It has been found that ranitidine (Zantac), contains an impurity called N-Nitrosodimethylamine (NDMA), a probable human carcinogen. Zantac is one of the most common over-the-counter medications used my millions of people around the world.
Still many questions are still out there about whether or not it is safe to take this medication, but as a precaution, I would strongly suggest that you do not, and that you share this information with anyone you know that might be taking it.
Listen to the below podcast if you have time, or if you’d like a brief and hastily-written summary, please read on!
Find a link to Dr. Peter Attia’s podcast “the drive” here, or from your favorite player. This particular podcast, #75 with David Light, speaks about a recent Zantac recall. During the interview, it is explained in detail the timeline of this issue, and how the FDA has moved on this information.
David Light is the CEO of Valisure, the company which alerted the FDA to the cancer concerns of Zantac back in June, and then filed a citizen petition on September 13, 2019. Valisure is an online pharmacy that tests all of its medications. We’ll get into, at another time, the dangers and fraud surrounding certain generic medicationsand manufacturers, but for now we’ll focus on this particular drug.
I would like to emphasize that this carcinogen, NDMA, is certainly a well-studied impurity, which is widely used in animal studies to induce cancer. Valisure found that through testing this product (and all products containing ranitidine, not just one brand or manufacturer), that they were ALL unstable and resulted in dangerous amounts of NDMA concentrations. Other studies that were cited in this podcast found dangerous amounts in urine and blood.
Since these announcements and discoveries, FDA has taken a very laid-back approach to this information, treating it like no big deal. This is a little scary, and there is a lot of information to back this up. Even if there is no issue, and all these studies are debunked, it’s still a silly idea for us to keep taking this medication. It’s not a life-saving medication, nor is this a life ending disease. There are alternatives, and if you are experiencing heartburn then there’s probably something going on in your system and our acupuncturists, herbal doctors, or functional medicine providers could help you get to the bottom of your discomfort.
You can find other, natural substitutes here, at our online pharmacy! Create an account if you would like to purchase physician grade vitamins and supplements.
*Heartburn Advantage by Integrative Therapeutics
*Heartburn Essentials by Pure Encapsulations
*Heartburn TX Powder by Vital Nutrients
*Heartburn Free w/ROH10 by Enzymatic Therapy
For minor issues try:
*1tbs Braggs Apple Cider Vinegar in warm water twice daily
*Licorice Supplements- we carry a DGL (Deglycyrrhizinate Licorice) chew from Energetix
*Work on posture – standing up straight
OTC Alternatives (not the best, but they’re not Zantac!):
*Prilosec, Tums, Malox, Mylanta
–Just because I prefer medications that help to cure the underlying issue, and most meds just cover up the symptoms.
If you do have some of this in your medicine cabinet, and want to get rid of it, please dispose of responsibly! Most pharmacies have a way to dispose of medication – please do not throw away and DO NOT flush down the toilet. I’m not interested in this getting in our water.
South Korea published some of their own findings, and an article out of India discusses why certain countries have banned it and others have not
All links and related material (Directly from Dr Attia’s Show Notes relating to the podcast):
Peter’s interview of Katherine Eban about the generic drug industry: #71 – Katherine Eban: Widespread fraud in the generic drug industry | Peter Attia (peterattiamd.com) [6:45]
David’s unique pharmacy that tests all it’s drugs: Valisure | (valisure.com) [6:45]
Example of self-reporting system problems: Boeing 737 Max | (wikipedia.org) [6:45]
Katherine Eban’s book about the corrupt generic drug industry: Bottle of Lies: The Inside Story of the Generic Drug Boom by Katherine Eban | (amazon.com) [6:45]
Study that alarmed David that showed that simply refilling antiepileptic medication was associated with an over twofold increase chance of getting a seizure: Refilling and switching of antiepileptic drugs and seizure-related events(Gagne et al., 2010) [6:45]
Katherine’s article about two doctors at the Cleveland clinic who noticed patients on cardiac drugs were stabilized on the brand and then became unstable when they were switched to the generic and in some cases heart transplant patients were suffering organ rejection from a generic: These pills could kill you | Katherine Eban (bostonglobe.com) [6:45]
David spent 8 years as the head of chemistry and R&D at: Ion Torrent | (thermofisher.com) [6:45]
One of the “most potent carcinogens known to man”: N-Nitrosodimethylamine (NDMA) | (wikipedia.org) [24:30]
September 2019 recall on losartan: Updated: Torrent Pharmaceuticals Limited Expands Voluntary Nationwide Recall of Losartan Potassium Tablets, USP and Losartan Potassium / Hydrochlorothiazide Tablets, USP | (fda.gov) [24:30]
Valisure found that two-thirds of the manufacturers of valsartan had anywere from hundreds to over 100,000 nanograms DMF, which is a probable human carcinogen: Fourth Carcinogen Discovered in Heart Pills Used by Millions | Anna Edney (bloomberg.com) [24:30]
Valisure’s citizen petition filed with the FDA about DMF found in valsartan: Citizen Petition from Valisure, LLC. | (regulations.gov) [24:30]
NDMA is used to induce cancer in lab animals: N-Nitrosodimethylamine: Toxicity| (wikipedia.org) [48:45]
FDA statement estimating that if 8,000 people took the highest valsartan dose (320 mg) containing NDMA from the recalled batches daily for four years, there may be one additional case of cancer over the lifetimes of the 8,000 people: Laboratory analysis of valsartan products | (fda.gov) [48:45]
Valisure FDA Citizen Petition on ranitidine: Requests FDA to issue a regulation, revise industry guidance, and request a recall and suspend sales of ranitidine from the US market and take such other actions listed in the petition | (regulations.gov) [53:30, 1:07:30]
2004 paper by National Cancer Institute found a link to bladder cancer when looking at prescription antacids, which were both ranitidine and cimetidine at the time: Peptic ulcer disease and the risk of bladder cancer in a prospective study of male health professionals. (Michaud et al., 2004) [57:00]
Stanford University clinical study on ranitidine by Zeng and Mitch: Oral intake of ranitidine increases urinary excretion of N-nitrosodimethylamine. (Zang et al., 2016) [1:01:30, 1:07:30]
Bill Mitch’s first papers in 2002-2004 were concerned about NDMA in drinking water: N-Nitrosodimethylamine (NDMA) as a Drinking Water Contaminant: A Review (Mitch et al., 2004) [1:01:30]
Valisure identified the enzyme DDAH1 which grabs on to a molecule and breaks off a DMA group which then is very easy to form NDMA: See page 4 of the citizen’s petition | (fda.gov) [1:01:30]
FDA’s statement regarding NDMA and ranitidine on 9/13/19: Statement alerting patients and health care professionals of NDMA found in samples of ranitidine | Director – Center for Drug Evaluation and Research Janet Woodcock M.D. (fda.gov) [1:07:30]
Health Canada’s 9/17/19 announcement: Information Update – Health Canada requests that companies stop distributing ranitidine drugs in Canada while it assesses NDMA; some products being recalled | (newswire.ca) [1:07:30]
South Korean Regulator’s Findings that a minimum 2800 nanograms of NDMA and up to 32,000 nanograms of NDMA in ranitidine: Korea bans sales of Zantac and other ranitidine drugs after carcinogen alert | Seo Jeong-won and Kim Hyo-jin (pulsenews.co) [1:07:30]
Indian article on the confusion between “contamination” and fundamental toxicity of ranitidine: Explained: Why India, US haven’t recalled acidity drug Ranitidine but France & Canada have | Priyanka Pulla (theprint.in) [1:07:30]
FDA’s updated statement in Oct. 2019 challenging Valisure’s testing method: FDA Updates and Press Announcements on NDMA in Zantac (ranitidine) | (fda.gov) [1:07:30]
Walmart, Sam’s Club, and Kroger pharmacies are offering a refund on Zantac and other ranitidine products: Walmart and Kroger also halt sales of Zantac, generic ranitidine over possible cancer link | Brett Molina (usatoday.com) [1:27:45]