Effective immediately, one of the most common drugs for GERD has been discontinued—Zantac, known as ranitidine in generic form, will be pulled from shelves in both its prescription and over-the-counter (OTC) options.
On April 1, the U.S. Food and Drug Administration ordered all manufacturers to immediately pull all drugs containing ranitidine from circulation. The reason? FDA investigations have identified several issues with a contaminant found in some ranitidine products, which has been associated with an increase in cancer risk over time.
According to a release on FDA.gov, the contaminant known as N-Nitrosodimethylamine (NDMA) is an impurity that increases in ranitidine products over time, particularly when stored at higher temperatures. Consumers risk exposure to “unacceptable levels of this impurity,” which has been classified as a carcinogen (a substance that could cause cancer). NDMA is present at a low level in many substances in our diet and isn’t considered a cancer risk in this context. However, there’s concern when exposure to this carcinogen is prolonged and extensive.
What does this announcement mean for anyone using ranitidine drugs?
The FDA is advising consumers taking OTC ranitidine to stop using any tablets or liquid they currently have and dispose of them properly. For those who wish to continue treating their condition, they should consider using other approved OTC products.
Patients taking prescription ranitidine should speak with their healthcare professional about other treatment options before stopping the medicine. There are multiple drugs approved for the same or similar uses as ranitidine, but don’t carry the same risks from NDMA. To date, FDA research has not found evidence of NDMA in famotidine (Pepcid), cimetidine (Tagamet), esomeprazole (Nexium), lansoprazole (Prevacid) or omeprazole (Prilosec). Be sure to check with your doctor if one of these alternatives is best for you.
How can you manage GERD while making these potential changes?
“Focus on lifestyle and dietary adjustments, and discuss with your doctor if you can get started on an alternate medication,” says Simon C. Mathews, MD, Vivante Health’s Chief Medical Officer.
Beyond medication, Dr. Mathews shared other common ways to manage GERD:
- Elevate the head of the bed to relieve nighttime symptoms. Place six to eight-inch blocks under the legs of the head of the bed, or use a Styrofoam wedge under the mattress.
- Avoid meals 2-3 hours before bedtime, and don’t lie down right after you eat.
- If you’re overweight, continue efforts to lose extra weight.
- Avoid trigger foods. Common triggers include fatty foods, caffeine, chocolate, spicy foods, carbonated beverages and peppermint.
At the moment, there’s no need to panic or make any sudden changes to your medical treatments. It’s best to speak with your healthcare provider for the best options to help you personally manage GERD symptoms.
For members enrolled in the GIThrive digestive health program, food tracking and personalized food recommendations in the app, combined with working with our Care Teams—including a registered dietitian—can also help with managing symptoms.