As someone who suffers from migraines, I have a series of prescriptions for three drugs from this list. Two of them have the potential to form nitrosamines that the FDA deems as the most potent. Well, each of those drugs contains up to 26.5 nanograms of harmful chemicals in a daily dose. It’s not quite a comforting feeling.

The limits that were set by the FDA also imply that the amount of nitrosamine in any drug can’t exceed a 1 in 100,000 cancer risk for people who ingest the chemicals on a regular basis over a lifetime. However, we can’t 100% tell whether these specific drugs for migraines contain zero nitrosamines or just fall below the list.

The FDA’s list only highlights the potential for these drugs to reach a certain limit. In the meantime, it’s close to impossible to live with migraines. For some, the risk is needed.

This is an issue the FDA and other drug industries have been trying to grapple with since 2018, when blood pressure pills known as angiotensin II receptor blockers, such as valsartan and irbesartan, were discovered to contain a nitrosamine onc used in rocket fuel called NDMA.

As pharmaceutical companies and the FDA dug into this, it became quite apparent that some drugs weren’t made with known nitrosamines such as NDMA, but a bunch of different types of nitrosamines never seen before, that the agency deemed as “nitrosamine drug substance-related impurities.”