Key takeaways:
In 2020, the FDA issued a recall of all versions of a heartburn medication called ranitidine, better known as Zantac, due to a potential cancer risk.
Recently, Zantac relaunched with a new name and a different ingredient — Zantac 360 (famotidine). Famotidine doesn't have the same cancer risk as ranitidine, making it a safer option.
Famotidine is available over-the-counter as a lower-cost generic. You can find it for less than $5 at certain pharmacies with a free GoodRx discount.
Save on related medications
In April 2020, the FDA issued a recall of all prescription and over-the-counter (OTC) versions of ranitidine, the generic name of Zantac. Although the FDA began investigating and recalling certain manufacturers of ranitidine, this announcement called for all retailers to completely clean their shelves of the product, regardless of which company produced it. This left many people wondering why and if they would ever see the medication return.
In 2021, Zantac made an over-the-counter reappearance in pharmacies. But if you read the package closely, you’ll find the new Zantac 360 is not the same as the original. So then, what’s the difference?
In this article, we’ll discuss what Zantac 360 is, why the original Zantac was recalled, and what you can expect from the new version.
What is Zantac?
Zantac — both the original and the new version — is often used to treat or prevent heartburn and acid reflux. At higher, prescription-only doses, it can also be used to treat stomach ulcers and erosive esophagitis (when the tube that connects your mouth and stomach is damaged by stomach acid). When prescribed by a healthcare provider, Zantac can be used in people of all ages, even newborn infants.
Unlike proton pump inhibitors, such as omeprazole (Prilosec) and lansoprazole (Prevacid), which can take several days to kick in and lessen symptoms, Zantac starts relieving heartburn 15 to 60 minutes after you take it. And it will keep working for up to 12 hours, compared to traditional antacids like Tums and Mylanta that tend to wear off within a half-hour.
These qualities make Zantac a great choice for people who have occasional heartburn or know they’re likely to experience it soon.
What is Zantac 360?
Zantac 360 is an oral tablet containing the ingredient famotidine. It comes in two different strengths (10 mg and 20 mg) and is available without a prescription. The OTC tablets are only recommended for adults and children over 12 years old.
If the word famotidine looks familiar, that’s because it is also the active ingredient in brand name Pepcid AC, another OTC heartburn remedy. The famotidine in these competing products is the same. Both provide the same symptom relief, and neither has any advantages over the other.
How does famotidine work?
Famotidine belongs to a class of medications called histamine-2 antagonists (H2 blockers). It works by blocking the acid-producing cells in the stomach. Think of it like plugging up a hole that’s leaking water. The only other H2 blocker currently on the market is cimetidine (Tagamet HB).
Zantac 360 dosage
If you’re currently experiencing heartburn, take 1 tablet by mouth. To prevent heartburn, on the other hand, take 1 tablet by mouth 15 to 60 minutes before the drink or food that typically causes your acid reflux symptoms.
Remember to not chew on the tablet. Take the tablet with water, and don’t take more than 2 tablets within a 24-hour period.
Zantac 360 precautions
If you had a previous allergic reaction to famotidine or other H2 blockers, don’t take famotidine.
To be safe, talk with your healthcare provider before taking Zantac 360. Heartburn symptoms can sometimes be similar to those of more serious problems, like stomach cancer. Using Zantac 360 could mask those symptoms or prevent you from seeking the proper medical attention.
Contact your healthcare provider if you have the following symptoms:
Bloody or black stools
Heartburn for more than 3 months
Pain that is causing swallowing difficulties
Nausea or vomiting with or without blood
Stomach pain
Unexplained weight loss
Zantac 360 is also linked to brain-related effects, such as:
Agitation
Confusion
Disorientation
Hallucinations
Seizures
Tiredness and low energy
Older adults — over 65 years of age — and people with kidney problems might have a higher risk for these brain-related effects. If you experience these side effects, stop taking Zantac 360, immediately notify your healthcare provider, and seek medical attention.
How is Zantac 360 different from the original Zantac?
Both Zantac 360 and original Zantac included H2 blockers. The previous version contained a medication called ranitidine. Just like famotidine, it worked within an hour and lasted for up to 12 hours. Prior to the 2020 recall, many people had a personal favorite they preferred, but in studies both famotidine and ranitidine were equally effective for heartburn and acid reflux.
Zantac recall
In 2018, the FDA started releasing warnings that various medications contained a chemical called N-nitrosodimethylamine (NDMA). A year later, a pharmacy named Valisure discovered ranitidine contained much higher levels of NDMA than what is considered safe. They submitted these findings to the FDA, which ultimately led to the removal of the medication.
Small amounts of NDMA can be found in food, water, and naturally in the environment. Our bodies can break down small amounts of this chemical without problems. But being exposed to too much can be harmful. The biggest concern with NDMA is that it is a known carcinogen, meaning it may raise your risk of developing cancer.
While studies are ongoing, current research shows people who regularly used ranitidine were diagnosed with breast, testicular, thyroid, or kidney cancer more often than people who used other heartburn medications. However, these reports need to be investigated further before experts can say ranitidine was the definite cause.
Does Zantac 360 have this cancer risk?
Thankfully, Zantac 360 does not carry this potential cancer risk. After discovering NDMA in ranitidine, the FDA requested other H2 blockers be tested for the carcinogen. They found famotidine had no NDMA in it at all. Because it is free of this chemical, there is no current concern of a possible link between Zantac 360 and cancer.
What are the side effects of Zantac 360?
Zantac 360 is very well-tolerated, and most people have no side effects after taking a dose. In clinical studies of famotidine, greater than or equal to 1% of the participants reported headache, dizziness, or constipation.
Some serious but less common side effects may include:
Fever
Palpitations (feeling like your heart is pounding or fluttering)
Elevated liver enzymes
Hallucinations
Rash
Trouble sleeping
If you’re experiencing anything unusual after starting this medication, contact your healthcare provider to discuss alternatives.
How to save on Zantac 360
There are many ways to save on Zantac 360, which is available OTC as both a brand-name and generic medication. GoodRx can help you save over 40% off the average retail price of the generic version. Generic Zantac 360's price at certain pharmacies is less than $5 with a free GoodRx discount.
Keep in mind that the GoodRx coupon may include the name Pepcid AC on it. But it can be applied to any OTC version of famotidine, including generic Zantac 360.
The bottom line
Due to a possible cancer risk, all forms of ranitidine were recalled by the FDA in 2020, including over-the-counter Zantac. This acid reflux medication has finally returned to pharmacy shelves but with a different ingredient called famotidine. The new Zantac 360 provides the same relief as the original and has no known link to cancer. Be sure to look for it in the stomach remedy aisle the next time you need quick heartburn relief.
Why trust our experts?
References
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Tougas, G. et al. (1997). Efficacy of H2 receptor antagonists in the treatment of gastroesophageal reflux disease and its symptoms. Canadian Journal of Gastroenterology and Hepatology.
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