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The FDA isn’t telling patients to avoid the medication at this point. Getty Images
  • The generic name for the drug Zantac is ranitidine.
  • The medication may contain a cancer-causing chemical that’s already been detected in certain blood pressure medications.
  • The Food and Drug Administration (FDA) is still investigating whether the chemical is at a high enough level to be a health risk.

Editor’s note: This is a developing story that’s been updated since it was first published. Healthline will continue to update this article when there’s new information.

More generic forms of the heartburn medication ranitidine have been recalled.

The recalls have been issued after the FDA detected the cancer-causing chemical N-nitrosodimethylamine (NDMA) in several brand-name and generic heartburn medications.

The FDA announced on Wednesday that two pharmaceutical companies have voluntarily recalled generic ranitidine tablets:

  • Appco Pharma LLC is voluntarily recalling prescription ranitidine hydrochloride capsules.
  • Northwind Pharmaceuticals is voluntarily recalling prescription ranitidine tablets (150 milligrams and 300 mg), manufactured by Glenmark Pharmaceutical Inc.

These are just the latest two voluntarily recalls of ranitidine. There have been multiple recalls in the months since NDMA was first detected in some of the drugs.

The full list of recalled medications can be found here.

The FDA is advising companies to recall the drug if they find NDMA levels exceeding 96 nanograms per day or 0.32 parts per million.

In October, pharmaceutical company Sanofi announced it’s undertaking a voluntary recall of Zantac due to concerns about a potential cancer-causing chemical.

Last year, multiple drugstores stopped selling the drug. CVS and Walgreens no longer sell Zantac and other ranitidine medications.

CVS is currently offering customers who recently bought Zantac or another ranitidine drug a refund. The chain will continue to sell other over-the-counter (OTC) heartburn medications, like Pepcid and Tagamet, which don’t contain ranitidine.

In September, the FDA reported that small amounts of NDMA were detected in several brand-name and generic heartburn medications.

This affects the many people who regularly use ranitidine medications to prevent and treat heartburn, ulcers, and gastroesophageal reflux disease (GERD).

The FDA is investigating whether the low levels found in the ranitidine medicines create a health risk.

“Although NDMA may cause harm in large amounts, the levels the FDA is finding in ranitidine from preliminary tests barely exceed amounts you might expect to find in common foods,” Dr. Janet Woodcock, the director of the FDA’s Center for Drug Evaluation and Research, said in a statement.

If you take a medication with ranitidine, you might want to consider opting for a different drug — though it’s not necessary at this time.

Cimetidine, known as Tagamet, and famotidine, or Pepcid, are two other types of OTC medications commonly used to treat heartburn and acid reflux.

If you have a prescription, your doctor can recommend another treatment option.

“While Zantac may prove safe in the long run, this latest statement adds confusion and concern, so my interim advice to patients is simple: Switch to another drug (there are other options), and of course confirm with your doctor the need for an antacid,” Dr. David Robbins, the associate chief of endoscopy at Lenox Hill Hospital, said in an earlier statement.

Dr. Linda Nguyen, a gastroenterologist at Stanford Health Care in California, has similar advice.

“According to the FDA alert, the issue does not appear to be related to the drug class but due to contaminants specific to ranitidine,” Nguyen told Healthline in an earlier interview.

“Ranitidine is an H2 (histamine-2) blocker that decreases the acidity in the stomach. It is frequently used for heartburn and dyspepsia (stomach upset or indigestion). Ranitidine is available over the counter and [by] prescription. There are alternative H2 blockers available in the U.S., including famotidine (Pepcid) or cimetidine (Tagamet). Patients should consult with their clinician or pharmacist for equivalent dose conversions,” Nguyen said.

NDMA is an environmental contaminant found in water along with meat, dairy, and vegetables.

It’s classified as a B2 carcinogen, meaning it’s a probable human carcinogen. Exposure to high amounts of NDMA is thought to cause gastric or colorectal cancer, according to the World Health Organization.

It’s extremely toxic to the liver. Even small amounts may be linked to liver damage.

The chemical was once used to make rocket fuel. Today the chemical is only used for research purposes in the United States, according to the Environmental Protection Agency.

It’s also a byproduct of many manufacturing processes at industrial sites, including tanneries, pesticide manufacturing plants, and rubber and tire manufacturers.

The chlorination of drinking and wastewater, which treatment plants do to purify our water, can unintentionally create NDMA as well.

Since last year, the FDA has been investigating NDMA in certain blood pressure and heart failure medicines categorized as angiotensin II receptor blockers.

In July, the agency issued a handful of recalls of blood pressure medications after a concerning amount of NDMA was found in the drugs valsartan, losartan, and irbesartan.

The FDA estimated that if 8,000 people took the highest dose of the recalled valsartan daily for 4 years, there’d be just one additional cancer case from that group of people.

The FDA stressed the importance of continuing to take the medications until a healthcare provider could recommend a replacement.

If you experience any side effects after taking these blood pressure medications or any heartburn medications with ranitidine, report it to the FDA’s MedWatch Program.

More recalls of the heartburn medication ranitidine have been issued.

The news comes months after the FDA announced that ranitidine may contain traces of a cancer-causing chemical known as N-nitrosodimethylamine (NDMA).

The agency is currently looking into the health risks associated with the amount of NDMA identified in the drugs. It will post more information as it learns more.

As of now, the FDA isn’t recommending people stop taking ranitidine, but those who’d like to switch medications should talk to their doctor about other treatment options.