A large sample size means less if the problems are longer-term in nature such as an increase in cancer rates down the road or problems with fertility, which might take more time to fully detect and understand.
And a large sample size means little without a control group: yet if some people had their way, there'd be no control group left.
Of course, catching covid may also have unknown long term side effects, like how some who caught Spanish flu went on to develop encephalitis lethargica.
Vaccinated or not you're part of what is effectively the largest post marketing clinical study, either as the treatment or control group. Science is fun like that.
Also each company is independent.
If we had this much money and this many eyes on studying and testing Zantac, I have no doubt they wouldn't have been able to keep the cancer risks secret.
And the linked article says:
> Valisure discovered the link of Zantac and its generics to the carcinogen NDMA during its routine testing of every batch of every medication, and first notified the FDA of its initial findings in June of 2019. On September 13th, Valisure filed a detailed petition with the Food and Drug Administration asking the agency to recall all products containing ranitidine.
How in the world is it profitable for an online pharmacy to do this? It's great, but honestly who would pay extra to an online pharmacy to do this testing? Would most people even believe an online pharmacy that said that they did such testing? I'd love to know how they survive.
This means that they have to do some inbound quality control to ensure that what they believe they are selling really is what they are selling.
Note that ValisureRx (consumer pharmacy that dispensed lot-tested drugs) was sold to Medley Pharmacy, which just folded. Valisure is now just a testing lab.
Finally, it's not just a chain of custody thing. Even big generic brands and name-brands source a huge amount of active pharmaceutical ingredients (APIs) from China and India.
I suspect it's not that they go out of their way to do extra testing, it's that they don't necessarily trust suppliers but willing to eat the cost of testing + risk of bad inputs because they still net ahead compared to more reputable but expensive suppliers.
As of 2021, it appears they pivoted to running the lab as a service for other companies. I found one online pharmacy that was using Valisure (Medly.com) but it appears to have gone bankrupt, assets acquired by Walgreens and shut down.
https://www.businessinsider.com/walgreens-buys-medly-pharmac...
Its hot enough to chemically alter things, activate diffusions, speed bacterial growth, etc.
Its not hot enough to sterilize what you're ingesting.
(sadly before the era of camera phones, but the needle crystals really did look neat. The contents of the bottle were not ingested.)
Interestingly, all the Southern grannies knew this: they distrusted ice and made their tea with a pinch of baking soda, although this does change the flavor a bit.
Luckily I don't like sweet tea or other full sugar drinks (you can pry diet coke from my dead hands). Hadn't heard about the ice thing though.
My biggest triggers are fatty foods, tomato, chocolate, and palm oil.
https://www.chemistryworld.com/news/judge-dismisses-ranitidi...
If they could find a way to ensure the impurity didn’t exist, I would certainly buy ranitidine again. I found it was the most effective antacid for me.
Further, one judge is not an arbiter of whether science is sound or not. In fact, the American legal system is infamous for its persistent reliance on fraudulent forensic techniques even well after there's widespread consensus that they're unreliable if not outright fraudulent.
Polygraphs, writing analysis, fiber analysis, hair analysis, fingerprint analysis, drug-sniffing dogs...all have long been found to be far less reliable than courts treat them to be.
The latter is probably the most egregious example, with the Supreme Court agreeing that such dogs are actually worse than a coin flip in terms of correctly indicating a "hit" on drugs...and then shrugged and said dogs were still a valid legal basis for further, more invasive searching.
1: "Anticholinergic Accumulation: A Slumbering Interaction between Drugs and Food Supplements" https://onlinelibrary.wiley.com/doi/full/10.1111/bcpt.12437
2: Chart of medicines with high ACB scores (higher is worse) - you will recognize some of these, such as allergy and anti-nausea meds: (pdf warning) https://corumpharmacy.com/wp-content/uploads/2020/08/Anticho...
Everything will kill you, no need to get worked up about the infinitesimal risk.
> GSK's leadership was warned on several occasions about the storage issue, but it opted against making any changes to existing plans.
In a way, this makes it worse, because they could have taken action to limit the risk to people, but chose not to, presumably to save money or to avoid bad publicity.
How old your ranitidine would have to be to have too-high NDMA level without higher heat, I haven't seen any specifics around that.
I imagine they could have instead instituted limits about temperature of storage and transport, and chop down the expiration dates, and add big warnings for consumers to actually respect the dates, not keep them in cars, etc... though the market reality that there are several other H2 blockers out there that haven't been shown to have the NDMA issue, not to mention PPIs, likely meant that just pulling ranitidine was the better call.
It's paywalled, but this seems to be referenced by a lot of reports:
https://www.bloomberg.com/news/articles/2020-01-02/carcinoge...
Maybe someone else has the actual source.
That was almost two years ago. This is the first I'm hearing about this. So for all I know, I was exposed to an unknown amount of carcinogen for years without being told anything about it even after that information was discovered.
What's my recourse?
A lawsuit, like the thousands mentioned in the article.
Oh wait. Maybe they would. everything gives you cancer now, doesn't it?
Yes, but only in California
Exposure to some things can cause more mutations or hinder your body's error-correction systems, sometimes to extreme degrees. It is a numbers game, though.
Putting this on GSK means that the people who knowingly sold a cancer-causing drug while hiding the risks get away without any consequences. Given this went on for 40 years, probably a lot of those people are retired, and won't even lose pay, bonuses, share price, etc.
Meanwhile, assuming this leads to any sort of lawsuits, fines, and lost sales, the people who will pay the price if GSK is held responsible will be shareholders, who likely had no visibility into these decisions, and workers who will be laid off, again without having had any role in these decisions.
This system is fundamentally broken. It's not just a small loophole that can be closed: the entire thing is a loophole that allows sociopaths to exit with the profits of wrongdoing while workers and shareholders pay the consequences. We need to stop letting bad people hide behind corporations.
Name the people responsible, and hold them responsible.
In theory shareholders have the power to prevent this sort of thing, but they don't have the visibility into the daily goings on at a company to see when things like this happen.
Likewise, the vast majority of workers had nothing to do with this decision.
In a more general sense, I do think it's healthy to let companies fail rather than subsidizing non-working business models. But as a means of disincentivizing bad behavior, it's totally ineffective.
Pepcid (famotidine) and Tagamet (Cimetidine) are H2 blockers, another class of heartburn medication, that hasn't shown the same issues.
On the other hand, untreated chronic reflux is a big driver for stomach and esophageal cancers. So it's possible that having taken Zantac for a long time was less risky cancer-wise than not taking anything.
The real problem is that they get a slap on the wrist from the regulator and the business continues as usual.
Remember: GSK didn't make an unethical decision, people did. Letting those people hide behind a corporation means that workers and shareholders pay the consequences for decisions that were only made by a few people.
These are the same class of chemicals that are found in cured meat and they are present in an awful lot of food because they are produced during fermentation. Bacon, beer, even a side product of drinking water treatment.
[PDF warning]
it also has the wholesale prices on there.
