Accuretic supply issue, almost 36,000 New Zealanders taking the blood pressure medicine will need to change treatments

Media release Medicines

Pharmac has updated healthcare professionals that supply of quinapril with hydrochlorothiazide (branded as Accuretic), from supplier Pfizer, will be disrupted due to the detection of a contaminant called nitrosamine. This is a global issue, with voluntary recalls happening in other countries, including in Australia, Europe, the United States of America, and Canada.

“Accuretic, is a medicine generally used to manage blood pressure, and is used by almost 36,000 New Zealanders,” explains Pharmac’s Director of Operations Lisa Williams.

“We want to ensure, first and foremost, that patients can continue to access funded treatment,” says Ms Williams. “Medsafe has advised us that there is a very low risk to people who are taking Accuretic, and they should continue with their treatment because the risk associated with suddenly halting blood pressure medication exceeds that presented by the contaminant.”

People taking Accuretic will need to consult their doctor about an alternative treatment when next due for a prescription. “Pharmac is asking healthcare professionals to talk with their patients about changing medicines for their blood pressure, and we are grateful to professional bodies including General Practice New Zealand, the Royal New Zealand College of General Practitioners, the Pharmacy Guild, and the Pharmaceutical Society for helping us spread the word to their members.”

“We have been working with Pfizer over the past few months, to see if we can secure an alternative quinapril with hydrochlorothiazide product. Unfortunately, because it’s a global issue, no alternative brand is available in sufficient volumes for New Zealand and that can be verified as being free from contamination. This means there is currently no acceptable direct chemical substitute for New Zealanders taking this medicine.”

“Our expert clinical advice is that losartan with hydrochlorothiazide would be an appropriate, currently funded and Medsafe approved, alternative for most patients. Pharmac has received assurances from its supplier, Teva, that there is sufficient stock of losartan with hydrochlorothiazide to accommodate patients transitioning from Accuretic. There is also enough of the other alternative funded angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) to meet the additional demand from people changing from Accuretic.”

“We know that our healthcare sector is currently under a huge amount of strain, and that changing this many people to alternative treatments will add to that strain. We are asking clinicians to move their patients to alternative medicines as soon as possible, and we really appreciate the support that we know that both clinicians and pharmacists will provide to their patients.”

“Pharmac is committed to working closely with healthcare professionals, patient support groups, and other key stakeholders to make this change as easy as possible for patients, including covering the cost of the GP clinic visit and prescription fees.

Pharmac will continue to update the healthcare sector and public and will keep our website up to date.

Learn more

Nitrosamines are believed to raise a small cumulative risk of cancer when taken long term. While the extent of the risk cannot be further defined, cautious acceptable level limits have been set globally and pharmaceutical suppliers and medicines regulators are responding to this through either further research, reformulation of products or withdrawal. 

Varying levels of nitrosamines can be found in potable water, grilled foods, vegetables, and dairy products, as well as medicines.