In December 2022, the judge overseeing consolidated Zantac cases in federal multidistrict litigation (MDL) dismissed over 50,000 lawsuits, ruling that the scientific evidence linking the popular heartburn drug to various types of cancers was weak. However, more than 100,000 Zantac cases are pending in state courts, mainly in California, Delaware, Illinois and New York. 

An MDL is a litigation of similar cases that prevents U.S. district courts from being overwhelmed. The dismissal from an MDL is not an indication that the defendant is correct, but simply that the MDL was not the correct venue to litigate those claims.

Zantac lawsuits involve allegations that the drug’s active ingredient, ranitidine, breaks down over time and with heat exposure into a potentially carcinogenic compound, N-Nitrosodimethylamine or NDMA. The plaintiffs allege that the amount of NDMA in Zantac is several times higher than the safe upper limit set forth by the U.S. Food & Drug Administration (FDA). 

The five types of cancer that plaintiffs in the dismissed federal lawsuits alleged they developed because of taking Zantac are esophageal, bladder, stomach, liver, and pancreatic. In addition to these cancers, in state lawsuits, plaintiffs have claimed other types of cancer.

In July, the first state Zantac case is scheduled for trial (Goetz v. GlaxoSmithKline) in California. The judge who will proceed over the trial issued a ruling in March that allowed the plaintiff's experts' testimonies to testify on the link between ranitidine and cancer. Judge Evelio Grillo’s ruling, however, did not weigh in on whether the evidence establishes conclusive causation. 

The Goetz case will be the first Zantac bellwether trial, which will help establish a precedent for future cases. The main reason why Zantac trials were dismissed at the federal level but remain active on the state level is that federal courts require more rigorous evidentiary standards than state courts. 

The court in James Goetz’s lawsuit will consider several issues, including whether ranitidine degrades to NDMA outside or inside the body, whether NDMA generally causes cancer, whether Goetz consumed significant doses of NDMA, and whether the NDMA from ranitidine specifically caused the plaintiff's bladder cancer.

In 2020, the FDA recalled all ranitidine products from the market. Zantac is now back on the market with a different active ingredient, famotidine.