As if things in the world of healthcare weren’t chaotic enough, last week the FDA pulled the popular heartburn medicine ranitidine, brand name Zantac, from the shelves due to a possible cancer link. This follows months of investigation first prompted by Valisure, a small start-up pharmacy that looked into the chemistry of the popular medication.
Here’s what people with heartburn should know about the recall.
What is ranitidine?
Ranitidine is an H2 (histamine-2) blocker, which decreases the amount of acid created by the stomach, according to the FDA. This makes it a good fix for health issues like heartburn, sour stomach, or acid indigestion.
Some ranitidine drugs are available over the counter (Zantac can be found OTC), but others are prescribed for treatment and prevention of ulcers and treatment of gastroesophageal reflux disease.
Does Zantac cause cancer?
“It’s important to note that there are no data available linking ranitidine to cancer in humans,” Harvard epidemiology professor Joshua Gagne says, “only data showing that some ranitidine products that have been tested contain NDMA.”
If ranitidine is exposed to high temperatures, says Gagne, who has been writing about the drug on Harvard’s medical school blog, the drug can break down to form N-nitrosodimethylamine, or NDMA. This substance is classified as a possible carcinogen. But not all of the samples tested by the FDA were found to have an unacceptable level of the potential carcinogen.
“Long-term studies are needed to determine whether long-term use of ranitidine is associated with cancer occurrence in humans,” Gagne adds. “Nevertheless, I would not count on ranitidine returning to shelves.”
What is NDMA?
According to Gagne, NDMA is an environmental contaminant that can be produced by industrial processes like water treatment. Very low levels of NDMA can also be found in drinking water and certain foods like cured meats and dairy.
But before you lose your head about this scary-sounding molecule, it’s important to note that it’s classified right now as a “probable carcinogen.” This means there’s some evidence that it can cause cancer in animals, but the data on its relationship to cancer in humans is limited, Gagne says.
Ranitidine isn’t the only drug that has been linked with NDMA. Several blood pressure medications were recalled in July 2018 for a similar connection to the potential carcinogen.
I take Zantac. What now?
The FDA is telling consumers to stop taking any pills or liquid versions of ranitidine.
Luckily, there are lots of drugs that can help you out with heartburn struggles that don’t contain ranitidine. A few examples include famotidine (Pepcid), cimetidine (Tagamet), esomeprazole (Nexium), lansoprazole (Prevacid), or omeprazole (Prilosec). So if you’re a regular Zantec user, chat with your healthcare provider about another option that’s free of NDMA risks.
Gagne also suggests that lifestyle changes can be helpful for managing heartburn symptoms. Avoiding spicy foods, carbonated beverages, and smoking are just a few ways to try and prevent heartburn without stepping foot in your local pharmacy.