Zantac is the brand name of a medication used to treat heartburn. The prescription and over-the-counter drug is an antihistamine that also goes by the generic name ranitidine. Zantac belongs to a class of drugs known as histamine-2 blockers or H2 blockers. Besides preventing allergic reactions to environmental triggers, ranitidine decreases the acid production in the stomach. It does this by blocking the normal actions of histamine in the cells
Zantac first became commercially available in October 1984 after gaining approval from the Food and Drug Administration (FDA) of the United States. Drug manufacturers touted its ability to reduce stomach acid by up to 70 percent, and doctors prescribed it as a tablet, syrup, or injection until recently. Drug manufacturers sold the OTC version of Zantac under several labels until the FDA issues a formal recall of the drug on April 1, 2020.
Heartburn and Other Conditions Treated by Zantac
The term heartburn describes a medical condition known as pyrosis and has nothing to do with the heart. The chief complaints associated with pyrosis are a hot and/or burning sensation behind the breastbone that can also make it difficult to swallow. Heartburn occurs when excess stomach acid rises from the stomach to the throat and causes acid reflux. You have probably referred to this problem as indigestion or acid indigestion as well.
The FDA originally approved Zantac for people ages 12 and over for conditions related to excess stomach acid. Prior to the April 2020 recall, doctors frequently prescribed or recommended OTC ranitidine for these health conditions:
- Duodenal (small intestine) ulcers: Also known as a peptic ulcer, a duodenal ulcer first develops in the upper portion of the small intestine and inside the lining of the stomach. Long-term use of non-inflammatory anti-steroidal drugs (NSAID) and contamination by H-pylori bacteria are the most common causes of a duodenal ulcer.
- Erosive esophagitis: The term erosive esophagitis refers to inflammation, irritation, erosion, or ulceration occurring on the walls of the esophagus. Your esophagus is the tube that connects your stomach and throat. Typical symptoms of erosive esophagitis include a sensation that something is stuck in the throat, difficulty swallowing, a burning sensation, and blood in the vomit or stools.
- Gastric ulcer: If your doctor has diagnosed a gastric ulcer, it means that a break has occurred in the lining of your stomach due to contact with the H-pylori bacteria.
- Gastroesophageal reflux disease: GERD is a chronic condition of the digestive system that causes the stomach’s liquid contents to travel to and become trapped in the esophagus.
- Heartburn, which is an overproduction of stomach acid.
- Zollinger-Ellison syndrome: This rare medical condition occurs when a tumor or tumors develop on the upper portion of the small intestine (duodenum) or the pancreas. People are typically between the ages of 20 and 50 at diagnosis.
Side Effects Commonly Associated with Zantac
The FDA issued a recall of Zantac and all ranitidine medications under the Zantac label due to the identification of a carcinogen known as n-nitrosodimethylamine (NDMA) that can increase the risk of several types of cancer. Like all medications, however, Zantac caused both minor and rare side effects prior to its recall. Minor side effects, which typically lessened or disappeared after the first few days on Zantac, included the following:
- Muscle pain
Rarely, people experienced serious side effects when taking Zantac that required immediate medical intervention. These rare side effects included:
- Yellowing of the eyes or skin
- Visual changes
- Irregular heartbeat
- Hair loss
- Bruising or bleeding easily
If you currently take Zantac or a ranitidine medication and feel concerned about side effects, speak to your doctor about possibly switching to an alternative. Depending on your specific medical condition, you may be able to reduce your stomach acid issues by making some simple lifestyle changes.
Typical Dosages and Drug Interactions Associated with Ranitidine
The instructions on prescription Zantac and OTC ranitidine products such as Nexium, Omeprazole, Pepcid, Prilosec, Tagamet, Zantac 75, or proton pump inhibitors, indicate that you can take the medication with or without food. The usual dosage for GERD, duodenal ulcers, and gastric ulcers is 150 mg twice per day. Erosive esophagitis, which produces stomach pain and other more intense symptoms, responds best to 150 mg of Zantac or ranitidine four times per day.
If you have Zollinger-Ellison syndrome, your doctor may prescribe as much as six grams of Zantac per day. Finally, you should take Zantac or ranitidine products at a dose of 75 to 150 mg approximately 30 to 60 minutes before consuming a food or beverage known to produce high amounts of stomach acid. Your doctor will let you know what to do about a missed dose and when to take your next dose should this occur.
Ranitidine products may interact with other medications that rely on stomach acid for the body to absorb them properly. Common brand names of drugs that may have a negative interaction with ranitidine products include Extina, Kuric, Nizoral, Sporanox, and Xolegel. If you are breastfeeding, you should know that ranitidine products secrete into breast milk and can transfer to your baby. Current medical evidence shows little to no increased risk when using Zantac products during pregnancy.
NDMA Contamination in Ranitidine and Blood Pressure Medications
Sandoz, a drug manufacturing company, first reported that NDMA may be a probable human carcinogen in September 2019. Several other companies followed suit and voluntarily recalled lots of affected prescription drugs and over-the-counter medications. On April 1, 2020, the United States Food and Drug Administration issued a voluntary recall based on this new information. The voluntary recall also applied to certain blood pressure medications found to have enough NDMA to cause an increased cancer risk.
Your risk of developing cancer increases if you took high doses of medication containing NDMA or took it for a long time. You may have a legitimate product liability case if your healthcare provider continued to prescribe or recommend ranitidine even after knowing of the danger. Drug manufacturers could also be responsible for failing to warn the public of NDMA and its role as a probable human carcinogen.