Concern over the use of Zantac continues to mount as Walmart announced this week that the company will now join Walgreens, Rite Aid and CVS in pulling the heartburn medicine from its shelves.
“The company is taking this action after closely monitoring the recent product alert from the U.S. Food and Drug Administration (FDA) that ranitidine products may contain a low level of nitrosodimethylamine (NDMA),” a statement from Walmart reads. “Customers who purchased these products may return them to Walmart or Sam’s Club for a refund.” Walmart’s comment are in reference to a Sept. 13 FDA report in which laboratory tests confirmed that small amounts of NDMA, a “substance that could cause cancer” may be present in the drug.
The FDA’s report did not recommend a recall of the drug, noting instead that the levels of NDMA found in Zantac “barely exceed amounts you might expect to find in common foods.” But the news was enough to convince multiple pharmacy chains to pull it from their shelves. Benyam Muluneh, a clinical pharmacist practitioner at the University of North Carolina’s top-rated Eshelman School of Pharmacy, says this isn’t necessarily a bad thing.
“It’s always a very tough decision for pharmacies to make, but it’s [weighing] benefits versus risk,” Muluneh tells Yahoo Lifestyle. “And given the fact that there are several other options for the management of heartburn, I think it makes sense ... the implications of [the FDA’s report] still need to be further elucidated so that we know what’s happening, but I think that the pharmacies definitely made the right decision in not making it available.”
Now that the medicine is off the shelves at major pharmacy chains nationwide, what should those suffering from gastroesophageal reflux disease and other heartburn-related conditions be taking? Muluneh says the good news is that there are multiple alternatives — but says that the first step should be getting in touch with your healthcare provider to see what they recommend. If you can’t get an appointment with your physician right away, he says you can always talk to your local pharmacist instead.
One option they may present is famotidine (sold under the brand name Pepcid), a drug that — like Zantac — works by blocking the histamine receptors in your stomach. But it’s not necessarily safe for everyone. “Zantac has more data over longterm in pregnant women,” Muluneh says. “That’s why I don't want to just say everyone should switch over without the knowledge of their healthcare provider. There may be some patient-specific reasons.”
If Pepcid isn’t a good option, Muluneh says healthcare providers may recommend short-acting medicines (such as Tums or Gaviscon) or — in more serious cases — something that treats heartburn and acid build-up over the long term, like Prilosec. Muluneh is quick to note that stopping the medicine without guidance is a bad idea. “I think the worst step to take is to self-discontinue and turn to other unapproved herbal supplements that are completely unregulated by the FDA,” he says. “We can not say what's in them. It's best to seek guidance from healthcare providers who know the data and can help make evidence-based recommendations.”
Perhaps most importantly, Muluneh says that those who have been taking Zantac shouldn’t panic. “This type of information is important, but I don’t think the purpose is to raise fear in the public,” he tells Yahoo Lifestyle. “Keep in mind that this is a substance that is actually found in some food that we consume ... so the risk is probably small.”
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