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

Ranitidine 150 mg was once one of the most commonly used medications for acid reflux, heartburn, and related gastrointestinal issues. Known by brand names such as Zantac, it belonged to a class of drugs called H2-receptor antagonists (H2 blockers). These medications were considered highly effective and widely available—until safety concerns led to global recalls and discontinuation of many ranitidine products.

In this article, we’ll explore what ranitidine is, how it works to treat acid reflux, why it was popular, and the safety issues that changed its role in medicine.

What Is Ranitidine?

Ranitidine hydrochloride is a medication that was primarily used to reduce the production of stomach acid. It was prescribed to treat conditions such as:

• Gastroesophageal reflux disease (GERD)

• Peptic ulcers

• Zollinger-Ellison syndrome (a rare condition with excessive acid production)

• Heartburn and indigestion

• Acid-related damage to the esophagus

Ranitidine was available in both prescription and over-the-counter (OTC) forms. The OTC versions were typically used for short-term relief of heartburn, while prescription-strength ranitidine treated more chronic or serious acid-related disorders.

How Ranitidine Works for Acid Reflux

To understand how ranitidine works, it helps to understand what causes acid reflux.

🔹 What Is Acid Reflux?

Acid reflux occurs when stomach acid flows backward into the esophagus, causing symptoms like:

• Burning chest pain (heartburn)

• Sour taste in the mouth

• Regurgitation

• Chronic cough or throat irritation

This backflow of acid often happens when the lower esophageal sphincter (LES)—a muscle ring that closes off the stomach from the esophagus—does not function properly.

🔹 Ranitidine’s Mechanism of Action

Ranitidine is a histamine-2 (H2) receptor blocker. It works by blocking histamine on the H2 receptors of the parietal cells in the stomach lining.

Here's what that means in simple terms:

1. The stomach produces acid to aid digestion.

2. Histamine stimulates acid production by binding to H2 receptors.

3. Ranitidine blocks this action—so less stomach acid is produced.

By reducing acid levels, ranitidine relieves the symptoms of acid reflux and helps heal acid-induced damage to the esophagus.

Benefits of Ranitidine for Acid Reflux

When it was in widespread use, ranitidine offered several benefits for acid reflux sufferers:

✅ 1. Rapid Symptom Relief

Ranitidine typically started working within 1 to 2 hours, making it effective for relieving occasional heartburn or post-meal discomfort.

✅ 2. Longer Duration of Action

Ranitidine provided acid suppression for up to 12 hours, allowing for twice-daily dosing in most cases.

✅ 3. Promoted Healing

In cases of GERD or peptic ulcers, consistent use of ranitidine helped heal inflamed or eroded tissue by reducing acid exposure.

✅ 4. Good Tolerability

Compared to older treatments like antacids, ranitidine was considered safe and well-tolerated by most patients, with few side effects.

Common Uses of Ranitidine

Ranitidine was prescribed or recommended for a variety of acid-related issues:

• Mild to moderate GERD

• Chronic heartburn

• Duodenal or gastric ulcers

• Post-meal indigestion

• Preventing ulcers caused by NSAIDs (e.g., ibuprofen)

• Aspiration prevention before surgery (hospital use)

Its versatility made it a mainstay in medicine cabinets and clinics for decades.

Ranitidine vs. Other Acid-Reducing Medications

Ranitidine was one of several medications used to treat acid reflux. Others include:

🔸 Antacids (e.g., Tums, Maalox)

• Work within minutes

• Short duration

• Neutralize existing acid

🔸 H2 Blockers (e.g., Ranitidine, Famotidine)

• Reduce acid production

• Longer-lasting

• Best for moderate symptoms

🔸 Proton Pump Inhibitors (PPIs) (e.g., Omeprazole, Lansoprazole)

• Stronger acid suppression

• Take longer to work

• Ideal for severe or chronic conditions

Ranitidine filled the middle ground: more powerful than antacids but with fewer side effects than PPIs, making it suitable for daily use in many patients.

Safety Concerns and the Ranitidine Recall

Despite its benefits, ranitidine was voluntarily withdrawn from markets around the world in 2019–2020 due to safety concerns.

⚠️ NDMA Contamination

The issue began when independent laboratories detected N-Nitrosodimethylamine (NDMA), a probable human carcinogen, in some ranitidine samples. NDMA can form under certain conditions—particularly when ranitidine is stored at high temperatures or for long durations.

Though the risk was unclear, regulatory agencies such as the U.S. FDA and European Medicines Agency (EMA) opted for precautionary recalls.

As of 2023–2025, ranitidine is no longer widely available, and safer alternatives have taken its place.

Current Status of Ranitidine

Due to the NDMA issue:

• Most manufacturers stopped production

• Pharmacies removed ranitidine from shelves

• Doctors stopped prescribing it

• The FDA requested complete market withdrawal

While some low-NDMA formulations were under review, ranitidine is not currently recommended or used in mainstream clinical practice.

Alternatives to Ranitidine

If you previously relied on ranitidine for acid reflux, don’t worry—there are safe and effective alternatives:

✅ H2 Blockers

• Famotidine (Pepcid): Now the preferred H2 blocker due to its lack of NDMA contamination.

• Nizatidine: Less commonly used but still available in some regions.

✅ Proton Pump Inhibitors (PPIs)

• Omeprazole, Esomeprazole, Lansoprazole

• Best for chronic or severe GERD

• More potent than H2 blockers but carry long-term use risks

✅ Lifestyle Modifications

• Avoid spicy, acidic, or fatty foods

• Eat smaller meals

• Don’t lie down after eating

• Elevate head while sleeping

• Avoid smoking and alcohol

Conclusion

Ranitidine was once a widely trusted and effective medication for treating acid reflux, GERD, ulcers, and related conditions. It worked by reducing stomach acid production, providing quick relief from heartburn and promoting healing in the digestive tract.

However, due to safety concerns over NDMA contamination, ranitidine was withdrawn from global markets. While it is no longer in use, many safer and equally effective alternatives are available, such as famotidine and proton pump inhibitors.

If you were using ranitidine and need ongoing treatment for acid reflux, consult your healthcare provider for the best alternative tailored to your needs. With the right medication and lifestyle adjustments, effective relief is still very much possible.