Pensacola, Florida
If you go to your local pharmacy or convenience store, you won’t be able to find any Zantac or other products made with ranitidine. At least, you shouldn’t. But not because people store these heartburn medications as if they were toilet paper. Instead, the U.S. Food and Drug Administration (FDA) requires manufacturers to immediately withdraw all ranitidine medications from the market. This is all in OTC prescriptions and versions.
The US Food and Drug Administration took this measure because it could no longer tolerate the amount of N-Nitrosodimethylamine (NDMA) that could contaminate ranitidine drugs. Forbes also covered, in September 2019, the U.S. Food and Drug Administration issued a warning about finding NDMA, a possible human carcinogen, in tested samples of ranitidine. The phrase “potentially human carcinogen” means that at sufficiently high levels NDMA can cause cancer. These were certainly not the levels found in the ranitidine test. In fact, the measured levels were low enough that the FDA did not request a recall at the time.
At the time, the FDA did not know what was in the “store” for ranitidine and this NDMA problem. Subsequent testing revealed that when storing drugs at room temperature, NDMA levels can actually increase over time. Exposing the product to a higher temperature can result in greater increases in NDMA. Indeed, the US Food and Drug Administration found that “the older the Ranitidine product, or the longer it has been since its manufacture, the greater the NDMA level,” in the words of the FDA announcement. Thus, if you extrapolate these relationships, at some point, the levels of NDMA in the drugs may eventually exceed the daily acceptable limits. Urp.
So if you are taking any kind of OTC ranitidine, whether it is Zantac or any other version, whether it is tablets or fluids, stop. stop it now. If you are concerned that “heat burns will continue”, there are a number of other options. Usually, you should try lifestyle adjustments first before choosing to take heartburn medication anyway. Examples of lifestyle medications include avoiding things that may predispose to heartburn such as smoking, drinking coffee or soft drinks, eating fried food, chocolate, or spicy foods, eating large meals, and lying down within two hours of a meal and wearing tight clothes.
So if you love your coffee with hot chocolate fried while lying in bed and wearing your cotton clothes or Shazam costume, you have some space for some changes.
If lifestyle adjustments don’t work, there are other medicines for treating heartburn. For example, the FDA declared that NDMA problems were not found in famotidine (Pepcid), cimetidine (Tagamet), esomeprazole (Nexium), lansoprazole (Prevacid), or omeprazole (Prilosec). If you are taking ranitidine on a prescription, consult your doctor first before stopping the medication. There may be reasons why your doctor wants you to take a particular medicine.
Also be sure to safely dispose of any remaining ranitidine. This means putting medicines in a bag tightly before putting them in the trash. This will prevent someone from accidentally ending up in someone’s mouth, which is not a suitable waste disposal container, no matter how dirty the mouth is. Leaving exposed medications can make it easier for children or pets to accidentally take medications. You also don’t want to pollute the environment with medication. Usually the introduction of the package for the drug has specific instructions on proper disposal. This FDA video also offers some tips
Usually, one of the options is to take the medication to the place where the medicine is retrieved. But, of course, these times are not normal. The current COVID-19 coronavirus pandemic means that you should not lose sight of social spacing measures such as staying at home just to go to this site.
Ranitidine is not the first drug with problems with NDMA contamination. As I mentioned earlier for Forbes, NMDA contamination has led to 2018 recall of some blood pressure medications. All this requires a closer look at the processes involved in the manufacture, storage, and transportation of these and possibly other drugs. How well are these operations monitored? How did the pollution happen? What can prevent something like this from happening again? After all, being unable to trust the safety of the drug supply, in itself can cause more than just heartburn.
