Acid reflux is a widespread digestive issue that affects millions of people around the world. Characterized by heartburn, regurgitation, and discomfort in the upper abdomen, acid reflux can significantly disrupt daily life if left untreated. For decades, one of the most trusted treatments for this condition was Ranitidine 150 mg, a widely used H2 (histamine-2) receptor antagonist.

However, in recent years, ranitidine has undergone scrutiny due to safety concerns. In this article, we’ll explore what ranitidine is, how it works to reduce acid reflux, its historical use, the reasons for its recall, and what alternatives exist today.

What Is Ranitidine?

Ranitidine is a medication that was commonly prescribed or available over-the-counter to treat various gastrointestinal conditions, including:

• Acid reflux (GERD)

• Heartburn

• Peptic ulcers

• Zollinger-Ellison syndrome

• Indigestion and sour stomach

It was sold under brand names such as Zantac, Aciloc, and Rantac, and was one of the most commonly used H2 receptor blockers globally before its recall.

How Acid Reflux Happens

To understand how ranitidine works, it’s important to know how acid reflux occurs:

• The stomach naturally produces hydrochloric acid to digest food.

• A muscle called the lower esophageal sphincter (LES) acts like a valve, preventing stomach acid from flowing backward into the esophagus.

• In acid reflux (also called gastroesophageal reflux disease, or GERD), the LES weakens or relaxes, allowing acid to move upward, causing burning sensation (heartburn) and other symptoms.

Excess stomach acid and weak LES function are primary contributors to this condition.

How Ranitidine Works

Ranitidine works by reducing the amount of acid your stomach produces. It does this by targeting histamine receptors in the stomach lining.

Here’s how it works in simple terms:

🔬 Mechanism of Action:

1. Histamine stimulates acid production in the stomach by binding to H2 receptors on cells called parietal cells.

2. Ranitidine blocks these H2 receptors, preventing histamine from triggering acid secretion.

3. As a result, stomach acid levels drop, reducing the irritation of the esophagus and helping ulcers and inflammation heal.

By lowering acid production, ranitidine helps relieve symptoms of acid reflux, prevent further damage to the esophageal lining, and promote healing of ulcers.

Benefits of Ranitidine (Before Recall)

Before it was recalled, ranitidine was considered one of the most effective and accessible medications for treating acid-related disorders. Its benefits included:

✅ Fast relief from heartburn and indigestion
✅ Long-lasting action, with effects lasting up to 12 hours
✅ Safe for long-term use when taken under medical supervision
✅ Minimal side effects compared to some other acid reducers
✅ Available in multiple forms: tablets, syrup, and injectables

It was often prescribed as a first-line therapy for GERD and peptic ulcers.

Why Ranitidine Was Recalled

In 2019 and 2020, health authorities around the world—including the U.S. Food and Drug Administration (FDA) and India’s Central Drugs Standard Control Organization (CDSCO)—began investigating ranitidine after finding unacceptable levels of a chemical called NDMA (N-Nitrosodimethylamine) in certain samples.

🧪 What Is NDMA?

NDMA is classified as a probable human carcinogen, meaning it may cause cancer based on animal studies. It can form as a byproduct when ranitidine is stored at high temperatures or for extended periods.

📢 Key Events:

• April 2020: The FDA requested the withdrawal of all ranitidine products from the U.S. market.

• Many countries followed suit, suspending the sale and use of ranitidine-containing medications.

This action was precautionary—not all ranitidine products were found to contain NDMA, but the risk was considered too high to continue widespread use without reformulation.

Side Effects of Ranitidine (When in Use)

Ranitidine was generally well-tolerated. However, like all medications, it could cause side effects in some individuals.

Common Side Effects:

• Headache

• Drowsiness or fatigue

• Diarrhea or constipation

• Nausea

• Dizziness

Rare but Serious Side Effects:

• Liver dysfunction

• Blood count abnormalities

• Allergic reactions

• Confusion in elderly patients

Who Should Not Have Taken Ranitidine?

Even before its recall, ranitidine was not recommended for:

• People with allergies to H2 blockers

• Those with severe liver or kidney disease

• Pregnant or breastfeeding women (without medical supervision)

• Patients using other medications that could interact dangerously

Alternatives to Ranitidine

Since ranitidine was pulled from the market, several effective alternatives are available for acid reflux and related conditions:

✅ Other H2 Blockers:

• Famotidine (Pepcid) – Considered a safer alternative without the NDMA risk

• Nizatidine – Another H2 blocker, though less commonly used

✅ Proton Pump Inhibitors (PPIs):

• Omeprazole (Prilosec)

• Pantoprazole (Protonix)

• Esomeprazole (Nexium)

• Lansoprazole (Prevacid)

PPIs are often more powerful than H2 blockers and are used when acid reflux is more severe or persistent.

✅ Lifestyle and Natural Approaches:

• Elevating the head during sleep

• Eating smaller meals

• Avoiding spicy, acidic, or fatty foods

• Reducing caffeine and alcohol intake

• Weight loss and quitting smoking

Should You Be Concerned If You Used Ranitidine?

If you previously used ranitidine before the recall, there is no need to panic. According to the FDA, short-term use at standard doses posed very low risk. However, for those who used it regularly or long-term, it’s a good idea to:

• Speak to a healthcare provider about potential risks

• Switch to a safer alternative if needed

• Monitor any unusual symptoms or changes in health

Conclusion

Ranitidine was once a cornerstone in the treatment of acid reflux, heartburn, and peptic ulcers due to its effectiveness and convenience. However, concerns over NDMA contamination led to its global withdrawal as a precautionary measure.

While the recall may have disrupted treatment for many, there are now safe and effective alternatives available. Medications like famotidine and omeprazole, along with lifestyle adjustments, continue to offer excellent results for those struggling with acid reflux and related conditions.

If you have questions about past or current treatment for acid-related disorders, it’s always best to consult with a healthcare provider to determine the safest and most effective solution tailored to your needs.