Risk of cancer with ranitidine or nizatidine?
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Risk of cancer with ranitidine or nizatidine? According to study results reported in Drug Safety, there is no evidence that ranitidine or nizatidine are associated with an increased risk of cancer, although "further studies with more accurate measurement of exposure, inclusion of older people, and longer follow-up may be needed". The study used data from the Japan Medical Data Center (JMDC) administrative claims database in 2005–2018. The 113 745 new users of ranitidine or nizatidine were compared with 503 982 new users of other histamine 2 receptor antagonists (H2 blockers). The probably carcinogenic N-nitrosodiumethylamine (NDMA) has been detected in both ranitidine and nizatidine. A first cancer diagnosis occurred in 2289 ranitidine or nizatidine users, compared with 9038 H2 blocker users (incidence rate 6.39 vs 6.17 per 1000 person-years; adjusted hazard ratio [HR] 1.02; 95% CI 0.98, 1.07). Analyses revealed a comparable cancer risk when comparing cumulative doses, for 1–180 defined daily doses (DDDs; HR 1.03, 0.98, 1.08), 181–365 DDDs (HR 1.00; 0.73, 1.39), 366–730 DDDs (HR 0.95; 0.61, 1.48) or >730 DDDs (HR 083; 0.45, 1.55). However, the authors note that "a relatively small number of people received large cumulative doses", and therefore few people may have been "exposed to a high enough level of NDMA to increase the risk of cancer". Results were also similar for each group when compared by cancer site, length of follow up, or when comparing each drug separately with H2 blockers, or in other analyses. "The results of this study may alleviate concerns about a potential risk of cancer in people exposed to ranitidine/ nizatidine", note the authors. Iwagami M, et al. Risk of Cancer in Association with Ranitidine and Nizatidine vs Other H2 Blockers: Analysis of the Japan Medical Data Center Claims Database 2005-2018. Drug Safety : 27 Nov 2020. Available from: URL: https://doi.org/10.1007/s40264-020-01024-0
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Reactions 12 Dec 2020 No. 1834
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