Zantac was a popular heartburn medication. It also went by its generic name ranitidine.
ALERT: All ranitidine products, including Zantac, have been recalled as of April 1, 2020. The United States Food and Drug Administration (FDA) requested this voluntary recall. The agency cited tests showing the presence of a probable human carcinogen in the drug. The carcinogen, N-nitrosodimethylamine (NDMA), has triggered recalls of other drugs as well.
Consumers are concerned about this recall and how to respond to it. This page provides general information about Zantac and its generic forms. Consumers can use this information to identify potential risks and determine alternatives.
What is Zantac?
Zantac 150 Maximum Strength
Apotex (Walgreens) Wal-Zan ® Ranitidine Tablets
Sandoz Ranitidine Capsules
Walmart Generic Ranitidine Tablets
*Zantac is also available as prescription ranitidine
Zantac is the brand name for a type of antihistamine called ranitidine. It can weaken certain allergic reactions and decrease stomach acid production. It belongs to a class of drugs called histamine-2 blockers (H2 blockers).
Brand-name Zantac became commercially available in the 1980s. The World Health Organization (WHO) includes ranitidine on its "List of Essential Medicines." This list includes more than 400 drugs WHO deems necessary for protecting global public health.
Due to Zantac's ability to decrease stomach acid, it was commonly used as a heartburn drug. It can reduce stomach acid by more than 70%.
Prior to the recalls, Zantac was available in several forms:
- Effervescent Tablet
There were prescription-strength and over-the-counter (OTC) versions of Zantac. The instructions for each form of Zantac varied.
Instructions for ranitidine drugs can be found:
Zantac was FDA approved for the treatment of heartburn in adults and children 12 years or older. It was also used to treat other conditions caused by the overproduction of stomach acid. These conditions include:
- Gastric ulcers
- Small intestine (duodenal) ulcers
- Zollinger-Ellison syndrome
- Excess production of stomach acid
- Gastroesophageal reflux disease (GERD)
Heartburn is not related to the heart. It is a non-technical term for the medical condition pyrosis. Pyrosis is discomfort accompanied by a burning or hot sensation behind the breastbone.
Heartburn is often caused by acid reflux, or acid rising up from the stomach into the throat. Acid reflux can be triggered by excess stomach acid. It is sometimes referred to as acid indigestion or indigestion.
Common Side Effects
Clinical trials show patients experienced Zantac side effects infrequently. But, some side effects were more common than others.
Zantac users have reported the following side effects:
- Skin rash
- Stomach cramps
Very rarely, people who take Zantac reported a severe side effect. For a list of severe side effects associated with Zantac, please see this page from WebMD.
Warnings and Contraindications
Note: Zantac is not currently available in the United States. The following information was accurate before the recall.
Zantac prescribing instructions provide several warnings and contraindications for the drug. A contraindication is a condition that makes a drug unusable for a given patient. For example, a penicillin allergy is a contraindication for taking penicillin.
Individuals with any of the following conditions should not have taken Zantac:
- Hypersensitivity to ranitidine
- Hypersensitivity to any Zantac ingredient
- A history of acute porphyria*
*Acute porphyria is a sudden condition with several symptoms. It is caused by high levels of a protein called porphyrin.
Doctors should have adjusted Zantac dosage for patients with the following conditions:
- Lowered kidney function
- Lowered liver function
Patients should have been issued the following warnings about Zantac:
- Patients with stomach or intestinal cancer may take Zantac. Zantac may improve their symptoms. This improvement does not rule out the existence of cancer.
- Zantac contains 2.81 mg of phenylalanine for every 25 mg of ranitidine. Individuals who cannot metabolize phenylalanine should adjust their dosage accordingly.
- Zantac may cause false-positives with certain drug tests.
- Taking zantac may have posed other possible drug interactions.
Notable Zantac Drug Interactions
Zantac may have interacted or interfered with any of the following drugs:
Alternatives to Zantac
The FDA suggests the following OTC alternatives for Zantac:
- Nexium (omeprazole, esomeprazole)
- Pepcid (famotidine)
- Prevacid (lansoprazole)
- Prilosec (omeprazole)
- Tagamet (cimetidine)
These five drugs have not been affected by the contamination behind the Zantac recalls. The FDA tested them independently and confirmed them to be safe alternatives.
Note: Several Zantac alternatives belong to a class of drugs called proton pump inhibitors (PPIs). PPIs have recently been linked to an increased risk of COVID-19. In a Cedars-Sinai study, PPI users had 2 to 4 times the risk of testing COVID-19 positive versus non-users.
You can discuss this potential risk and that of Zantac with your healthcare provider. You may be able to avoid these risks by choosing Pepcid or Tagamet instead. Pepcid and Tagamet are H2 blockers, not PPIs. You should consult a physician to determine which, if any, heartburn medication is best for you.