Daily hypertensive drugs linked to cancer are still being dispensed in chemists around the country with no warning to the public.
Chemists in Nairobi, Nakuru and Mombasa are still stocked with the drugs, and the only question asked to a buyer is: “How many pills do you need?”
The pills retail at Sh2 to Sh5 in seven pharmacies in Mombasa, five in Nakuru and nine in Nairobi that the we visited.
The sellers do not ask for a prescription, or which of the two available dosages — 25mg and 50mg — the patient needs. A patient is expected to stick to the dosage prescribed, unless ordered otherwise by a doctor.
When asked if there was any cause for concern about the medication, one seller said that HCTZ “is the best that there is in the market for hypertension”.
On January 14, the Pharmacy and Poisons Board posted a statement on its website and shared it with healthcare providers.
It was about hypertension drugs containing hydrochlorothiazide (HCTZ), a chemical linked to skin cancer.
In July 2018, the board also issued a statement on an ingredient called valsartan used in generic medicines to treat high blood pressure. Valsartan is no longer under patent.
Dr Christabel Khaemba, a board official, said in the statement that certain products with valsartan should be tested for “an impurity”.
While the Kenyan wording did not specify the impurities, the situation was different in the US.
Medicine with the chemical was recalled by the Food and Drug Administration. It said the drugs contained one or both of two organic chemicals: N-nitrosodimethylamine (NDMA) and N-nitrosodiethylamine (NDEA).
NDMA is a by-product of industrial processes while NDEA is used to make liquid rocket fuel. The latter is also a by-product of pesticide manufacturing.
The World Health Organisation says NDMA is a potent carcinogen. Both are classified as cancer-causing agents.
For this reason, they should not be found in any blood pressure medication.
Other brands of hypertensive medications — such as Losartan and amlodipine — have been recalled but are still sold to Kenyans.
The statements on HCTZ by Director of Information and Pharmacovigilance Stephen Kimathi also recommended that healthcare workers inform patients about the effects of the drug.
However, pharmacists do not seem to know what to do since the statement did not offer any guidance.
Mr Elo Mapelu, a long-serving pharmacist, said he stopped dispensing the drugs immediately the statement was issued.
“The circular was in our WhatsApp and Facebook groups,” he said. But three other pharmacists said they only “stumbled on the information early this week”.
Pharmaceutical Association of Kenya chairman Eric Gichane said he stopped stocking the medicines, but added that he is is still waiting for communication on what to do with the remaining stock.