Ranitidine is a type of drug known as a histamine H2 receptor antagonist. These drugs work by blocking the action of histamine, a chemical in the body that stimulates acid production in the stomach. By blocking histamine receptors, ranitidine decreases the amount of acid produced, providing relief from symptoms of acid reflux and heartburn. Originally developed and marketed by GlaxoSmithKline as Zantac, ranitidine became one of the best-selling drugs of all time after its launch in 1981. For decades it was a popular over-the-counter option for treating occasional heartburn. Uses of Ranitidine Ranitidine is primarily used to treat conditions involving excess stomach acid such as gastroesophageal reflux disease (GERD), peptic ulcer disease and Zollinger-Ellison syndrome. Some of its approved uses include: - Heartburn - Ranitidine works by reducing stomach acid production and can provide relief from the discomfort of occasional heartburn and acid indigestion. It is often used as a short-term treatment when heartburn symptoms occur. - GERD - For patients with gastroesophageal reflux disease, ranitidine may be prescribed long-term to control acid reflux symptoms and prevent complications from acid damage over time. GERD is a chronic condition where stomach acid backs up into the esophagus. - Peptic Ulcers - Ranitidine is effective at reducing stomach acid levels and promoting the healing of existing ulcers in the stomach and upper small intestine. It has historically been a common treatment for both prevention and symptom relief of peptic ulcers. - Zollinger-Ellison Syndrome - This rare disorder causes cells in the pancreas to overproduce acid. Ranitidine is used to control excess stomach acid and symptoms for patients with this syndrome. Potential Side Effects of Ranitidine Ranitidine is generally well tolerated by most adults when taken as directed for approved uses and durations. However, like all medications, it can cause some potential side effects such as: - Headache - Diarrhea - Nausea - Dizziness - Constipation - Insomnia - Fatigue Side effects are usually mild and may go away within a few days of starting the drug as the body adjusts. More serious side effects are rare but can include rashes, allergic reactions or abnormal liver function in some cases. Ranitidine Safety Concerns and Recall In 2019, the FDA announced that some ranitidine medicines, including both prescription and over-the-counter brands, had been found to contain low levels of an impurity called N-nitrosodimethylamine (NDMA). NDMA is classified as a probable human carcinogen based on animal studies. Testing had shown levels of NDMA in ranitidine products were higher than acceptable limits over time. This prompted a voluntary recall of numerous ranitidine tablets and liquids sold by both brand-name and generic manufacturers including popular Zantac products. The FDA advised patients taking prescription ranitidine to speak with their doctor about alternative treatment options. For over-the-counter Zantac, the agency recommended discontinuing use. GlaxoSmithKline, the original maker of Zantac, stopped distributing all ranitidine products worldwide in 2019 due to safety concerns raised by regulatory bodies. While short-term low dose use was considered reasonably safe by health officials, the long-term ingestion of NDMA impurities led to an unfavorable risk-benefit analysis for continued ranitidine prescription or OTC use. Alternative Treatments for Heartburn With ranitidine now taken off the market globally due to safety risks, patients seeking relief from occasional heartburn or acid reflux now have some alternative over-the-counter options to consider: - H2 blockers like famotidine (Pepcid) and nizatidine (Axid) - These are in the same drug class as ranitidine but have not been found to contain dangerous NDMA levels. - Proton pump inhibitors like omeprazole (Prilosec) and lansoprazole (Prevacid) - A more potent class of drugs that works by reducing acid production in a different way than H2 blockers. - Antacids like Tums, Rolaids, Mylanta - Provide fast acting symptom relief through neutralizing stomach acid but only work temporarily. - Alginate drugs like Gaviscon - Form a protective layer or "raft" on top of stomach contents that traps acid. - Nonmedication options like water, bland foods, aloe vera juice - Lifestyle changes and natural remedies can also help manage occasional heartburn. As always, talk to your doctor or pharmacist if you have questions about the best treatment approach based on your individual health needs and circumstances. There are options beyond ranitidine that may safely provide heartburn relief.
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