Ranitidine 150 mg was once a popular medication used worldwide to treat various stomach-related issues, particularly acid reflux and ulcers. Known by the brand name Zantac, it belonged to a class of drugs called H2 receptor antagonists (H2 blockers). These medications reduce the amount of acid the stomach produces, offering relief from symptoms like heartburn, indigestion, and gastroesophageal reflux disease (GERD).

Though ranitidine was widely prescribed for decades, concerns about its safety led to a global reevaluation of its use. In this article, we’ll explore what ranitidine is, how it works, its role in treating acid reflux, and the controversies surrounding its recall.

What Is Ranitidine?

Ranitidine is a histamine-2 (H2) receptor blocker that works by reducing the amount of acid your stomach produces. It was used for:

• Heartburn and acid reflux (GERD)

• Peptic ulcers

• Zollinger-Ellison syndrome (a rare condition with excessive acid production)

• Preventing ulcers in patients taking NSAIDs (like ibuprofen)

• Treating conditions in both adults and children related to acid overproduction

It was available both over-the-counter (OTC) and by prescription, in various forms including tablets, syrups, and injectable solutions.

How Ranitidine Works

To understand how ranitidine helps with acid reflux, let’s first look at what acid reflux is.

Acid Reflux and Stomach Acid

Your stomach naturally produces acid to aid in digestion. Sometimes, this acid can move backward into the esophagus, the tube connecting your mouth to your stomach. This backward flow of acid is called acid reflux, and it can cause:

• A burning sensation in the chest (heartburn)

• Sour taste in the mouth

• Difficulty swallowing

• Chronic cough or sore throat

Over time, untreated acid reflux can lead to GERD, a more severe and chronic form of reflux.

Ranitidine’s Role

Ranitidine works by blocking histamine H2 receptors in the stomach lining, which are involved in signaling acid production. When these receptors are blocked:

• The stomach produces less acid

• There's less irritation in the esophagus

• Symptoms like heartburn and discomfort are reduced

This makes ranitidine especially helpful for managing mild to moderate acid reflux, healing ulcers, and preventing flare-ups.

Benefits of Ranitidine for Acid Reflux

Ranitidine gained widespread use due to its effectiveness, affordability, and tolerability. Here are some of its key benefits when it was actively prescribed:

✅ Fast-Acting Relief

Ranitidine could begin reducing acid production within 1 hour of ingestion, making it helpful for sudden episodes of heartburn.

✅ Long-Lasting Effect

One dose of ranitidine could work for up to 12 hours, making it ideal for overnight reflux or maintaining symptom relief throughout the day.

✅ Good Safety Profile (Historically)

Before concerns about contamination, ranitidine was considered safe for short and long-term use, even in children and the elderly.

Forms and Dosages

Ranitidine was commonly available in these forms:

• 150 mg or 300 mg tablets

• 15 mg/mL syrup

• Injectable form for hospital use

OTC ranitidine was typically 75 mg or 150 mg and used on an as-needed basis, while prescription doses were stronger and used for more serious or chronic conditions.

Ranitidine Recall and Controversy

In 2019, the U.S. Food and Drug Administration (FDA) and similar global agencies began investigating reports that ranitidine contained N-nitrosodimethylamine (NDMA) — a potentially cancer-causing impurity.

🧪 What is NDMA?

NDMA is classified as a probable human carcinogen. In testing, some ranitidine products were found to contain unacceptable levels of NDMA, possibly due to the chemical instability of the ranitidine molecule under certain storage conditions or over time.

📢 FDA Action

In April 2020, the FDA requested the removal of all ranitidine products from the U.S. market. Other countries, including Canada, the EU, and India, also took regulatory action.

This means ranitidine is no longer legally available in many countries. Patients were advised to stop using it and consult their healthcare providers for safe alternatives.

Alternatives to Ranitidine

Since the recall, many patients and doctors have turned to other medications to manage acid reflux. These include:

🔹 H2 Blockers

• Famotidine (Pepcid) – now the most commonly recommended H2 blocker

• Cimetidine (Tagamet) – less commonly used due to drug interactions

🔹 Proton Pump Inhibitors (PPIs)

PPIs are often stronger and longer-lasting than H2 blockers:

• Omeprazole (Prilosec)

• Lansoprazole (Prevacid)

• Esomeprazole (Nexium)

These are useful for people with frequent or severe acid reflux but may have more long-term side effects like nutrient malabsorption or bone thinning.

Ranitidine's Place in Medical History

Ranitidine was first approved in the early 1980s and quickly became one of the most prescribed drugs globally. It offered a gentler alternative to antacids, which only neutralize acid after it’s produced, and it was widely used in hospitals, clinics, and homes.

Despite its eventual recall, ranitidine paved the way for modern acid suppression therapies and changed how conditions like GERD and ulcers are treated.

Patient Tips and Final Thoughts

If you were using ranitidine or still experience acid reflux, here are a few tips:

• Avoid self-medicating with leftover or unverified ranitidine products.

• Consult your doctor about safer alternatives like famotidine or PPIs.

• Manage reflux naturally by avoiding spicy foods, eating smaller meals, and not lying down right after eating.

• Maintain a healthy weight and avoid smoking and alcohol, which can worsen reflux.

Conclusion

Ranitidine was a game-changer in its time, offering millions of people relief from acid-related stomach issues. While it is no longer available due to safety concerns, its mechanism—blocking H2 receptors to reduce acid—remains an essential concept in gastroenterology.

Fortunately, safer alternatives now exist, and patients can still manage acid reflux effectively with the right medications and lifestyle changes. Always speak to your healthcare provider about the best and safest treatment for your specific needs.