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On September 10, 2007, Pfizer issued a letter warning clinicians about an impurity in the PI nelfinavir (Viracept). The drug has been found to contain ethyl methanesulfonate (EMS), a process-related chemical that is potentially carcinogenic in humans. The levels of EMS detected in Pfizer-manufactured nelfinavir are lower than the levels detected in Roche-manufactured nelfinavir, which was recalled recently from the European market. Nevertheless, the FDA, Pfizer, and the U.S. Department of Health and Human Services agree that pregnant women and children who are starting antiretroviral therapy should not be offered nelfinavir-containing regimens “until further notice.” Children who are stable on the drug can continue to receive it, whereas pr…