Popular Heartburn Drug Ranitidine Recalled: What You Need to Know and Do

Heartburn is a common condition that occurs when stomach acid rises up into the esophagus. It produces a burning sensation in the chest region, and can even make people feel like their chests are on fire. The condition typically occurs after eating food, especially if you have eaten a big meal or consumed certain foods such as acidic, fried, or spicy foods. Heartburn can be quite painful and often interferes with people's everyday lives, such as their sleep patterns. Ranitidine is a popular drug for treating heartburn, but has been recalled due to the discovery of NDMA in the medication. NDMA is a harmful substance that can increase the risk of cancer in humans. It's important for heartburn sufferers who are taking ranitidine to stay informed about the recall and to take appropriate steps to ensure their health is not compromised.

Background on Ranitidine and the Recall

The popularity of ranitidine, a drug used to treat heartburn, has rapidly declined following the discovery of NDMA, a carcinogenic substance, in the drug. Ranitidine is a type of medication known as an H2 blocker that works by reducing the amount of acid produced by the stomach. When taken as prescribed, it can provide relief for people suffering from heartburn and digestive issues. Ranitidine has been sold under a variety of brand names including Zantac, and is also available as an over-the-counter medication.

What is Ranitidine and How Does it Work?

Ranitidine is a medication that belongs to the class of drugs known as H2 blockers. The medication works by blocking histamine receptors in the stomach, which reduces the amount of acid produced in the stomach. There are many causes of heartburn, but it is usually caused by a build-up of stomach acid kicking back into the esophagus. The reduction of stomach acid helps to alleviate heartburn and other related symptoms.

How Did the Recall Come About?

The discovery of NDMA in ranitidine led to the recall of the drug. NDMA is a naturally occurring carcinogenic substance that is found in water and some foods. It can also be produced in small amounts under certain laboratory conditions. Despite its low toxicity in small doses, long-term exposure to NDMA is linked to various types of cancer, including liver, kidney, and lung cancer.

In September 2019, the FDA issued a statement alerting healthcare providers and the public that low levels of NDMA were detected in samples of ranitidine. The levels of NDMA in the samples were not high enough to pose an immediate risk, leading the FDA to conclude that the risks associated with the drug are low and that the benefit of the medication outweighs the potential risk. However, the FDA recommended additional testing to be done to determine the full extent of the issue.

Further testing confirmed that NDMA levels were found to increase over time and when the drug was stored in higher than room temperatures. As a result, pharmaceutical companies began voluntarily recalling their ranitidine products from the market. Current guidance advises people not to take ranitidine in any form and to speak with their healthcare providers about alternative medications that can be used to manage their heartburn and GERD symptoms.

Health Risks Associated with NDMA and Ranitidine

Understanding the potential health risks associated with consuming ranitidine containing NDMA is important for individuals who currently use this medication.

What is NDMA?

N-nitrosodimethylamine, commonly known as NDMA, is a chemical found in water and certain types of foods. NDMA is classified as a probable carcinogen based on animal studies, which found that long-term exposure led to the development of tumors in various organs, including the liver, lungs, and kidneys. In humans, exposure to high levels of NDMA can lead to more immediate adverse effects, including liver damage, internal bleeding, and decreased function of the central nervous system.

NDMA can also form as a byproduct of various industrial activities and manufacturing processes, including the production of rocket fuel and certain pesticides. In the case of ranitidine, it is thought that the drug may break down over time and under certain storage conditions, such as high temperatures, leading to the formation of NDMA in the body.

How is NDMA Linked to Ranitidine?

Recent studies have found that certain types of ranitidine products, including both prescription and over-the-counter (OTC) medications, were contaminated with small amounts of NDMA. The contamination is thought to be a result of a chemical reaction that occurs during storage or transit of the drug. Over time, the NDMA levels in the drug can increase, placing individuals at increased risk of adverse effects.

The levels of NDMA identified in various ranitidine products were not deemed high enough to pose any immediate risk to consumers. However, long-term use of these drugs containing the contaminant could lead to significant health problems.

What are the Potential Health Risks of Taking Ranitidine Containing NDMA?

Long-term use of ranitidine containing NDMA could pose several health risks to consumers. These include:

  • Increased risk of cancer: Long-term exposure to NDMA has been linked to cancer of various organs including the liver, kidney, and lungs.
  • Liver damage: NDMA is known to be toxic to the liver, causing damage to the organ over time.
  • Gastrointestinal (GI) problems: When ingested, NDMA may lead to GI problems, including nausea, vomiting, and diarrhea.
  • Central nervous system (CNS) damage: NDMA is toxic to the central nervous system and exposure to high volumes of the substance can lead to seizures and other CNS disorders.

It is important to speak to your healthcare provider if you are currently using ranitidine or any other medications containing NDMA. Your healthcare provider can work with you to determine alternative treatment options that may be safer for long-term use. Additionally, be aware that all ranitidine products have been removed from the market and should not be used, as this contamination issue has not been fully resolved.

What to Do If You Have Been Taking Ranitidine

If you are currently taking ranitidine or any medication containing the drug, it is crucial to understand what steps you should take to protect your health and safety.

Contact Your Healthcare Provider

First and foremost, you should reach out to your healthcare provider as soon as possible to address any concerns you may have about the recall and potential health risks associated with ranitidine-containing NDMA. Your healthcare provider can recommend alternative medications or treatment options and help ensure that you are receiving safe and effective treatment for your heartburn symptoms.

It is also important to discuss if you have a history of cancer and/or regular exposure to NDMA for work or other purposes. These factors may put you at greater risk for harm from exposure to ranitidine containing NDMA.

Alternative Treatment Options

There are many alternative treatment options available to individuals who currently use ranitidine for heartburn symptoms, some of which may be equally or more effective for reducing symptoms.

  • Antacids: Over-the-counter antacid medications, such as Maalox, Tums, and Rolaids, work by neutralizing the acid in the stomach. Although antacid medications do not provide long-term relief for chronic heartburn sufferers, they can be helpful in the short term.
  • Proton pump inhibitors (PPIs): PPI medications, such as omeprazole, lansoprazole, and esomeprazole, work by reducing the amount of acid produced in the stomach. PPIs are effective for treating GERD and other conditions in which acid reflux occurs regularly or fiercely.
  • H2 blockers: Similar to ranitidine, H2 blockers such as famotidine and cimetidine temporarily block the histamine receptors in the stomach and reduce the amount of acid produced. H2 blockers provide longer-lasting relief compared to antacids but have a slower onset of action than PPIs.
  • Lifestyle Changes: Lifestyle changes such as decreasing portion sizes, avoiding triggers, losing weight (if applicable), and eating slowly can all help to reduce the occurrence of heartburn and other acid reflux symptoms.

Proper Disposal of Ranitidine

If you have any remaining ranitidine-containing medications at home, it is important to dispose of them properly to prevent any potential harm to individuals or the environment.

  • Do not flush the medication down the toilet or drain. This could potentially contaminate the water supply.
  • Do not throw the medication in the trash. Instead, mix the pills with an unpalatable substance like cat litter or coffee grounds and put them in a sealed container.
  • Check with local pharmacies or hazardous waste facilities to see if they accept medications for safe disposal.

By taking these steps, individuals who currently use ranitidine-containing medications can protect their health and safety and ensure that they are receiving effective and safe treatment for heartburn and related symptoms.

Conclusion and Takeaway

The recall of ranitidine-containing medication is an important issue for individuals who use these drugs for treating heartburn and related symptoms. With the potential health risks associated with NDMA exposure, it is vital that individuals stay informed and proactive about their health and medication choices.

Recap of the information covered in the article:

  • Ranitidine is a popular drug used to treat heartburn, but it has been recently recalled due to the discovery of NDMA contamination, which poses potential health risks.
  • NDMA is a carcinogenic substance that can cause long-term health issues if consumed in large amounts regularly.
  • Individuals who have taken ranitidine-containing medication should speak with their healthcare providers about alternative treatment options and proper medication disposal.
  • Alternative treatment options such as antacids, PPIs, H2 blockers, and lifestyle changes are available to individuals who use ranitidine for heartburn symptoms.
  • Proper disposal of any remaining ranitidine-containing medication is essential to prevent any harm to individuals or the environment.

Remember, your healthcare provider is the best source of guidance and information when it comes to your health. If you have concerns about ranitidine-containing medication or heartburn treatment, do not hesitate to discuss them with your healthcare provider.

Staying informed and proactive about your health and medication choices can help ensure that you receive safe and effective treatment for heartburn and related symptoms.

Resources and References

Here are some additional resources and references that readers may find helpful in learning more about the recall of ranitidine-containing medication.

Food and Drug Administration (FDA)


Mayo Clinic

Additional Studies and Research

It is essential to stay up to date with the latest news and information regarding the recall of ranitidine-containing medication. Discuss any concerns or questions with your healthcare provider, as they can offer guidance on alternative treatment options and proper medication disposal.

William H. McDaniel, MD

Dr. Robert H. Shmerling is the former clinical chief of the division of rheumatology at Beth Israel Deaconess Medical Center (BIDMC), and is a current member of the corresponding faculty in medicine at Harvard Medical School.

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