After last year’s valsartan recall, reports indicate that emergency room visits have risen as patients face health effects linked to stopping their use of the blood pressure medications.

Last year, common high blood pressure medicine valsartan was subjected to a massive recall. Valsartan is the generic form of Diovan, and is produced by various manufacturers including Major Pharmaceuticals, Mylan Pharmaceuticals, Solco Healthcare, Teva Pharmaceuticals, Torrent Pharmaceuticals, and others. In total, six generic valsartan products were recalled in Canada.

The drug was recalled as the result of concerns that it may have been contaminated by a possible carcinogen during the manufacturing process. Reportedly, the potential contamination at issue was nitrosodimethylamine, or NDMA.

High blood pressure medicine valsartan was recalled in July 2018, and some patients did not replace their medication with a different one, says CTV News.

The study that examined this possible increase in emergency room visits connected to high blood pressure medicine valsartan was conducted by the Institute for Clinical Evaluative Sciences, a non-profit group.

Reportedly, around 5,461 Canadians were affected by the recall, and 10.7 percent of these people did not replace their medications during the three months after the recall. The study indicated that 95 percent of these valsartan users used the drug for hypertension, and five percent of them used it for heart failure. 

CTV News says that the study indicated that emergency room visits among valsartan users went up 55 percent. The authors of the study explained that this number was still small — 0.17 percent of patients affected by the recall — but the increase was noteworthy. Before the recall, around 0.11 percent 

The study did not indicate which patients were those who visited the emergency room, though — whether they were patients seeking new prescriptions, or those who had experienced problems with their hypertension after stopping valsartan.

The report by the Institute for Clinical Evaluative Sciences indicated that when recalls occur, there is a high likelihood that the risks involved with the recalled medication will be misunderstood by the public. 

The report said, “While government agencies issued advisories to continue taking medications until contacting their prescribers, there is a high potential for misunderstanding by patients, particularly given the mass media news that may have heightened the alarm regarding the potential negative consequences.”

The studies’ authors shared that this potential for miscommunication may be an indication that Health Canada, medication prescribers, and pharmacists need a better way to coordinate, especially if these miscommunications with the public can lead to individuals not taking needed medication. 

Canada is not the only country to have issued valsartan recalls, says CNN Health. Twenty-three countries issued valsartan recalls over similar concerns. CNN explains that in the US, the valsartan recall also led to a shortage of the drug, and required the U.S. Food and Drug Administration to take steps to ensure that patients had their medication needs met even during the recall.

Though the recalls were widespread, some medications that contained valsartan did not get recalled, because they were reportedly not part of the drug supply affected by NDMA contamination, explains CNN.