FDA Warning About Heartburn Medications, What Is The Contaminant?



This announcement could give you some heartburn.

The U.S. Food and Drug Administration (FDA) has issued warning about a commonly-used type of heartburn medication. And this warning included some impure thoughts. Testing has found batches of ranitidine to be contaminated with an impurity called NDMA. If you think that this news doesn’t apply to you because you take Zantac, think again. Zantac is actually one brand name for ranitidine. Ranitidine can decrease acid secretion in your stomach acid by blocking histamine H2 receptors and therefore is frequently used to treat stomach ulcers and heartburn, otherwise known as gastroesophageal reflux disease or GERD, which rhymes with turd.

NDMA doesn’t stand for North Dakota-Massachusetts but instead is short for N-nitrosodimethylamine. It’s classified as a probable human carcinogen, meaning that there is a good chance that the compound can cause cancer. If you’ve heard of this chemical compound before, it may be because this was the contaminant found in certain blood pressure medications, Angiotensin II Receptor Blockers (ARBs), last year, as I covered previously for Forbes.

If you recall, NDMA contamination did result in blood pressure medication recalls. So the obvious questions are will ranitidine be recalled, what should you do if you are taking ranitidine, and what rhymes with ranitidine? The answers are “no, not at the present moment”, “talk to your doctor and possibly select an alternative medication”, and “passionate scene or plasma choline.”

The levels of NDMA detected in the ranitidine were apparently quite low, lower than the levels found in the blood pressure medications that were recalled. Ingesting such levels probably won’t put you at risk for developing cancer. There is a good chance that you have already been exposed to NDMA since it can be a contaminant in your environment, food, and water. What matters is how much goes into your body over time. As a result, it is a good idea to try to minimize your intake of NDMA.

Therefore, while the FDA “is not calling for individuals to stop taking ranitidine at this time,” you may want to find alternatives if you can. Ranitidine is certainly not the only medication available for heartburn, stomach ulcers, and other stomach acid-related problems. There are other H2-receptor blockers that work by the same mechanism as ranitidine. These include nizatidine (sold via the brand name Axid), famotidine (Pepcid, Pepcid AC), and cimetidine (Tagamet, Tagamet HB). All of these also sort of rhyme with “passionate scene” and “plasma choline.”

If you are on ranitidine, check with your doctor. You may not even need to be on such medications. For example, for heartburn, there are a number of options including lifestyle modifications such as eating less oily or acidic foods, cutting down on alcohol intake, adjusting when and how you sleep, and wearing more loose-fitting clothes (i.e., no more spandex tuxedos).

With all the blood pressure medication recalls over this past year, this latest FDA announcement does seem like déjà vu all over again. The question is whether drug manufacturers are maintaining appropriate safety and quality control measures and how these are being monitored. As more and more manufacturing is being done overseas, it can be harder and harder to keep track of what’s happening. It can be tempting to cut manufacturing costs but producing drugs is not the same as making handbags. Even a small mistake can have serious consequences. The thought of that alone could give you heartburn.

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