; runtime=124 min; creator=Jane Austen; In 1800s England, a well meaning but selfish young woman meddles in the love lives of her friends; Stars=Johnny Flynn; Genres=Comedy

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In 2018, nitrosamine impurities, including N-nitrosodimethylamine (NDMA), were found in a number of blood pressure medicines known as 'sartans'. This led to some product recalls and to a regulatory review, which set strict new manufacturing requirements for these medicines. Subsequently, a nitrosamine impurity has been detected in batches of ranitidine, a medicine used to treat heartburn and stomach ulcers, and the Agency's Committee for Medicinal Products for Human Use ( CHMP) has started a review. Nitrosamines are chemical compounds classified as probable human carcinogens on the basis of animal studies. However, there is a very low risk that nitrosamine impurities at the levels found could cause cancer in humans. The European Medicines Agency (EMA) has asked marketing authorisation holders to take precautionary measures to mitigate the risk of nitrosamine formation or presence during the manufacture of all medicines containing chemically synthesised active substances. EMA and national competent authorities continue to monitor the presence of nitrosamine impurities in medicines, in co-operation with regulators from outside the European Union (EU), and will work with marketing authorisation holders to find rapid solutions to address any adverse findings. Guidance to avoid nitrosamines in human medicines Review of ranitidine medicines At the request of the European Commission, EMA is currently reviewing ranitidine medicines after tests showed that some of these products contained NDMA. For more information, see: Ranitidine-containing medicinal products Review of sartans (angiotensin II receptor antagonists) EMA has completed its review of sartan blood pressure medicines (also known as angiotensin II receptor anatgonists). Manufacturers of sartan medicines must review their manufacturing processes to ensure they do not produce nitrosamine impurities. For more information, see: Angiotensin-II-receptor antagonists (sartans) containing a tetrazole group The European medicines regulatory network is conducting an exercise to determine what lessons can be learnt from the presence of nitrosamines in sartans. It plans to publish recommendations for the prevention and management of presence of impurities in the future. Metformin-containing medicines EMA and the national competent authorities are assessing the impact of tests which showed NDMA in some EU batches of metformin-containing medicines, used for the treatment of diabetes. This follows confirmation of NDMA in some batches outside the EU in late 2019. EMA and the national competent authorities are awaiting further test results of EU medicines. They are working closely with companies and the official medicines control laboratories (OMCLs). EMA will provide further updates as soon as possible. EMA advises patients in the EU to continue to take metformin medication as the risks from not treating diabetes far outweigh any possible effects of the low levels of NDMA seen in tests. As metformin is considered a critical medicine, EMA and national authorities are cooperating closely to avoid possible shortages so patients can continue to get the treatments they need. For more information, see: Update on nitrosamines in EU medicines (03/02/2020) EMA update on metformin diabetes medicines (06/12/2019).

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