Stomach disease is a common disease in life, and the “star drug” of gastrointestinal diseases, ranitidine, since its launch in 1981, has accumulated sales of up to 95 billion DOLLARS, ranking seventh in the global best-selling drug list. Such a good seller, it can be seen how significant its effect! However, back in September, the US Food and Drug Administration announced that preliminary tests had found low doses of n-nitrosodimethylamine (NDMA) in the stomach drug Ranitidine. After the announcement, some related pharmaceutical companies announced the recall of ranitidine on the market, but still some pharmaceutical companies did not announce the recall!
The FDA issued a warning about the possible risks of ranitidine and urged doctors and patients to consider alternatives to ranitidine. A stone arouse thousand layer waves!
On September 22, India announced it was suspending global supplies of ranitidine until the results of the FDA investigation are confirmed.
On September 25, Health Canada suspended sales of ranititin until there is evidence that they contain the required amount of NDMA!
On September 26, South Korea’s Ministry of Food and Drug Safety called for a moratorium on the use of ranitidine and banned the production, import and sale of ranitidine.
On December 9, The Chinese Pharmacopoeia Commission issued the Public Notice on the draft revision of national Drug Standards for Ranitidine Hydrochloride and its Preparations to add the production requirement: evaluation of the possibility of the existence of N-nitrosodimethylamine.
FDA calls for total removal!
On April 1, 2020, the US Food and Drug Administration (FDA) issued a notice, requiring all pharmaceutical companies to immediately withdraw and recall all ranitidine drugs, because it contains cancer-causing N-nitrosodimethylamine (NDMA), which can accumulate over time or at conditions higher than room temperature, exceeding acceptable safe levels for humans.
What is NDMA?
According to the list of carcinogens published by WHO, NDMA is a category 2A carcinogen (that is, there is sufficient evidence in animal experiments, and there is limited evidence that it may cause cancer in humans)! NDMA has been identified as an animal carcinogen through animal experiments, and its target organs are mainly liver and kidney.
Acute NDMA poisoning can cause abdominal pain, lethargy, headache, fever, vomiting, diarrhea and other symptoms. Long-term consumption of small doses of NDMA significantly increases the risk of liver cancer.
What is ranitidine?
Rani tidine, it is strong effect histamine H2 receptor antagonist, can reduce gastric acid secretion, it is one of the drugs that the most extensive treatment canker disease applies at present! The bioavailability of intramuscular injection is more than 90%. The effect is 5 ~ 8 times stronger than cimetitin. It has a high curative effect on gastric and duodenal ulcer with few side effects and is safe. In the healing of gastric ulcer and reduce ulcer recurrence, ranitidine combined with bismuth is better than this product alone!
Can’t take ranitidine, what are the alternatives?
Acid suppressants are drugs that inhibit the secretion of gastric acid, usually including histamine H2 receptor blockers and proton pump inhibitors, and are currently the preferred treatment for peptic ulcer disease!
FDA tests have not found NDMA in products used for similar therapeutic purposes, such as famotidine, cimetidine, emeprazole, lansoprazole or omeprazole.
H2 receptor blockers include cimetidine, ranitidine, famotidine, nizatidine, etc., so when ranitidine cannot be used, it can be replaced by similar products. Famotidine is taken orally quickly, but not completely, and its inhibitory effect on gastric acid secretion is 7.5 times stronger than ranitidine! Similarly, it has high curative effect on gastric and duodenal ulcer, and has the advantage of quick effect and long effect!
In addition to H2 receptor blockers, proton pump inhibitors can also be chosen instead. Proton pump inhibitors are the most effective drugs for inhibiting gastric acid secretion and preventing peptic ulcer. At present, domestic listed proton pump inhibitors include omeprazole, pantoprazole, lansoprazole, esomeprazole and so on.
Omeprazole (ogilvy) on basis of gastric acid secretion, and histamine, food, pentagastrin and stimulate the vagus nerve, cause the gastric acid secretion, are powerful and lasting an adverse effect, and is suitable for gastric ulcer, duodenal ulcer, stress ulcer, reflux esophagitis and – airy syndrome (stomach secrete melanoma), etc., can be used as a replacement drugs of ranitidine.