An updated version of Health Canada's Guidance on nitrosamine impurities in medications(Update May 29, 2026)

What’s new

An updated version of Health Canada’s Guidance on nitrosamine impurities in medications has been posted online. Several updates have been incorporated into the Nitrosamines guidance document, including:

  • Health Canada’s change in expectation for reporting on the detection of nitrosamine impurities, notably:
    • Market Authorization Holders (MAHs) no longer need to inform Health Canada every time an elevated level of a nitrosamine impurity is detected. MAHs are only expected to notify Health Canada if a decision to initiate a recall is made and reporting should be conducted as specified in the Drug, natural health product and biocide recall guide (GUI- 0039) (number 15)
  • General and Quality:
    • Nitrosamine risk mitigation-related changes are no longer required to be filed as Level I (Supplement) submissions by default (number 13)
    • These changes should be classified and filed in accordance with Health Canada’s Post-Notice of Compliance (NOC) Changes - Quality Guidance, using a risk-based approach that considers the nature, scope, and potential impact on product quality, safety, and efficacy to determine the appropriate reporting category (Level I or Level III) (number 13)
  • Safety:
    • Added new contact information for enquiries related to applicable acceptable intake (AI) limit(s), including new AI limit proposals (number 24)
  • Appendix 2:
    • The decision tree in Appendix 2 has been updated to reflect the revised expectations for MAHs filing Nitrosamine risk mitigation-related changes.
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