Last Updated: August 9, 2026

CLINICAL TRIALS PROFILE FOR ZANTAC 75


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505(b)(2) Clinical Trials for ZANTAC 75

This table shows clinical trials for potential 505(b)(2) applications. See the next table for all clinical trials
Trial Type Trial ID Title Status Sponsor Phase Start Date Summary
OTC NCT00443963 ↗ Total Antioxidant Effects of Esomeprazole in Dyspeptic Patients Receiving Non-steroidal Anti-inflammatory Drugs Withdrawn AstraZeneca Phase 4 2006-12-01 The principal investigator hypothesizes that participants receiving NSAID drugs with dyspeptic symptoms have increased production of gastric levels of free radicals. The primary objective of the study is to determine if Esomeprazole Magnesium increases gastric total antioxidant capacity and decreases gastric free radical production in humans. Participants (age 18 years and older) with no history of upper GI bleeding who are receiving non-steroidal anti-inflammatory drugs and then develop dyspepsia will be recruited from our primary care clinic in Washington, DC. All eligible participants will undergo biopsies of antrum and corpus. The participants will be randomized to receive either Zantac OTC or Nexium for 15 days. On day 15, all participants will undergo repeat upper endoscopy to obtain biopsies of antrum and corpus. Tissue samples will then be extracted to determine total antioxidant capacity and lipid peroxide levels (as an indirect marker of free radical production).
OTC NCT00443963 ↗ Total Antioxidant Effects of Esomeprazole in Dyspeptic Patients Receiving Non-steroidal Anti-inflammatory Drugs Withdrawn Medstar Health Research Institute Phase 4 2006-12-01 The principal investigator hypothesizes that participants receiving NSAID drugs with dyspeptic symptoms have increased production of gastric levels of free radicals. The primary objective of the study is to determine if Esomeprazole Magnesium increases gastric total antioxidant capacity and decreases gastric free radical production in humans. Participants (age 18 years and older) with no history of upper GI bleeding who are receiving non-steroidal anti-inflammatory drugs and then develop dyspepsia will be recruited from our primary care clinic in Washington, DC. All eligible participants will undergo biopsies of antrum and corpus. The participants will be randomized to receive either Zantac OTC or Nexium for 15 days. On day 15, all participants will undergo repeat upper endoscopy to obtain biopsies of antrum and corpus. Tissue samples will then be extracted to determine total antioxidant capacity and lipid peroxide levels (as an indirect marker of free radical production).
OTC NCT03145012 ↗ Histamine Receptor 2 Antagonists as Enhancers of Anti-Tumour Immunity Unknown status Dalhousie University Phase 4 2018-05-01 The immune response against tumors can be highly effective in preventing tumor development, growth and metastasis under certain circumstances. However, tumor associated immune suppression can profoundly limit the impact of natural tumor immunity and also reduce the effectiveness of tumor immunotherapy strategies. A major component of tumor associated immune suppression is mediated by myeloid cells, especially the monocytic subset of myeloid derived suppressor cells (MDSC). In recent studies that were conducted through a CCSRI Innovation grant, the investigators discovered that oral treatment of mice with the commonly used histamine receptor 2 (H2) antagonists ranitidine or famotidine inhibits both primary breast tumor development and metastasis, in three distinct mouse tumor models and reduces the numbers of monocytic MDSC. These findings have enormous potential to aid in effective cancer immunotherapy and may have immediate implications for cancer patients. The objective of this investigation is to determine whether treatment with the H2 receptor antagonist ranitidine alters immune suppression, through modulation of immune cell populations. The investigators will examine peripheral blood monocyte, neutrophil and NK cell numbers, subsets and activation status from healthy volunteers treated for 6 weeks with daily oral ranitidine. Ranitidine is widely available and used over the counter in Canada. These drugs are widely recognized as safe, well tolerated and have very few side effects. It has been suggested that among the general population, over 10% of those over the age of 65 take such medications on a regular basis for relief against gastrointestinal discomfort. The outcome of pre-clinical studies in mice warrant further investigation into transferability to humans. If the outcome of the current proposal proves to be viable, then these drugs could provide a safe method to reduce tumor associated immunosuppression with broad implications, both for current cancer patients and for those at high risk of developing cancer. Further to this, the outcome of our proposal may provide a new strategy for improving the effectiveness of T-cell mediated immunotherapy.
OTC NCT03145012 ↗ Histamine Receptor 2 Antagonists as Enhancers of Anti-Tumour Immunity Unknown status Nova Scotia Health Authority Phase 4 2018-05-01 The immune response against tumors can be highly effective in preventing tumor development, growth and metastasis under certain circumstances. However, tumor associated immune suppression can profoundly limit the impact of natural tumor immunity and also reduce the effectiveness of tumor immunotherapy strategies. A major component of tumor associated immune suppression is mediated by myeloid cells, especially the monocytic subset of myeloid derived suppressor cells (MDSC). In recent studies that were conducted through a CCSRI Innovation grant, the investigators discovered that oral treatment of mice with the commonly used histamine receptor 2 (H2) antagonists ranitidine or famotidine inhibits both primary breast tumor development and metastasis, in three distinct mouse tumor models and reduces the numbers of monocytic MDSC. These findings have enormous potential to aid in effective cancer immunotherapy and may have immediate implications for cancer patients. The objective of this investigation is to determine whether treatment with the H2 receptor antagonist ranitidine alters immune suppression, through modulation of immune cell populations. The investigators will examine peripheral blood monocyte, neutrophil and NK cell numbers, subsets and activation status from healthy volunteers treated for 6 weeks with daily oral ranitidine. Ranitidine is widely available and used over the counter in Canada. These drugs are widely recognized as safe, well tolerated and have very few side effects. It has been suggested that among the general population, over 10% of those over the age of 65 take such medications on a regular basis for relief against gastrointestinal discomfort. The outcome of pre-clinical studies in mice warrant further investigation into transferability to humans. If the outcome of the current proposal proves to be viable, then these drugs could provide a safe method to reduce tumor associated immunosuppression with broad implications, both for current cancer patients and for those at high risk of developing cancer. Further to this, the outcome of our proposal may provide a new strategy for improving the effectiveness of T-cell mediated immunotherapy.
>Trial Type >Trial ID >Title >Status >Phase >Start Date >Summary

All Clinical Trials for ZANTAC 75

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00030992 ↗ BMS 247550 to Treat Kidney Cancer Completed National Cancer Institute (NCI) Phase 2 2002-02-01 This study will examine whether the experimental drug BMS 247550 (Ixabepilone) is an effective treatment for kidney cancer. BMS 247550 belongs to a class of drugs called epothilones that interfere with the ability of cancer cells to divide. In the way they kill cells, they are very similar to a class of compounds known as the taxanes, which include the drug Taxol. Other characteristics of the epothilones, however, enable them to work in cells that are resistant to Taxol. Patients 18 years of age or older with kidney cancer that has not spread to the central nervous system (unless the brain tumor has remained stable for at least six months after surgical or radiation treatment) may be eligible for this study. Pregnant or nursing women may not participate. Candidates are screened with various tests that may include blood and urine tests, electrocardiogram (EKG), and chest x-ray. Computerized tomography (CT) scans or X-rays, and possibly nuclear medicine studies may be done to determine the extent of disease. Participants receive BMS 247550 by a 1-hour infusion into a vein for 5 consecutive days (days 1, 2, 3, 4 and 5) of each 21-day treatment cycle. Patients must stay in the National Institutes of Health (NIH) area near Bethesda, Maryland, for 7 to 8 days during the first treatment cycle and for the 5 days of treatment in subsequent cycles. The total number of cycles will vary among patients, depending on their individual clinical situation. The drug dose may be increased gradually in subsequent cycles in patients who can tolerate such increases. In addition, participants undergo the following tests and procedures: - Periodic physical examinations and frequent blood tests - X-ray and other imaging studies to determine if the tumor is responding to the treatment. - Tumor biopsies to confirm the diagnosis or spread of tumor and to examine the reaction of certain proteins in cancer cells to BMS 247550. Two biopsies will be done. For this procedure, a small piece of tumor tissue is withdrawn through a needle under local anesthetic. Treatment will be stopped in patients whose tumor grows while receiving BMS 247550. Patients whose tumor disappears completely will be followed at NIH periodically for examinations and tests. Patients whose disease does not completely resolve or whose disease recurs may be advised of other appropriate research protocols at NIH or, if none are available, will be returned to the care of their local doctor.
NCT00223691 ↗ Treatment of Orthostatic Hypotension in Autonomic Failure Completed Vanderbilt University Phase 1 2002-03-01 The autonomic nervous system serves multiple regulatory functions in the body, including the regulation of blood pressure and heart rate, gut motility, sweating and sexual function. There are several diseases characterized by abnormal function of the autonomic nervous system. Medications can also alter autonomic function. Impairment of the autonomic nervous system by diseases or drugs may lead to several symptoms, including blood pressure problems (e.g., high blood pressure lying down and low blood pressure on standing), sweating abnormalities, constipation or diarrhea and sexual dysfunction. Because treatment options for these patients are limited. We propose to study patients autonomic failure and low blood pressure upon standing and determine the cause of their disease by history and examination and their response to autonomic testing which have already been standardized in our laboratory. Based on their possible cause, we will tests different medications that may alleviate their symptoms.
NCT00223691 ↗ Treatment of Orthostatic Hypotension in Autonomic Failure Completed Vanderbilt University Medical Center Phase 1 2002-03-01 The autonomic nervous system serves multiple regulatory functions in the body, including the regulation of blood pressure and heart rate, gut motility, sweating and sexual function. There are several diseases characterized by abnormal function of the autonomic nervous system. Medications can also alter autonomic function. Impairment of the autonomic nervous system by diseases or drugs may lead to several symptoms, including blood pressure problems (e.g., high blood pressure lying down and low blood pressure on standing), sweating abnormalities, constipation or diarrhea and sexual dysfunction. Because treatment options for these patients are limited. We propose to study patients autonomic failure and low blood pressure upon standing and determine the cause of their disease by history and examination and their response to autonomic testing which have already been standardized in our laboratory. Based on their possible cause, we will tests different medications that may alleviate their symptoms.
NCT00233935 ↗ Defined Green Tea Catechin Extract in Preventing Esophageal Cancer in Patients With Barrett's Esophagus Completed National Cancer Institute (NCI) Phase 1 2005-11-01 The goal of this clinical research study is to test the safety of defined green tea catechin extract at different dose levels. Researchers also want to find out what effects, good and bad, it may have on individual and their risk for esophagus cancer. Esophagus cancer is an increased risk associated with Barrett's esophagus. Chemoprevention is the use of certain drugs to keep cancer from forming, growing, or coming back. The use of defined green tea catechin extract may prevent esophageal cancer.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for ZANTAC 75

Condition Name

Condition Name for ZANTAC 75
Intervention Trials
Healthy 2
NSAID Associated Gastric Ulcers 2
Barrett Esophagus 1
Peptic Ulcers 1
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Condition MeSH

Condition MeSH for ZANTAC 75
Intervention Trials
Ulcer 3
Stomach Ulcer 2
Hypotension 2
Nausea 1
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Clinical Trial Locations for ZANTAC 75

Trials by Country

Trials by Country for ZANTAC 75
Location Trials
United States 12
Canada 2
Pakistan 2
United Kingdom 1
Egypt 1
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Trials by US State

Trials by US State for ZANTAC 75
Location Trials
Maryland 3
Texas 2
Utah 1
California 1
Massachusetts 1
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Clinical Trial Progress for ZANTAC 75

Clinical Trial Phase

Clinical Trial Phase for ZANTAC 75
Clinical Trial Phase Trials
Phase 4 5
Phase 3 3
Phase 2 6
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Clinical Trial Status

Clinical Trial Status for ZANTAC 75
Clinical Trial Phase Trials
Completed 13
Withdrawn 4
Terminated 2
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Clinical Trial Sponsors for ZANTAC 75

Sponsor Name

Sponsor Name for ZANTAC 75
Sponsor Trials
National Cancer Institute (NCI) 3
AstraZeneca 3
M.D. Anderson Cancer Center 2
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Sponsor Type

Sponsor Type for ZANTAC 75
Sponsor Trials
Other 18
Industry 7
NIH 4
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Last updated: July 28, 2026

Zantac 75 (ranitidine 75 mg) clinical trials update, market analysis and future projection

Executive summary: Zantac 75 is ranitidine 75 mg (H2 receptor antagonist). Across major markets, ranitidine has been withdrawn or had marketing suspended following NDMA (N-nitrosodimethylamine) contamination findings and subsequent regulatory actions. As a result, there is no credible near-to-mid term market runway for “Zantac 75” new commercialization, and clinical-trial activity is not a live development pipeline in the way typical active lifecycle drugs are. Any forward demand is limited to remaining inventory, re-claims in jurisdictions where it was not fully withdrawn, and indirect use via generics where permitted.


What happened to Zantac 75 (ranitidine 75 mg) after NDMA contamination?

Short answer: Ranitidine products, including 75 mg dosing formats, were removed from market or suspended in multiple jurisdictions due to NDMA impurity risk, which shut down routine prescribing and new supply.

Regulatory actions that define Zantac 75 market reality

  • US (FDA): FDA requested withdrawal of ranitidine from the market in 2019, citing NDMA impurity concerns (FDA communication regarding ranitidine NDMA risk and withdrawal requests). The US position effectively ended new availability for ranitidine products, including 75 mg presentations.
  • UK/EU: Multiple EU member states implemented withdrawals or suspensions following NDMA findings and follow-on regulatory work tied to impurity risk.
  • Other countries: Many jurisdictions followed with recalls, suspensions, or restrictions.

Implication for market projection: Even if trial activity existed for improved formulations, the core NDMA safety driver and broad withdrawal actions mean commercial timelines are not aligned with standard “patent-to-profit” modeling. The bottleneck is market authorization and supply legality, not trial completion.


Is there any current clinical trial pipeline for Zantac 75 ranitidine 75 mg?

Short answer: There is no meaningful active development pipeline identifiable for “Zantac 75” specifically as an ongoing, drug-discovery or reformulation program in the current market-access sense. Ranitidine’s status has shifted from mainstream use to withdrawal-era legacy availability, with trials largely discontinued or deprioritized.

What “clinical trials update” looks like for a withdrawn product

For withdrawn products, the remaining trial footprint is typically limited to:

  • observational work on prescribing patterns before withdrawal
  • stability, impurity, or analytical method comparisons
  • re-evaluation of NDMA risk factors across manufacturing and storage conditions
  • historical dataset publication rather than late-stage registration trials

These activities do not translate into a near-term “Zantac 75 market re-entry” timeline.


When does ranitidine regain FDA market exclusivity or re-approval?

Short answer: There is no reinstatement timeline for Zantac 75 ranitidine that reverses the post-2019 NDMA withdrawal posture in the US.

Why exclusivity modeling breaks

For a product with halted marketing authorization, exclusivity calculations (patent expiry, data exclusivity, 505(b)(2) exclusivity) become secondary to whether FDA will permit the product to be marketed. Once the regulatory pathway is blocked at the product-safety and approval-status level, exclusivity cannot recreate market access.


What is the Orange Book status of Zantac 75 (ranitidine 75 mg)?

Short answer: The Orange Book is not a meaningful forecasting tool for Zantac 75 market prospects because ranitidine products were withdrawn or effectively stopped from being marketed in the US. Any Orange Book listings that existed historically do not override the post-withdrawal marketing reality.

Featured-snippet summary

  • Orange Book utility for “when generic can launch”: limited, because market launch is constrained by withdrawn authorization and regulatory posture, not solely patent landscapes.
  • Practical market factor: availability is governed by whether FDA permits marketing of ranitidine products at all, not by Orange Book exclusivity alone.

How does Zantac 75 compare with alternatives for acid suppression (famotidine, cimetidine, PPIs)?

Short answer: The commercial replacement for ranitidine has been:

  • famotidine (another H2 receptor antagonist)
  • proton pump inhibitors (PPIs) (omeprazole, lansoprazole, pantoprazole) for GERD and ulcer prophylaxis
  • antacids and alginates for milder, episodic use

Market substitution mechanism

Zantac 75 demand was structurally redirected to therapies that did not share the same NDMA-driven withdrawal event. This reduces the plausibility of a ranitidine relaunch capturing prior volumes.


How many patents cover ranitidine 75 mg and what is their litigation relevance now?

Short answer: Patent estates for legacy ranitidine products are largely irrelevant to current commercialization because regulatory withdrawal dominates market viability.

What still matters for litigation strategy

If a company is litigating around historical ranitidine products, relevance can remain in:

  • indemnification disputes
  • distribution contracts and recall liabilities
  • product liability in legacy contexts
  • infringement suits tied to pre-withdrawal formulations

Those are not the same as active “generic entry risk” for a live platform drug.


What generic entry risks exist for Zantac 75 after withdrawal?

Short answer: “Generic entry risk” is primarily a “permission-to-market risk,” not a patent challenge risk. Where ranitidine remains withdrawn/suspended, generic launch is not a typical Paragraph IV pathway question.

Paragraph IV dynamics

  • If the drug is not authorized for marketing in a jurisdiction, Paragraph IV challenges do not operate like they do for currently marketed products.
  • If some jurisdictions permit ranitidine, generic risk is still constrained by impurity and manufacturing controls, because NDMA formation is the core safety driver.

What settlements or Paragraph IV litigation affected ranitidine products?

Short answer: In the ranitidine post-withdrawal era, litigation has tended to center on safety and recall-related issues rather than routine ANDA Paragraph IV resolution that drives a predictable generic launch calendar.

Commercial relevance

Settlement activity can affect:

  • liability and cost of goods
  • inventory destruction or buyback economics
  • brand/generic contract risk allocation

It does not restore a sustainable market base.


What do NDMA risk-control requirements imply for future ranitidine formulations?

Short answer: Any future ranitidine product would need robust controls to prevent NDMA formation and exposure across:

  • manufacturing impurities
  • storage time and temperature
  • packaging and stability
  • analytical release testing

Operational barrier

Even if a formulation is chemically “stable,” NDMA risk is often formation-and-storage dependent. That makes product viability contingent on stability-validated NDMA control.


Zantac 75 market analysis: current demand drivers and revenue exposure

Executive takeaway: Zantac 75 has limited revenue exposure going forward because mainstream demand routes are cut off by regulatory withdrawal. Near-term revenue, if any, is inventory- and jurisdiction-dependent.

Demand drivers that still exist

  • remaining supply in certain markets (if any availability persists)
  • substitution prescriptions that replaced ranitidine
  • consumer purchasing of legacy product where still legal
  • parallel import and remaining distribution channels

Revenue projection logic

A workable projection model is not “trial-to-launch.” It is:

  1. jurisdiction-level permission to market
  2. remaining inventory sell-through
  3. ongoing substitution by other acid-suppressing classes
  4. regulatory monitoring tightening, which can further restrict any residual availability

Market projection scenarios for Zantac 75 (ranitidine 75 mg)

Short answer: The base case is continued decline toward zero demand in major markets; any positive scenario is limited to niche jurisdictions with permitted sales and remaining stock.

Scenario table (high level, market-access driven)

Scenario Market access status Expected trajectory Revenue outlook for “Zantac 75”
Base case US and major EU markets remain withdrawn/suspended Persistent decline, limited new supply Minimal to negligible
Residual inventory Permitted in select jurisdictions with remaining channel inventory Short sell-through window Small, time-limited
Local re-authorization Rare, would require regulatory pathway + NDMA risk mitigation Potential re-entry only after approval Unlikely in near term
Replacement acceleration PPIs and famotidine capture remaining H2/GI demand Substitution continues Further headwinds to ranitidine share

Geographic outlook: where could Zantac 75 still be relevant commercially?

Short answer: Relevance is constrained to jurisdictions where marketing was not fully withdrawn or where re-approval occurred.

How to think about country exposure

  • High exposure: markets with permissive authorization status for ranitidine post-2019 (if any).
  • Low exposure: markets that followed with withdrawal or suspension.
  • Watch list behavior: any country re-evaluating NDMA controls could tighten distribution.

Given the regulatory emphasis on NDMA impurity risk, the default expectation is continued restriction globally.


Key takeaways

  • Zantac 75 (ranitidine 75 mg) is effectively a post-withdrawal legacy product in major markets after NDMA-related regulatory actions.
  • Clinical trial momentum for “Zantac 75” is not a practical pathway for near-term commercialization. Remaining trial activity, where present, is not aligned with re-entry timelines.
  • Market projection is supply-and-permission driven, not patent and exclusivity driven.
  • Replacement by famotidine and PPIs structurally reduces the addressable demand pool for ranitidine.

FAQs

1) Is Zantac 75 still sold in the United States?
US ranitidine marketing was requested for withdrawal following FDA’s NDMA concerns in 2019.

2) Are there active ANDA or Paragraph IV challenges tied to ranitidine 75 mg?
Where ranitidine is withdrawn or suspended, typical Paragraph IV “generic launch” mechanics are not the dominant issue; permission-to-market and NDMA controls dominate.

3) What alternatives work best for GERD now that ranitidine is withdrawn?
Clinicians generally pivot to PPIs (omeprazole/lansoprazole class) and to famotidine for H2-based therapy.

4) Could ranitidine return to market with improved NDMA controls?
Only a regulatory re-approval pathway with validated NDMA risk controls could permit re-market; that is not a predictable near-term outcome.

5) What is the main technical barrier for ranitidine products post-NDMA?
NDMA formation and exposure risk across manufacturing, stability, and storage conditions, requiring rigorous analytical release and validated controls.


References (APA)

  1. U.S. Food and Drug Administration. (2019). FDA requests removal of ranitidine products (Zantac) from the market. FDA. https://www.fda.gov/
  2. European Medicines Agency. (2019). Press release / assessment updates on ranitidine medicines due to NDMA impurities. EMA. https://www.ema.europa.eu/

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