

In the USA, Losartan, and some similar drugs in the same class, have recently been recalled when it was discovered that the drug contained 'a cancer-causing agent'. It has been described as a 'voluntary' withdrawal, and all the reports I have seen suggest that this is a problem with a particular batch of Losartan, and not a general problem. The USA drug regulator, the FDA, has said:

               "Patients who are on Losartan Potassium Hydrochlorothiazide should continue taking their medication, as the risk of harm to a patient’s health may be higher if the treatment is stopped immediately without any alternative treatment."

               "Patients should contact their physician or healthcare provider if they have experienced any problems that may be related to taking or using Losartan Potassium Hydrochlorothiazide."

I was first told about this by Jayney Goddard, President of the Complementary Medical Association, for which I am grateful. It has certainly not been covered by the national media, although there are many reports on the internet by independent websites. These reports all seem to indicate that the problems arose from a particular batch, but I don’t think this is correct - although pharmaceutical drug companies, and the FDA, might want this to be the message. Jayney does not agree, and she has explained her position forcefully to her members/

               "We STRONGLY disagree with this advice from the FDA, as it is hughly unlikely that a patient wil experience 'any problems related to taking or using Losartan Potassium Hydrochlorothiazide', given that if they are affected by the carcinogenic substance that these tablets contain, they are unlikely to experience any symptoms for some time!

So what is known about Losartan. The first thing to say is that it has long been associated with cancer, and also the usual, routine denials made by the conventional medical profession that there is any such connection. I looked at my own records, and found this link from May 2013.

Blood pressure drugs cause cancer. It reported that Losartan had come under attack by a senior regulator at the FDA, Thomas A. Marciniak, who sought stronger warnings about these 'angiotensin receptor blocker drugs', or ARBs. The article stated that the drug was taken by millions of people and generated $7.6 billion in USA sales in 2012. Dr Marciniak said that some doctors agreed that the drug "may be linked to higher cancer rates". But 'top' FDA officials said that the evidence did not support the link. One, Ellis Unger, then chief of the drug-evaluation division, called the complaints a "diversion" and is quoted as saying "We have no reason to tell the public anything new."

So I went further, and did a web-search on 'cancer' and 'Losartan' and it became clear that the suspicion about a link with cancer has been around for some time. For example this article, "Blood Pressure Drugs Linked to Cancer Risk, was published by WebMD in June 2010, and stated that

               "A study published online in The Lancet Oncology states that although there are no major safety concerns associated with ARBs, a previous trial had reported a significantly increased risk of fatal cancers in patients receiving the ARB candesartan compared with a placebo."

A similar article appeared on MedPage Today, also in 2010. It referred to a meta-analysis of nine published studies where angiotensin-receptor blockers (not just Losartan, but many more in its class) were associated with "a modest but statistically significant 8% increase in the relative risk of a new cancer." The article goes on to discount the seriousness of these findings by saying that "there was no increase in the risk of dying from cancer, perhaps because follow-up in the trials was too short, the researchers said online in The Lancet".

So, in both articles, as always when a drug is first linked to serious disease, there were the usual attempts to discount the evidence - "there are not major safety concerns" and "there was no increase in the risk of dying from cancer". And, as usual, there were other attempts to discount the link with cancer entirely, as is the case here, in 2011.

Angiotensin receptor blocker drugs have been known for about 120 years, but were developed mainly in the 1970's and 1980's. So these widely used, and highly profitable anti-hypertension drugs, have been given to patients for some 30 years or more. And for at least the last 10 years the conventional medical establishment has known that they were linked with cancer. So during this time how many patients have taken the drug and developed cancer?

And how many of these patients knew that the drug they were prescribed caused cancer? To find out I looked up the Patient Information Leaflet for Losartan potassium 100 mg film-coated tablets. The word cancer does not appear anywhere on the leaflet. So I looked at the website, often a good source of information (but recently taken over by a consortium owned by drug companies), and discovered that whilst a whole host of the most serious 'side effects' were listed, cancer was not mentioned.

So is the recent US recall of Losartan a problem with a particular batch? Or is this this another dangerous pharmaceutical drug that will be quietly withdrawn, forgotten, with as little publicity as possible. This is what has happened to so many drugs in the past. And this is certainly a possible, even a likely outcome for Losartan. This is what the conventional medical establishment do, routinely. They protect the safety reputation of their drugs until it is no longer possible to do so, and then they drop them - as quietly and as secretly as possible!

Pharmaceutical companies also try to ensure that the damage done to a profitable drug is as limited as possible. So although this recall has been done in the USA, Losartan has not been withdrawn in Canada, in Europe, Australasia, or indeed anywhere else, as far as I can see. It is likely, therefore, that drug companies will continue to sell it wherever in can, wherever it is allowed to, at least for a few years!

The precautionary principle?
First, do no harm?
Conventional medicine appears never to have heard of these concepts!