What Are My Alternatives to Zantac?



Since the discovery of NDMA contamination in Zantac in September of 2019, all manufacturing and distribution of the drug has been ordered to cease entirely. Over 15 million people across the country rely on Zantac as a form of relief from heartburn, stomach ulcers, and other related conditions. It was the 48th most prescribed drug in the United States in the last year. As the drug has been abruptly removed from pharmacies everywhere, you may find yourself eagerly searching for alternative options to Zantac to aid you in finding relief from heartburn. 

Histamine Receptor Antagonists

Fortunately, Zantac is not the only heartburn relief medication available. Rather, it belongs to an entire class of drugs known as H2 histamine receptor antagonists. The key function of these medications is to block histamines from causing the production and secretion of stomach acid by activating the cells of the stomach lining. Still, you must be vigilant when choosing your alternative within this group, as ranitidine (Zantac’s generic name) is not the only one that is contaminated with NDMA. Nizatidine – the brand names of which are Tazac and Axid – has been affected by the contamination as well. 

Safe H2 antagonist alternatives include: 

  • Cimetidine. Also known by its brand name, Tagamet. Side effects unique to this drug include:
    • Gynecomastia(a hormone imbalance that results in the enlargement of male breasts)
    • Vitamin B12 deficiency
    • Impotence 
    • Anemia
    • Thrombocytopenia(low blood platelet count, this may result in the inability to form scabs when bleeding)
    • Pancytopenia
    • Neutropenia
  • Famotidine, also known by the brand name, Pepcid

Possible side effects you may experience from the use of all H2 receptor antagonists include (older patients are more vulnerable to these effects):

  • Headaches
  • Altered mental condition
  • Restlessness 
  • Dizziness

Proton Pump Inhibitors (PPIs)

This is another class of medications that differ in their functionality from H2 receptor antagonists. The effects of PPIs are irreversible, as they block certain enzymes from being able to secrete acid into the stomach. These have long been common alternatives to ranitidine and nizatidine, and have been noted to be more effective in providing relief to acid reflux and related conditions. The Food and Drug Administration (FDA) recognizes three PPIs as effective alternatives to H2 receptor antagonists:

  • Omeprazole, known by the brand name, Prilosec
  • Esomeprazole, the brand name of which is Nexium
  • Lansoprazole, also known by its brand name, Prevacid

PPIs come with their own set of possible side effects, however, so both groups have their pros and cons. For instance, extended use of any of the PPIs listed above may result in:

  • Increased risk of gastric neoplasia
  • Increased risk of kidney disease
  • Impairment of the micronutrient absorption, especially vitamin B12 and magnesium
  • Increased risk of liver disease
  • Increased risk of stomach cancer
  • Increased risk of gastric infections

Keep in mind that these side effects rarely occur. 

If you relied on Zantac for relief from heartburn symptoms, the medications listed above are some great alternatives to soothe your condition. You must be aware of the possible side effects and consult your physician before committing to the use of any medications discussed here.