Popping acidity pills? The quick fix may have a hidden cost
Durgesh Nandan Jha speaks to Dr Ashwini Kumar Setya, senior gastroenterologist at Medanta Hospital
, to assess the risks
Why has this pill become so controversial?
Ranitidine belongs to a class of drugs called histamine-2 (H-2) blockers, which reduce but don't completely stop stomach acid production. Ranitidine is not carcinogenic on its own. The concern arises when the molecule breaks down over time or under certain conditions to form N-Nitrosodimethylamine (NDMA), a nitrosamine linked to possible cancer risk.
Since it's cheap and easily available, contamination could impact many.
Sold under brand names like Zantac and Rantac, should we stop using Ranitidine? Should long-term users be concerned?
We are yet to come across a medicine, including vitamins, which doesn't have side effects. No drug should be taken without medical supervision. Reports say the concentration of contaminants in Ranitidine is very small. But prolonged consumption and cumulative exposure could exceed safe limits.
The Drugs Technical Advisory Board has suggested that drug makers reduce Ranitidine's shelf life to lower NDMA levels. Will that help?
Ranitidine can degrade over time, especially when exposed to heat, humidity, and light, producing increased NDMA levels and potentially raising cancer risk. Reducing shelf life shortens the window in which NDMA can pile up, helping to keep it within safe limits.
In 2020, the US FDA had raised similar concerns and ordered its withdrawal. Why is India still allowing manufacture and sale?
CDSCO and the Drugs Controller General of India have been monitoring Ranitidine after the FDA and European Medicines Agency raised a red flag.
An expert committee identified cancer risks, but there aren't any documented cases of cancer attributed to the drug in India.
Pantoprazole
(brand name Pan D) is another common anti-acidity pill. Any risks of misuse?
Stomach acid serves three purposes — killing ingested germs, starting protein digestion, and activating pepsin for further protein breakdown. Drugs like Pantoprazole reduce stomach acid to nil, removing the first line of defence and raising chances of infections such as Hepatitis A and E, gastroenteritis, and typhoid.
These drugs can also lead to bloating as the undigested food ferments in the gut, producing more gas.
Which one's the safest acidity drug? And when to see a doctor instead of self-medicating?
Short-term use of Ranitidine (up to two months) is not a likely cause for concern. But if considering long-term, talk to the doctor about switching to another H-2 blocker like Famotidine or a proton pump inhibitor (PPI) like Omeprazole. If you're using it just to relieve burning in the chest or upper abdomen, replace with a liquid antacid.
Heartburn, acidity are now common due to sedentary lifestyle and poor diet. Any long-term effects of
anti-acidity pills
such as rebound acidity, peptic ulcers or even cancer?
Since acid secretion becomes nil with Pantoprazole and other PPIs, the body responds by increasing the hormone gastrin, which makes glands that secrete acid proliferate. When you stop using the drug, those glands start secreting acid with a vengeance, causing rebound acidity. It's a vicious cycle that makes patients want to go back to the drug. One long-term effect of these pills is non-cancerous stomach polyps.
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