In April 2020, the US Food and Drugs Administration (FDA) withdrew all available preparations of Ranitidine, more commonly known as Zantac, because of the high levels of NDMA—which is N-nitrosodimethylamine a potential carcinogen. While scientists are determining if ranitidine is linked to cancer, healthcare professionals like Internal Medicine specialist in Lahore are resorting to other medication for the treatment of GERD and PUD. But what exactly is ranitidine and how is it used clinically, read on to find out:
What is ranitidine?
Ranitidine is a class of drug known as the H-2 histamine blockers. It is available as an over-the-counter medication for the relief of heartburn, and is therefore commonly used by patients of gastrointestinal reflux disease (GERD) and peptic ulcer disease (PUD).
How is Ranitidine related to cancer?
The main chemical that is known as the potential carcinogen in ranitidine, as mentioned before, is NDMA. FDA found that of all the drugs that contain NDMA, including antidiabetic metformin, and antihypertensives valsartan and losartan, the content of NDMA in ranitidine increases overtime even as the drug is stored.
The problem was first addressed by the pharmacy Valisure in 2019 as they found that storing ranitidine could generate high amounts of NDMA as it sits on the shelf. In fact, ranitidine can generate millions of nanograms of NDMA, which is much higher than the acceptable daily intake limit of 96 ng.
What is NDMA?
NDMA is a contaminant found commonly in nature, including water, air, meat, dairy and vegetables. In terms of classification as a carcinogen, it is classified as B-2 which means it is a probable carcinogen. According to the World Health Organization (WHO), NDMA is linked to colorectal and gastric cancer. It is toxic to the liver even in extremely small amounts. NDMA is found in many manufacturing industries, like tanneries, pesticide plants, tire and rubber manufacturers. Once it was also used as rocket fuel but now it is used only for research purposes.
What cancers are associated with Ranitidine?
The compound found in ranitidine i.e. carcinogenic is NDMA, and it is linked to many types of cancers including: prostate, colon, kidney, liver, stomach, breast and bladder cancer. Other potential cancers include: ovarian, pancreatic cancers and melanoma. Researchers are trying to determine the exact link of NDMA with cancers as the topic is still new.
What to do if you are diagnosed with cancer after taking Ranitidine?
For someone diagnosed with cancer after taking ranitidine, telling your healthcare provider of the history with the drug is helpful in determining the diagnosis and designing the treatment regimen.
The FDA recommendations, in light of the COVID-19 pandemic, for the consumers and patients is to dispose of the drug with specific disposal instructions given within the package. These instructions allow the patients to safely dispose of these medications even at their homes.
What to do if you take ranitidine?
FDA has recalled ranitidine from the market but for patients there is no directive to stop the medication. For many conditions, ranitidine is only recommended for the short-term. People who are already taking ranitidine should reach out to their healthcare provider like Internal Medicine Specialist in Islamabad for alternate drugs.