A popular heartburn drug has been yanked from shelves, and the FDA has warned it should be thrown out of medicine cabinets, after testing revealed that it could contain a cancer-causing carcinogen. While the US Food and Drug Administration says it only discovered dangerous levels of NDMA in a small number of samples, it’s enough to warrant a complete lock-down on production.
The heartburn medications in question use ranitidine, which is more commonly known by its brand name of Zantac. The FDA was testing the drugs – which are available both over-the-counter (OTC) and by prescription – after finding a contaminant known as N-Nitrosodimethylamine (NDMA).
Small levels of NDMA are fairly commonplace, and present in food and water. At larger doses, however, they’re believed to be a human carcinogen, and thus capable of causing cancer. Testing of ranitidine began in the summer of 2019, and found not only was NDMA present in some samples, but that it was showing a worrying trend.
The impurity observed in some ranitidine-based heartburn medications was actually increasing over time, particularly when the drugs were being stored at higher than room temperatures. New testing since the initial discovery last year found that, at temperatures which could be encountered during distribution and handling by customers, the NDMA levels could rise above the acceptable daily intake limit. The older the ranitidine product, or the longer the length of time since it was made, the greater the NDMA levels it contains.
“We didn’t observe unacceptable levels of NDMA in many of the samples that we tested,” Janet Woodcock, M.D., director of the FDA’s Center for Drug Evaluation and Research, explained. “However, since we don’t know how or for how long the product might have been stored, we decided that it should not be available to consumers and patients unless its quality can be assured.”
The FDA is contacting all manufacturers of ranitidine, requesting that they withdraw their products from stores and pharmacies. Anybody who already has over-the-counter ranitidine or Zantac-based medications at home, meanwhile, should stop taking them immediately, and dispose of the remaining tablets or liquid.
If you’re on a prescription drug containing ranitidine, however, you should consult your health care professional first. They should be able to switch you over to a heartburn drug that doesn’t contain the substance.
Which heartburn medications don’t have ranitidine?
Those who still want to use an OTC heartburn drug do have some safe options. According to the FDA, it has tested other heartburn medications and found that many don’t have any sign of NDMA.
That list includes famotidine (Pepcid), cimetidine (Tagamet), esomeprazole (Nexium), lansoprazole (Prevacid), and omeprazole (Prilosec). If you’re picking up a new heartburn pill or liquid, whether that be in-store or ordered online during the coronavirus pandemic and social-isolating, make sure to check the list of active ingredients first. If you find one with ranitidine or Zantac listed, pick something else instead.