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Ranitidine, Zinetac removed from the essential medicines list over cancer concerns

Ranitidine, which is frequently used to treat acid reflux, other stomach-related conditions and is marketed under the brand names Rantac, Zinetac, and Aciloc, has been removed from the National List of Essential Medicines (NLEM) revised by Union Health Minister Mansukh Mandaviya on Tuesday due to concerns that it may cause cancer. 384 medications from 27 categories are also absent from the list.

As a result of the discovery of low levels of N-nitrosodimethylamine (NDMA), the Food and Drug Administration (FDA) had to recall all ranitidine products (both injectable and oral) in 2020. According to a study published in the Indian Journal of Pharmacology, N-nitrosamines are linked to stomach, oesophagus, nasopharynx, and bladder cancers.

The number of medications covered by the NLEM has increased by up to 34, including several anti-infectives like ivermectin, mupirocin, and nicotine replacement treatment.

Fludrocortisone, ormeloxifene, insulin glargine, and teneligliptin, as well as other endocrine medications and contraceptives, were reportedly added to the list. The list also includes the ophthalmological medicine Latanoprost and the respiratory tract medication Montelukast. Dabigatran and Tenecteplase, two cardiovascular drugs, are also mentioned in the PTI story.

In an effort to lower patients’ out-of-pocket expenditure, the health minister also announced a price restriction on widely prescribed medications and stated that several antibiotics, vaccinations, and anti-cancer treatments will now be more inexpensive and accessible. ‘The National List of Essential Medicines is being published today. Based on that… the National Pharma Pricing Authority will set its ceiling price… it is also based on this that it is decided no company increases the price (of essential medicines) on its own. It’s a very long process. All the work is done by an independent committee. Interacted with more than 350 experts and 140 consultations’, Mandaviya said on the new NLEM.

Here is the full list of medicines removed from the NLEM 2022:

1. Alteplase

2. Atenolol

3. Bleaching Powder

4. Capreomycin

5. Cetrimide

6. Chlorpheniramine

7. Diloxanide furoate

8. Dimercaprol

9. Erythromycin

10. Ethinylestradiol

11. Ethinylestradiol(A) + Norethisterone (B)

12. Ganciclovir

13. Kanamycin

14. Lamivudine (A) + Nevirapine (B) + Stavudine (C)

15. Leflunomide

16. Methyldopa

17. Nicotinamide

18. Pegylated interferon alfa 2a, Pegylated interferon alfa 2b

19. Pentamidine

20. Prilocaine (A) + Lignocaine (B)

21. Procarbazine

22. Ranitidine

23. Rifabutin

24. Stavudine (A) + Lamivudine (B)

25. Sucralfate

26. White Petrolatum

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