Q. I take metformin twice daily, but I heard that it was recalled due to a cancer risk. Should I stop taking it?
A. Metformin is the most widely used medication for treating diabetes. It helps to reduce the body’s natural production of glucose, decrease the absorption of glucose into the bloodstream, and improve the way insulin functions, all with very few side effects. Earlier this year, the U.S. Food and Drug Administration (FDA) recommended a recall of extended-release (ER) versions of metformin from several specific manufacturers — as of early November, these included Amneal, Apotex, AvKARE (repackager for Amneal), Bayshore Pharmaceuticals, Granules Pharmaceuticals, Lupin Pharmaceuticals, Marksans (labeled as Time-Cap), Nostrum Laboratories, PD-Rx Pharmaceuticals (repackager for Amneal and Marksans), Preferred Pharmaceuticals (repackager for Marksans), Sun Pharmaceuticals Industries, Teva (labeled as Actavis), and The Harvard Drug Group (repackager for Apotex) — because they were found to contain unacceptably high levels of a chemical called NDMA. At low levels, NDMA is not harmful. However, according to the World Health Organization, high levels of exposure over extended periods of time have been linked to an increased risk of some cancers and liver/spleen damage.
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Check to see what company produced your metformin. Unless it was manufactured by one of the companies listed earlier, there is no need for concern. The manufacturer is typically listed in the “fine print” under the medication brand name with the prefix MFG or MFR. On some bottles, it may be on the side panel with the safety warnings and storage information. If your medication was manufactured by one of the companies listed earlier, reach out to your pharmacy to request a new stock of medicine from a different manufacturer.
In the meantime, do not stop taking your medication. The immediate health risks associated with high blood sugar and diabetes complications are far greater than those from possible short-term exposure to NDMA. Speak with your doctor if you have any doubts about what to do.