CVS Pulls Zantac, Here Is The Latest On Cancer Concerns

Here is more heartburn for those who make Zantac and similar heartburn medications. The largest pharmacy chain in the U.S., CVS Pharmacy, has announced that it “has suspended the sale of all Zantac brand and CVS Health brand ranitidine products until further notice.”

This is following a September 13 announcement by the U.S. Food and Drug Administration (FDA) that certain lots of ranitidine were found tainted with low levels of NDMA, which is classified by the U.S. Environmental Protection Agency (EPA) as a “probable human carcinogen.” If you’ve already bought these products from CVS, you can return them for a refund. Just make sure that you bring your super-long CVS receipt.

NDMA doesn’t stand for “never discuss martial arts” but instead is short for N-nitrosodimethylamine. Manufacturing processes employed by the chemical rubber, tannery, fish processing, dye, and surfactant industries use this chemical, which can serve as an antioxidant, a lubricating agent, and a copolymer softener. Laboratory studies have shown that rats and mice who inhale NDMA over long periods of time have been more likely to develop liver, kidney, and lung tumors. Also, chronically feeding rats, mice, and hamsters NDMA have resulted in liver tumors.

Chronic exposure to high levels of NDMA in humans has led to liver damage and low platelet counts. The exact risk in humans of lower level exposure is unclear as few good human studies have been done. After all, you probably wouldn’t sign up for a study where you are willingly fed NDMA.

Like acid-reflux after eating a garlic-onion-chocolate-and-tomato pizza served with peppermint-splashed coffee, alcohol, and orange juice, this NDMA story has continued to evolve since I initially covered the story for Forbes. After the September 13 FDA announcement, Sandoz and then Apotex Corporation have issued voluntary recalls of their generic ranitidine medications.

Note that the CVS announcement is not like the Arnold Schwarzenegger movie, a total recall or even a partial recall. They aren’t saying “good GERD, stop taking ranitidine immediately!” Instead, CVS is suspending the sales of the ranitidine-containing products and allowing returns for refunds over what they call an “abundance of caution.”

So what should you do if you bought these products from CVS? First, contact your doctor to see if you really need to be on ranitidine. He or she may suggest lifestyle modifications instead such as cutting down on your coffee, alcohol, and garlic-onion-chocolate-and-tomato pizza consumption. Starting ranitidine without even seeing a doctor is not a good idea because heartburn may not even be the problem, and even if it is, you should always try lifestyle modifications before opting for any medications.

If you need to be on an H2 blocker, which is the type of medication that ranitidine is, there are alternatives such as Pepcid, Tagamet, or their generic counterparts, famotidine and cimetidine. (A National Library of Medicine website provides additional information on these different available H2 blockers.) Therefore, unless your doctor says that you absolutely need to be on ranitidine, you probably want to avoid ranitidine for now.

While the levels of NDMA in the ranitidine products are probably too low to be of major concern over a short period of consumption, it’s a good idea to avoid NDMA when you can. Ultimately, what matters is your cumulative exposure to such chemicals over time. You don’t want a new source of NDMA when you may already be getting exposed to NDMA from eating food, such as cured meat products and smoked fish, drinking contaminated water, breathing cigarette smoke, and breathing polluted air just in general. With pollution becoming an increasing problem, it’s getting harder and harder to avoid exposure to chemicals via regular daily activities. So why not cut down exposure wherever you can? If you are not eating or breathing at all, you may have other things to worry about.