Everything To Know About Ranitidine
Ranitidine, marketed under the brand name Zantac and others, is a medication used to reduce the formation of stomach acid. It is frequently used to treat ulcers, Zollinger–Ellison syndrome, and gastroesophageal reflux disease. It can be administered orally, injected into a muscle, or intravenously — also known as IV. There are also various ranitidine alternative to consider.
What is Ranitidine?
Ranitidine is a member of the histamine-2 blocker class of medications. It works by lowering the stomach’s acid production.
It has traditionally been used to treat and prevent stomach and intestinal ulcers. Also, it was used to treat conditions such as Zollinger-Ellison syndrome.
Additionally, ranitidine was used to treat gastroesophageal reflux disease (GERD) and other problems in which gastric acid, or stomach acid, goes back up into the esophagus, causing heartburn.
Zollinger-Ellison Syndrome and GERD
Zollinger-Ellison syndrome (ZES) is a relatively uncommon digestive disorder.
Individuals with ZES are likely to have one or more tumors in the small intestine’s first part, the pancreas, or both. The small intestine is divided into three-part:
- Jejunum, and
Gastrinomas are tumors that produce the hormone gastrin. This causes the stomach to produce an excessive amount of acid. Stomach acid is required to digest food.
However, too much acid can result in painful peptic ulcers in the intestine and stomach lining. While gastrinoma tumors can be bothersome, they are not malignant.
GERD arises when stomach acid flows back into the tube that connects the mouth and stomach (esophagus) on a frequent basis. This backwash (acid reflux) could irritate the stomach lining.
Many people occasionally encounter acid reflux. Mild encounters that happen at least twice a week, or moderate to severe reflux occurring at least once a week, is classified as GERD.
While the majority of people suffering from it can manage their symptoms with lifestyle changes and over-the-counter drugs, some may require stronger medications or surgery to alleviate symptoms.
Food and Drug Administration (FDA) Zantac Recall, 2020
Manufacturers recalled Zantac and its generic, ranitidine, from the market in September 2019 after the FDA received reports of N-Nitrosodimethylamine (NDMA) contamination.
In addition, the immediate recall of ranitidine products from the market on April 1, 2020, was requested to all manufacturers by the agency.
Furthermore, FDA investigated and evaluated ranitidine and discovered that NDMA levels increased under normal storage conditions and increased considerably in samples stored at elevated temperatures.
Additionally, the agency stated that NDMA levels are higher in the older ranitidine product, and it could expose consumers to unacceptable levels.
The recalls and market withdrawals of Zantac do not affect the current over-the-counter Zantac 360 formulation using famotidine.
N-Nitrosodimethylamine is a volatile, flammable, yellow, oily liquid nitrosamine with a faint distinctive odor that decomposes in the presence of light and generates hazardous nitrogen oxide fumes upon decomposition.
It is primarily utilized in animal research to develop tumors.
Exposure to the substance irritates the skin and eyes and causes liver damage. This chemical is considered probable to be carcinogenic to humans, which means it can cause cancer.
However, the FDA explained that low levels of NDMA are found in foods and water and are not likely to increase cancer risk.
What is an Alternative to Zantac?
Zantac is one of the most often prescribed drugs in the United States for the treatment of heartburn.
In the United States, it is estimated that over 15 million individuals take prescription Zantac, and millions more buy the over-the-counter (OTC) version or other generic alternatives containing ranitidine.
Consumers may be looking for alternatives to Zantac since its no longer available in the market. Along with FDA-recommended alternative drugs replacement, people may manage heartburn through diet and lifestyle changes.
What is comparable to Ranitidine 150mg?
Two types of medications may be comparable alternatives for Zantac and generic ranitidine:
- Proton pump inhibitors, and
- H2 histamine receptor antagonists
Proton Pump Inhibitors (PPIs) Ranitidine Alternative
According to the advice from a doctor, the following proton pump inhibitors are FDA-approved and may be appropriate, safe alternatives for treating heartburn:
- Esomeprazole — brand name Nexium
- Lansoprazole, and — brand name Prevacid
- Omeprazole — brand name Prilosec
These are PPIs, a class of drugs that acts by irreversibly inhibiting particular enzymes from secreting acid into the stomach.
The body responds by recognizing that there is insufficient acid and attempting to produce more through gastrin production. It has been discovered that excessive gastrin promotes the development of gastrointestinal tumors.
#1. Nexium (Esomeprazole Magnesium) works by reducing the quantity of stomach acid produced.
Additionally, it is used to treat GERD symptoms and other illnesses characterized by an excess of stomach acid, such as Zollinger-Ellison syndrome. It is also used to aid in the healing of erosive esophagitis (damage to the esophagus caused by stomach acid).
Esomeprazole may also be used to prevent gastric ulcers caused by Helicobacter pylori (H. pylori) infection or the use of nonsteroidal anti-inflammatory medications (NSAIDs).
It is not intended to provide immediate relief from heartburn.
Common side effects of Nexium are:
- Abdominal pain
- Dry mouth
- Nervousness, and
#2. Prevacid (Lansoprazole) is a crystalline powder that ranges from white to brownish-white in color and is odorless. It melts at roughly 166°C during decomposition, and it reduces the amount of stomach acid produced.
Additionally, It is used to treat and prevent erosive esophagitis (esophageal damage caused by gastric acid), stomach and intestinal ulcers, and other disorders characterized by an excess of stomach acid, including Zollinger-Ellison syndrome.
Prevacid is used to treat recurrent heartburn that occurs twice a week or more. It is not intended to provide instant relief from heartburn.
Possible side effects are:
- Acute Interstitial Nephritis
- Bone Fracture
- Clostridium difficile
- Cutaneous and Systemic Lupus Erythematosus
- Cyanocobalamin (Vitamin B12) Deficiency
- Fundic Gland Polyps, and
#3. Prilosec (Omeprazole) reduces the quantity of gastric acid generated. It is used as a medication to treat gastroesophageal reflux disease and other illnesses caused by an excess of gastric acid. Additionally, it is utilized to aid in the healing of erosive esophagitis — damage to the esophagus caused by gastric acid.
Additionally, It may also be used in conjunction with antibiotics to treat stomach ulcers caused by Helicobacter pylori infection (H. pylori).
Over-the-counter omeprazole is used to help treat heartburn that happens twice a week or more. It must be taken as a treatment for 14 consecutive days. You can also read about the Omeprazole Alternatives.
Common side effects are:
- Abdominal pain
- Acid reflux
- Upper respiratory infection, and
Helicobacter Pylori (H. Pylori) Infection
Infection with Helicobacter pylori (H. pylori) occurs when the H. pylori bacteria infect the stomach. This is a common occurrence during childhood. The infection is a prevalent cause of peptic ulcers and may be present in more than half of the world’s population.
The majority of people with Helicobacter pylori infection will never have any signs or symptoms. It is unknown why this is, although some people may be born with higher resilience to H. pylori’s harmful effects.
When signs or symptoms of H. pylori infection do emerge, they may include the following:
- Abdominal pain that gets worse when the stomach is empty
- Frequent burping
- Loss of appetite
- Nausea, and
- Weight loss
The specific manner by which H. pylori infects someone is uncertain. The bacteria can be transmitted from person to person via direct contact with saliva, vomit, or feces. Additionally, it can be transferred through contaminated food or drink.
Risk Factors Involved with H. Pylori
Infection with H. pylori is frequently acquired throughout childhood. The risk factors of infection are associated with childhood living conditions, including the following:
- Crowded conditions — H. pylori risk of infection is higher when living in a crowded place
- Without a reliable supply of clean water — A steady supply of clean water helps reduce the risks
- Developing country — Individuals who live in developing countries, where overcrowded and unsanitary living circumstances are more frequent, are at a greater risk of infection
- Living with an infected person — the chances of transmitting the infection if a person is living with someone infected
Cancer and Other Health Risks from PPIs
According to some research, suppression of gastric acid by PPIs results in increased levels of gastrin, inflammation of the stomach lining, and bacterial overgrowth.
This, in turn, may contribute to the development of gastrointestinal cancer.
According to a 2019 study, even after eradicating H. pylori infection, long-term usage of PPIs was related to a twofold increased gastric cancer risk.
Prolonged use of the product has been linked to:
- Increased risk of
- Chronic kidney disease
- Heart attack
- Hip fractures
- Pneumonia, and
- Reduced levels of B12
H2 Histamine Receptor Antagonist Zantac Alternatives
Zantac is a member of a class of drugs known as H2 histamine receptor antagonists.
These drugs function by inhibiting histamine’s activation of the stomach lining cells responsible for the production and secretion of acid into the stomach. Although Zantac has been related to NDMA contamination that has been associated with cancer, the contamination appears to be limited to ranitidine.
Three other H2 histamine receptor antagonists may be suitable alternatives for taking Zantac and generic ranitidine:
- Famotidine — brand name Pepcid
- Cimetidine — brand name Tagamet
- Nizatidine — brand name Axid
While these drugs are generally well accepted by patients, some H2 histamine receptor antagonists, such as cimetidine (Tagamet), have been associated with severe, potentially dangerous adverse effects.
#1. Famotidine (Pepcid) is a prescription and over-the-counter ranitidine alternative used to treat stomach and intestinal ulcers and intestinal ulcers recurrence once they have healed.
Additionally, it is used to treat certain stomach and throat conditions, including erosive esophagitis, gastroesophageal reflux disease, and Zollinger-Ellison syndrome.
Lastly, it helps by decreasing the quantity of acid produced by the stomach. It alleviates persistent coughs, stomach pain, heartburn, and difficulties swallowing. Pepcid is a member of the class of medications known as H2 blockers.
Common side effects are:
- Dizziness, and
#2. Cimetidine (Tagamet) is a prescription medication used to treat heartburn, benign gastric ulcers, duodenal ulcers, erosive gastroesophageal reflux disease, pathological hypersecretory conditions, and renal impairment. Additionally, it can be taken alone or in combination with other drugs as a ranitidine alternative.
The medication may come with serious side effects, including:
- Bloody or tarry stools
- Breast swelling or tenderness
- Cough with bloody mucus
- Pain when swallowing, and
#3. Nizatidine (Axid) is a prescription medication used to manage the symptoms of Active Duodenal Ulcers, Duodenal Ulcer Maintenance, Benign Gastric Ulcers, and GERD. Axid may be taken on its own or in combination with other drugs and can be used as an ideal ranitidine alternative. Axid is a member of the class of medications known as H2 blockers. In addition, its safety and effectiveness in children under 12 years old are still unknown.
Possible side effects are:
- Chest pain
- Difficulty in breathing
- Pale skin
- Worsening heartburn, and
- Swelling of the face, tongue, lips, or throat
An antacid is a chemical that balances the acidity of the stomach and is used to treat heartburn, indigestion, and upset stomach. It is the oldest on the market as a treatment for heartburn and a good ranitidine alternative.
Other types of antacids have been used to alleviate constipation and diarrhea. In addition, Antacids on the market currently contain aluminum, salt, calcium, magnesium, or sodium. Certain formulations combine two salts, for example, magnesium carbonate and aluminum hydroxide.
Antacids rarely cause side effects. However, it may occur, and the possible side effects are:
- Loose bowel movement, and
- Allergic reactions
Types and Known Brands of Antacid
Antacids come in the forms of:
- Chewable gummy
- Chewable tablet
- Effervescent, and
Known brands include:
- Rolaids, and
Along with medications, lifestyle changes may be beneficial in some situations for conditions treated with PPIs like acid reflux or GERD.
Several lifestyle changes may be beneficial, including the following:
- Avoid foods that are spicy, fatty, or acidic
- Eating smaller meals
- Getting enough sleep
- Inclined sleeping position
- Weight management
- Quitting smoking
Alternative therapy shows promising results for the treatment of conditions treated by PPIs. This includes the following:
- Herbal remedies
Acupuncture aids in the healing and prevention of peptic ulcer relapses and is an indirect ranitidine alternative. The researchers — from the Second Affiliated Hospital of Zhongnan University — find that acupuncture improves the overall efficacy of medication therapy for peptic ulcers.
Patients who received both drug therapy and acupuncture as part of a combination treatment plan had significantly better outcomes than those who received only drug therapy.
Additionally, acupuncture raises the rate of H. pylori-negative conversion and decreases the likelihood of medication therapy recurrence.
A significant finding is that when acupuncture is combined with regular therapy, the relapse rate decreases from 41.7% to 15.4%.
Certain herbs can help reduce inflammation on the gastrointestinal (GI) tract’s surface.
- Chamomile tea
- Licorice root, and
are examples of these anti-inflammatory herbs.
While chamomile tea can be soothing to the digestive tract, it should not be consumed by persons allergic to ragweed.
Licorice Root is believed to aid in the esophageal coating, so protecting it from irritation caused by stomach acid.
For generations, ginger has been used to improve digestion and as a treatment for heartburn.
What is the safest acid reflux medicine?
Acid reflux, heartburn, and GERD medications are classified into three categories:
- H2 blockers
- Proton pump inhibitors (PPIs), and
They all act differently but have the same goal — prevention or instant relief. As of the present time, there is no saying which one is the best because of the new findings every now and then.
What Can I Use Instead of Ranitidine in the UK?
Antacid — Quick Relief
While H2 blockers and proton pump inhibitors function better than antacids, antacids are an immediate ranitidine alternative when relief is required.
Antacids do not prevent GERD, but they can be administered on-demand to alleviate symptoms. They are inexpensive and easily accessible over the counter.
The most commonly prescribed antacids contain calcium carbonate (Tums, Rolaids) and/or magnesium (Mylanta, Maalox, milk of magnesia) and provide relief from heartburn within 5 minutes. However, they are only effective for a little period of time — no more than 30 to 60 minutes.
Antacids have a few modest side effects, including constipation, nausea, and diarrhea. Avoid excessive usage of them: Certain brands contain calcium, and an excessive amount of calcium might result in kidney stones.
If symptoms persist for more than two weeks on antacid alone, stronger medicine will be recommended.
H2 Blockers — Stronger Relief
H2 blockers are used as short-term preventative drugs to reduce stomach acid. They inhibit histamine, an inflammatory agent found in the body, from encouraging the stomach to produce acid.
If a person experiences mild reflux symptoms less than twice per week, they can begin with a small dose of famotidine (Pepcid) or cimetidine (Tagamet) as a ranitidine alternative.
Ranitidine (Zantac), another H2 inhibitor, was recently withdrawn from the market due to elevated levels of cancer-causing chemicals. However, the FDA has not detected this chemical in famotidine or cimetidine products.
The Best H2 Blocker
There are few studies comparing famotidine with cimetidine. A small study discovered that famotidine lowered acid by a little longer period of time than cimetidine, with a significantly greater acid reduction.
Proton Pump Inhibitors — If H2 Blockers Are Not Enough
If acid reflux symptoms persist after a few weeks of taking H2 blockers and/or occur on two or more days per week, discontinue use and try a proton pump inhibitor (PPI) once daily as a ranitidine alternative.
PPIs work by inhibiting an enzyme found in the cells of the stomach lining responsible for the production of stomach acid.
This leads them to produce less acid and alleviates heartburn and GERD symptoms.
The Best PPIs
A meta-analysis of 41 studies examined many PPIs, including:
- Pantoprazole, and
- Lansoprazole, head to head.
Except for two studies comparing esomeprazole and omeprazole, all investigations concluded no differences in GERD treatment between the PPIs.
Two trials claimed that esomeprazole was superior to omeprazole. Both studies used larger doses of esomeprazole than omeprazole, thus, making the comparison inaccurate.
Editor’s Note on Ranitidine Alternative (Zantac) – What Is Ranitidine, Its Recall, Side Effects, Substitutes, And History:
This article details Ranitidine Alternative and its history. Any acid reflux treatment should be complemented by dietary and lifestyle changes. We also suggest you to read alternatives for Metformin and Omeprazole.
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