The drug Zantac can elevate the risk of a person developing cancer. The active ingredient, ranitidine, contains a contaminant called NDMA, which is a probable human carcinogen.

The above information comes from the Food and Drug Administration (FDA).

Carcinogens are substances that cause cancer. Research suggests that ranitidine may have an association with several gastrointestinal cancers, but the most robust evidence involves cancer of the colon and rectum, known as colorectal cancer.

Safe alternatives to Zantac are available. The drug is one of several H2-receptor antagonists (H2RAs), including cimetidine (Tagamet) and famotidine (Pepcid). Testing does not show that these drugs contain N-nitrosodimethylamine (NDMA).

This article examines the association between Zantac and cancer, as well as the evidence regarding specific types of cancer. It also discusses what a person can do if they take Zantac, how to dispose of it, and what safe alternatives are available.

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Ranitidine (Zantac) belongs to the class of medications called H2RAs. These medications reduce acid secretion in the stomach. In the past, doctors prescribed Zantac for the following conditions:

On April 1, 2020, the FDA requested that manufacturers of prescription and over-the-counter (OTC) ranitidine products remove them from the market immediately. This is because some of the products contain a contaminant known as NDMA, which scientists class as a probable human carcinogen.

NDMA levels increase when the drug is in storage at higher-than-normal room temperatures. They also increase over time under average storage conditions. This exposes people to unacceptable levels of NDMA.

Within the body of scientific research on the topic, there are some inconsistencies regarding the cancer risk of ranitidine. However, according to a 2021 review, there is enough evidence to support the FDA’s withdrawal of the medication from the market.

Ranitidine may have a link with various types of cancer, including:

Research links Zantac to several types of cancer, including:

Colorectal cancer

The researchers behind a 2020 study looked at possible links between ranitidine and cancers of the gastrointestinal tract.

To evaluate the risk, the researchers noted the incidence of adverse effects associated with various cancers that users of ranitidine experienced. They compared these data against the incidence of the same effects that users of other H2RAs and proton pump inhibitors (PPIs) experienced. PPIs are another class of drugs that reduce stomach acid.

Of all the types of cancer in the gastrointestinal tract, the review found that the strongest link to ranitidine involved colorectal cancer.

Stomach cancer

Studies on the link between ranitidine and stomach cancer have produced mixed results.

A 2021 study investigated the potential association between ranitidine intake and stomach cancer using data from 40,887 people in South Korea.

When the researchers compared the outcomes of ranitidine users with those of other H2RA users and a control group, they found no significant difference in cancer development. The authors concluded that ranitidine users in South Korea might not have a higher cancer risk. This finding differs from some other studies on the same subject.

Pancreatic cancer

Research from 2020 assessed the risk of pancreatic cancer related to various medications and found an association between ranitidine and a significantly increased risk.

However, the researchers did not observe an exposure-response relationship. As a result, they were unable to determine the dosage of the drug and the duration of treatment necessary to pose a risk.

Bladder cancer

The cancer risk of Zantac may extend beyond the gastrointestinal tract. A 2021 study compared the rate of bladder cancer in ranitidine users with the rate in nonusers. It found that the incidence of bladder cancer was higher among ranitidine users, especially those who took the medication for more than 3 years.

The FDA advises that people who take OTC ranitidine stop doing so immediately, dispose of it properly, and purchase no more of the drug.

Individuals who take prescription ranitidine should talk with a doctor about an alternative medication before they stop taking it.

Instead of taking Zantac to a drug take-back location, the FDA recommends the following:

  1. Mix uncrushed capsules or tablets with an unappealing substance, such as cat litter, dirt, or used coffee grounds.
  2. Place the mixture in a sealed plastic bag.
  3. Throw the bag away in the trash at home.
  4. Delete all personal information on the medication label on the empty bottle or packaging.
  5. Throw away the empty bottle or recycle it.

It is important never to flush the medication down a toilet or sink.

FDA testing has not detected NDMA in some other H2RAs, such as Tagamet and Pepcid. The FDA also did not detect NDMA in the below PPIs:

All of these drugs have a similar purpose and may help reduce stomach acid in people who used to take Zantac.

However, it is worth noting that while PPIs do not have a cancer risk from NDMA, a 2021 study found that they link to stomach cancer due to other factors.

People can discuss the potential risks and benefits of Zantac alternatives with a doctor.

No, Zantac is not back on the market. There is another OTC medication known as Zantac 360, but this does not contain ranitidine. Instead, the active ingredient is famotidine, which the FDA has approved for heartburn relief.

An association exists between ranitidine (Zantac) and cancer. This is because of a contaminant known as NDMA. Although research on the link has produced mixed results, studies generally show that this medication increases the risk of certain types of cancer, such as colorectal cancer.

People who take OTC ranitidine should discontinue its use. Those who take the prescription medication should talk with a doctor about a safer alternative.

Zantac 360 may be an appropriate substitute because it does not contain ranitidine. Alternatively, people can try other H2RAs.