Since their discovery in valsartan-containing drugs, nitrosamine impurities have
emerged as a significant safety problem in pharmaceutical products, prompting extensive recalls
and suspensions. Valsartan, candesartan, irbesartan, olmesartan, and other sartans have been discovered
to have additional nitrosamine impurities, such as N-nitroso-N-methyl-4-aminobutyric
acid (NMBA), N-nitroso-Di-isopropyl amine (NDIPA), N-nitroso-Ethyl-Isopropyl amine (NEIPA),
and N-nitroso-Diethyl amine (NDEA). Concerns about drug safety have grown in response
to reports of nitrosamine contamination in pharmaceuticals, such as pioglitazone, rifampin, rifapentine,
and varenicline. This review investigates the occurrence and impact of nitrosamine impurities
in sartans and pharmaceutical goods, as well as their underlying causes. The discussion
emphasizes the significance of comprehensive risk assessment and mitigation approaches at various
phases of medication development and manufacturing. The link between amines and nitrosamine
impurities is also investigated, with an emphasis on pH levels and the behaviour of primary,
secondary, tertiary, and quaternary amines. Regulations defining standards for nitrosamine
assessment and management, such as ICH Q3A-Q3E and ICH M7, are critical in resolving impurity
issues. Furthermore, the Global Substance Registration System (GSRS) is underlined as being
critical for information sharing and product safety in the pharmaceutical industry. The review specifically
focuses on the relationship between ranitidine and N-nitroso dimethyl amine (NDMA) in
the context of the implications of nitrosamine contamination on patient safety and medicine supply.
The importance of regulatory authorities in discovering and correcting nitrosamine impurities
is highlighted in order to improve patient safety, product quality, and life expectancy. Furthermore,
the significance of ongoing study and attention to nitrosamine-related repercussions for increasing
pharmaceutical safety and overall public health is emphasized.