Ranitidine
H2 blocker for stomach acid, later linked to cancer risk.
Ranitidine, sold under the brand name Zantac among others, is a medication used to decrease stomach acid production. It is used in the treatment of peptic ulcer disease, gastroesophageal reflux disease, and Zollinger–Ellison syndrome. It can be given by mouth, injection into a muscle, or injection into a vein. It is on the World Health Organization's List of Essential Medicines.
- class
- H2 histamine receptor antagonist
- common brand
- Zantac
- route
- oral, intramuscular, intravenous
- withdrawn US
- April 2020
Lore & Background
In April 2020, ranitidine was withdrawn from the United States market and suspended in the European Union and Australia due to these concerns. The FDA acknowledged that ranitidine medicines contained NDMA at unacceptable levels, though testing methods were disputed: a third-party laboratory using higher temperatures found very high levels, while FDA testing using liquid chromatography-high resolution mass spectrometry showed much lower levels.
Reader's Guide
Ranitidine's significance lies in its widespread use as an effective acid-reducing medication for decades, being on the World Health Organization's List of Essential Medicines. Common side effects include headaches and pain at injection site; serious side effects may include cancer, liver problems, slow heart rate, pneumonia, and masking of stomach cancer. It is also linked to increased risk of Clostridioides difficile colitis. The controversy over NDMA levels highlighted challenges in pharmaceutical testing and regulation, as different testing methods produced varying results. Ranitidine remains a key example of a once-common drug whose safety was later called into question due to chemical instability.
Did You Know?
- Ranitidine may return a false positive result with some commercial urine drug screening kits.
Frequently Asked Questions
What are Ranitidine's powers/role?
Its core function is to block H2 receptors on parietal cells, thereby reducing the volume of acid the stomach produces. Clinically, that made it a go-to treatment for peptic ulcer disease, gastroesophageal reflux disease, and the rare Zollinger-Ellison syndrome, deliverable by mouth, intramuscular injection, or intravenous infusion.
How does Ranitidine's story end?
Ranitidine's run in the United States was cut short in April 2020 when regulators pulled it from the market after a potential carcinogenic impurity (NDMA) was detected in the compound. That withdrawal effectively closed out its nearly four-decade career as a household acid reducer.
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