Emily,

Thank you for question regarding your concerns about the potential effect the following could have on pregnancy. We begin all communication by informing that all pregnancies start with a 4-5% risk for birth defects. This is the general population risk.

Your question is about ranitidine (Zantac) use in pregnancy.
Ranitidine (Zantac) is a histamine H2 antagonist (H2 blocker) used to reduce gastric acidity and approved by the FDA in 1983.  Other related drugs include cimetidine (Tagamet), famotidine (Pepcid), and nizatidine (Axid).  A 1996 cohort study of 178 women who used H2 blockers did not see any increased incidence of birth defects, miscarriages, low birth weight, or prematurity when compared to a similar group of 178 women who used no drugs to reduce gastric acidity.  Seventy-one per cent of the women in this study used ranitidine.

The Swedish Medical Birth Registry published a report in 1998 concerning 547 women who had used a variety of acid suppressing drugs in pregnancy.  Ranitidine was taken by 176 of these women.  Of that group, there were 7 (3.9%) birth defects, with no common pattern.  The frequency of malformations was not increase in combined data from Italian and British databases published in 1999, on 330 infants of mothers who received prescriptions for ranidtidine in the first trimester.  A 1991 Canadian study of 142 women using H2 blockers also did not uncover an increased incidence of birth defects.  Several reports are available on the successful use of ranitidine in labor to prevent gastric acid aspiration (Mendelson’s syndrome).

In summary, the available reports do not suggest ranitidine increases the incidence of birth defects or other adverse outcomes of pregnancy.

It’s flu season! Time to get your annual flu shot! Pregnant women are encouraged to get their seasonal flu shot as well as the H1N1 vaccine. Pregnant women that get the flu are more likely to get pneumonia or end up in the hospital. Prevention is key to staying healthy and protecting your unborn baby. Call your doctors office, tell them that you are pregnant, and ask them about where you can receive your flu shot.

I hope that I have been able to answer your questions and give you some useful information today. One of the things that CTIS also does is follow up with some women who call us to develop better information about the outcome of pregnancy in women who have certain exposures.  If you are eligible for this follow-up program, would you agree to have one of our staff-members call you back on another day and explain more about the program? The follow up program is strictly confidential and free. If you're interested, please e-mail back with your phone number and the best time to reach you.

If you have additional questions and you live in California, we encourage you to call us at 800-532-3749 to receive a more complete response to your concerns. If you live in the U.S. but not California, please call 866-626-6847.

All the above information is an accumulation of facts from the medical literature, which has been evaluated by and discussed with Kenneth Lyons Jones, M.D. of CTIS Pregnancy Risk Information.