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What if a drug you take causes cancer? - (11/24/2020)

By Dr. Ron Gasbarro

Fred came up to the pharmacy counter and said to the pharmacist. “I heard that Zantac® causes cancer. Do you have something called ranitidine? Is it okay to take for my stomach?” The pharmacist explained that ranitidine is the generic for Zantac, and both were taken off the market after 37 years. Back in 1983, the Food and Drug Administration (FDA) green-lit the medication for heartburn and to prevent ulcers. By 1988, Zantac has become the world’s best-selling prescription drug. In 2004, Zantac was sold over-the-counter (OTC), making it available to every person on the planet. Billions of bucks were made. Life was good for the world’s tummies. 

However, in the mid-2010s, researchers found that Zantac contained a dangerous carcinogen, NDMA (N-nitrosodimethylamine). NDMA can cause cancer of the liver, stomach, and lung. In early 2020, the FDA requested that all merchants stop selling Zantac and ranitidine products. Alarmingly, the FDA also revealed that the longer a box sat on the store shelf, the more NDMA was found in each tablet.

NDMA forms during the manufacturing process of certain drugs. NDMA is the same agent that led to a widespread recall in 2018 of the blood pressure drugs valsartan and losartan. This recall stemmed from a new manufacturing process first used by a factory in China. Will you get cancer from these drugs? Maybe. But you would be foolish to keep taking them despite these warnings, mainly because there are safer drugs you can use instead. Ask your pharmacist.  

While the products mentioned above have been on the market for many years, newer drugs can be similarly problematic. In 2020, the weight-loss medication Belviq® (lorcaserin), introduced to the market in 2012, was withdrawn from the market per the FDA. This recall was based on new data showing that those who had taken the drug in a clinical trial had a spike in various solid tumors within five years after the trial ended.

Should you sue the drug manufacturer if you get cancer from a medication? In the case of Zantac, because the drug has been on the market for decades, proving it caused cancer would be difficult. Conversely, suppose you took the relatively newer Belviq and developed cancer after you started taking the drug. In that case, you have a better chance of receiving compensation. Some medications are still prescribed despite their dangers. Consider certain diabetes medications: Patients who take Actos® (pioglitazone) have a higher risk of bladder cancer. Those who take Victoza® (liraglutide) have a higher risk of thyroid cancer. Yet, they are still on the market. Why? In the case of Actos, no other drugs in that drug class exist. A prescriber is unlikely to write for it. Patients who take Victoza must be checked for thyroid cancer for 15 years after they start the drug. If you have not died by then, you should be fine! In both cases, the benefits of successfully controlling blood glucose outweigh the risks. 

How do you protect yourself? First, look at the drug’s package insert. If it has a Black Box warning at the top of the PI, confer with a health care provider. If you feel a drug has harmed you, enlist the help of a lawyer who specializes in personal damage suits. Such lawyers often advertise on TV and in magazines. Listen for drug recalls. In Fred’s case, several other drugs can help with his stomach woes. Do NOT stop taking any medication without checking with your doctor. Get evaluated for any sudden abnormalities. Incidences of cancer are rare, yet they do exist.

Ron Gasbarro, PharmD, is a registered pharmacist, medical writer, and principal at Rx-Press.

 


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