Ranitidine was developed in response to the increasing need to prevent high acid content in the Gastrointestinal tract of the human body which was the lead cause of diseases and wounds such as heartburn, ulcers, and Zollinger-Ellison syndrome in the digestive organs of the body. It is used clinically to decrease the secretion of Gastric acid in the stomach to treat heartburns and ulcers. It does this by antagonizing the histamine receptors. It is also deployed in the cure of gastroesophageal reflux disease(GERD).
In April 2020, The United States ordered the withdrawal of Ranitidine from the market because it was realized that a cancer-causing element (N-Nitrosodimethylamine) was present in many ranitidine medicines which may multiply to an uncontrollable amount over time, and if the drugs are kept at high temperatures. This led to the increase in the production of alternatives to ranitidine.
Alternatives to Ranitidine
Ranitidine was the most common and easily attainable histamine-2 receptor blocker but not the only histamine-2 receptor blocker. Due to the increased shortage of ranitidine drugs in the market, Pharmaceutical companies have increased the availability of other drugs to substitute ranitidine in the market and these alternatives are as follows;
• Famotidine
• Nizatidine
• Cimetidine
Famotidine
Famotidine is classified as one of the four histamine-2 receptor inhibitors. It is prescribed by Physicians for the treatment of ulcers in the digestive organs, gastroesophageal reflux, heartburn, and also Zollinger-Ellison syndrome. It acts by decreasing the amount of gastric acid produced in the stomach. Famotidine is a safer drug to use as the cancer-causing contaminant found in Ranitidine is absent in it. Studies have also shown that Famotidine is more potent than Ranitidine and Cimetidine and similar to ranitidine, Famotidine lacks anti-androgenic side effects at higher dosages or blocks the hepatic breakdown of drugs. Due to this, and also its high anti-secretory potency, Famotidine may be the predominant choice of physicians in treating the Zollinger-Ellison syndrome.
Side Effects of Famotidine
Because medications modify the body’s internal environment in various ways, they all have one or more side effects. This is also true for Famotidine, but unlike Ranitidine, Famotidine’s side effects are less severe and normally pass quickly. Dizziness, diarrhea, and constipation are major adverse effects associated with histamine H-2 receptor blockers. When combined with QT-prolonging medicines, Famotidine can contribute to QT-prolongation in people with compromised kidney function.
Cimetidine, like Famotidine and Ranitidine, is used to treat most ulcers, heartburns, gastroesophageal reflux, and the Zollinger-Ellison syndrome. It also inhibits the Histamine 2 receptor. Cimetidine was discovered in 1971 as a result of a series of research studies carried out by SK&F laboratories particularly James Black and Rob Ganellin but sold commercially in 1977. It was discovered prior to Ranitidine at a time traditional histamine inhibitors had no effect in decreasing acid secretion in the stomach but as time went on, Ranitidine and Famotidine were discovered and they were seen to have lesser adverse effects and decreased drug interactions compared to cimetidine although cimetidine is still in use today, it is no more among the most widely used Histamine receptor antagonists.
The side effects of cimetidine include constipation, dizziness, and muscle pain which are commonly mild, adverse side effects may include mental confusion in elderly people, and because of its hormonal effects, it can lead to sexual dysfunction in both males and females specifically erectile dysfunction and loss of libido in males. It can also result in hepatotoxicity but this is rare.
Nizatidine is also a medicine that prevents peptic ulcers, heartburns, duodenal ulcers, and gastroesophageal reflux by blocking histamine-2 receptors and keeping gastric acid concentrations at levels that prevent these conditions. Eli Lilly developed it in 1980 and received FDA approval for clinical use in 1988. Nizatidine is the most recent histamine-2 antagonist to be produced, and it is thought to be interchangeable with Ranitidine. Their chemical design differs in that ranitidine has a Thiazole ring instead of a Furan ring. An experiment was conducted in which healthy volunteers were given 300mg of Ranitidine and 300mg of Nizatidine to compare the effects of both medicines. The outcome revealed that although ranitidine was more effective than Nizatidine in decreasing the secretion of gastric acid, the subjects of the experiment were seen to have tolerance within the 28-days drug administration span. In contrast, Nizatidine showed stable anti-secreto
ry effectiveness during this period.
Most of the side effects experienced by patients who take Nizatidine are usually mild and short-termed. They include headache, fatigue, constipation, muscle pains, and drowsiness. In some patients, however, these side effects are rare.
Does Ranitidine cause disturbance of sleep?
Disturbance in sleeping patterns caused by Ranitidine is one of the adverse side effects in patients receiving this medication as it causes mild insomnia. However, it is unusual.
What time can Ranitidine alternatives be taken?
Ranitidine and its alternatives are either administered at bedtime or three times daily, depending on which drug it is and the physician’s prescription. It is sometimes taken 20-30 minutes after the ingestion of meals capable of causing heartburn but it should be noted that Ranitidine and its alternatives shouldn’t be taken without a doctor’s prescription.
How do I know if my ranitidine medication is recalled?
Not all Ranitidine medications have been recalled however, information about Ranitidine recalls is available on the F.D.A ’s Ranitidine webpage.
Ranitidine was used widely in the treatment of ulcers, gastroesophageal reflux, and Zollinger-Ellison syndrome for a long time but it was necessarily withdrawn from the public due to the carcinogenic constituent (N-Nitrosodimethylamine). This was done following the medical ethic which encourages no harm to be done to patients and rather than making a situation worse, it is best to seek alternatives. Patients presently taking ranitidine medication who desire to stop should consult their doctors for alternatives to ranitidine with minimal side effects or other treatment options.
