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Comment by eikenberry | Hacker News Reader

I read that it is only carcinogenic if stored improperly, which was one of the reasons it stayed available for as long as it did. The article doesn't seem to counter this idea. Do you have any references on the not heat-exposed risks?

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My understanding is that the carcinogen (NDMA) builds up over time even with storage at recommended temperatures, though increased temperature makes it build up much faster. That's what the FDA said when they pulled it from the market.

How old your ranitidine would have to be to have too-high NDMA level without higher heat, I haven't seen any specifics around that.

I imagine they could have instead instituted limits about temperature of storage and transport, and chop down the expiration dates, and add big warnings for consumers to actually respect the dates, not keep them in cars, etc... though the market reality that there are several other H2 blockers out there that haven't been shown to have the NDMA issue, not to mention PPIs, likely meant that just pulling ranitidine was the better call.

Even something as simple as telling people to store the bottle in the refrigerator...

I think even that was seen as a potential “guilty conscience” risk if things went into litigation, so best to just let people suffer and die, that’s less expensive.

This sort of "we refuse how to tell you to get better results because then some ambulance chaser could use that" behavior is all over the corporate world (albeit less in B2B than B2C).

if you have to sell your OTC medication in a refrigerator, your sales will drop a lot. It's not somewhere people think to look, and the impression is that it's perishable. Which people can appreciate for something like a steak, but not their "safe and usual" medications.

I would gladly refrigerate it if it meant I could still use it. I've never had another acid reducer that works as well for me as Zantac.

I have so many major health problems that quite frankly I'll probably be dead before I could get cancer from this stuff.

It's still manufactured overseas. There are shady-but-legit websites that sell it.

Nothing else on the market compares.

I store all medicines (prescription and some OTC) in the fridge. So it’s the first place I look. They ARE perishable.

Any of those marketplaces you'd recommend?

Not particularly.

The few batches we've bought have been legit (Ranimax 150, product of India), but QA with these sorts of vendors isn't exactly guaranteed (for all I know, your first purchase would be reconstituted sawdust and rat droppings). I'm not comfortable giving standing referrals to any fly-by-night operation.

I just mentioned it as a possibility because for those with bad-enough GERD, there are no retail options, and the assumption is that the product has been recalled worldwide. Not so!

YMMV, but 20mg famotidine tablets work well for me since Zantac is gone.

Nexium, or esomeprazole, works well, or better than Zantac, and can be purchased OTC (at least here in the UK). It’s pricey but usually lasts a couple of days or more so it stretches further.

Paracetamol for children was stored in the fridge and just lived there in my household. It’s a sweet syrupy liquid.

It’s not over-the-counter where I live, but the adult (tablet) version is.

AKA acetaminophen AKA Tylenol. On the safety scale, it's dangerous stuff. Profitable not only because it works, and is perceived as safe, but the long term side effects are even more profitable.

No. I had heard Zantac was recalled due to cancer risk, but didn't know it was related to how it was stored until now.

It's paywalled, but this seems to be referenced by a lot of reports:

https://www.bloomberg.com/news/articles/2020-01-02/carcinoge...

Maybe someone else has the actual source.

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