Ranitidine: What It Is and How It Works for Acid Reflux

Acid reflux, a common digestive disorder, affects millions of people worldwide. It occurs when stomach acid flows back into the esophagus, causing discomfort, heartburn, and, over time, damage to the esophageal lining. For years, Ranitidine 150 mg was one of the most widely used medications to relieve the symptoms of acid reflux and related conditions. Known for its effectiveness and availability, ranitidine provided relief to countless patients—until safety concerns led to its withdrawal from the market.

This article explores what ranitidine is, how it works for acid reflux, its medical uses, safety profile, and what led to its global recall.

🔵 What Is Ranitidine?

Ranitidine is a medication that belongs to a class of drugs known as H2 blockers or histamine-2 receptor antagonists. These drugs reduce the production of stomach acid by blocking histamine receptors in the stomach lining.

Ranitidine was first approved by the FDA in 1983 under the brand name Zantac. Over time, it became available in various forms, including:

• Tablets (75 mg, 150 mg, 300 mg)

• Liquid syrup

• Injectable forms (used in hospital settings)

Ranitidine was widely used as both a prescription and over-the-counter (OTC) drug for treating heartburn and other gastrointestinal issues.

🔵 How Ranitidine Works for Acid Reflux

To understand how ranitidine works, it’s important to know how acid production occurs in the stomach:

• The parietal cells in the stomach produce hydrochloric acid, essential for digesting food.

• This process is stimulated by histamine, a natural chemical in the body.

• Histamine binds to H2 receptors on the stomach lining, triggering acid secretion.

Ranitidine works by blocking H2 receptors, which inhibits the effect of histamine. As a result, the amount of acid produced in the stomach is significantly reduced, leading to:

• Relief from heartburn

• Reduction in esophageal irritation

• Improved healing of ulcers and reflux-related damage

By decreasing stomach acid, ranitidine helped prevent acid from backing up into the esophagus, which is the root cause of acid reflux and gastroesophageal reflux disease (GERD) symptoms.

🔵 Common Conditions Treated with Ranitidine

Ranitidine was used to treat a range of acid-related digestive conditions, including:

1. Gastroesophageal Reflux Disease (GERD): A chronic condition where acid repeatedly flows into the esophagus.

2. Heartburn and Acid Indigestion: Occasional symptoms of stomach acid irritation.

3. Stomach and Duodenal Ulcers: Ranitidine promoted healing by reducing acid that aggravates ulcerated tissues.

4. Zollinger-Ellison Syndrome: A rare condition involving excessive stomach acid production.

5. Erosive Esophagitis: Inflammation or damage to the esophagus due to acid reflux.

6. Prevention of Stress Ulcers in Hospitalized Patients

It was also used prophylactically before surgeries or anesthesia in certain patients to reduce the risk of acid aspiration.

🔵 Benefits of Ranitidine

Some of the key benefits that made ranitidine a go-to treatment for acid reflux and related conditions included:

• Quick relief from symptoms of heartburn

• Long-lasting acid control, especially with higher doses

• Fewer side effects compared to proton pump inhibitors (PPIs) in some individuals

• Availability in OTC form, making it accessible to many patients

• Safe for short- and long-term use under medical supervision

🔵 Side Effects of Ranitidine

Ranitidine was generally considered safe and well-tolerated, but some patients experienced side effects, especially with prolonged use or higher doses.

Common Side Effects:

• Headache

• Constipation or diarrhea

• Dizziness

• Fatigue

• Nausea

Rare but Serious Side Effects:

• Liver enzyme abnormalities

• Blood count changes (e.g., low platelets)

• Confusion or hallucinations (mostly in elderly or hospitalized patients)

• Allergic reactions

Despite its popularity, concerns about long-term safety eventually emerged, leading to further scrutiny.

🔴 Ranitidine Recall and NDMA Concerns

In 2019, the FDA and several other health authorities around the world raised concerns about the presence of NDMA (N-Nitrosodimethylamine) in ranitidine products. NDMA is a probable human carcinogen, meaning it may increase the risk of cancer with long-term exposure.

Key issues included:

• NDMA was found to accumulate over time, especially when stored at higher temperatures.

• The levels detected were above acceptable safety limits.

• There were inconsistencies across different manufacturers and batches.

As a result, in April 2020, the U.S. FDA requested a market withdrawal of all ranitidine products, and many countries followed suit. Manufacturers were instructed to stop distribution, and patients were advised to switch to alternative medications.

🔵 Alternatives to Ranitidine

With ranitidine no longer available, healthcare providers began recommending safer alternatives, including:

1. H2 Blockers:

• Famotidine (Pepcid): Most recommended substitute; similar action with no NDMA contamination.

• Nizatidine: Another H2 blocker, although some formulations were also recalled.

2. Proton Pump Inhibitors (PPIs):

• Omeprazole, Lansoprazole, Esomeprazole

• More potent acid suppression than H2 blockers

• Often used for severe or chronic GERD

3. Lifestyle Modifications:

• Eating smaller meals

• Avoiding spicy, acidic, or fatty foods

• Elevating the head of the bed

• Avoiding eating before bedtime

• Quitting smoking and reducing alcohol intake

🔵 Current Status of Ranitidine

As of 2025, ranitidine is not approved for sale or use in many countries, including the United States, Canada, and most of Europe. Some manufacturers are exploring NDMA-free formulations, but no re-approval has been granted yet.

Patients who previously used ranitidine are now advised to:

• Dispose of old products safely

• Consult their doctor for alternatives

• Monitor any past exposure if used long-term (though cancer risk remains low for most)

🔵 Conclusion

Ranitidine was once a trusted and effective treatment for acid reflux, heartburn, and related conditions. By blocking histamine’s action on the stomach lining, it helped millions of people control painful digestive symptoms. However, concerns about NDMA contamination led to a global recall, shifting the landscape of acid suppression therapy.

Today, safer alternatives like famotidine and PPIs offer similar benefits with fewer risks. If you previously relied on ranitidine, speak with your healthcare provider about switching to a safe, effective option tailored to your current needs. While ranitidine may no longer be on the shelves, effective and modern treatments continue to help patients manage acid reflux successfully.