these cells function to open and close stomata

these cells function to open and close stomata

Ranitidine

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Ranitidine
Ranitidine.svg
Ranitidine-A-3D-balls.png
Clinical data
Pronunciation /rəˈnɪtɪdn/
Trade names Zantac, others
SynonymsDimethyl [(5-[(2-[1-(methylamino)-
2-nitroethenyl]aminoethyl)sulfanyl]
methylfuran-2-yl)methyl]amine
AHFS / Drugs.com Monograph
MedlinePlus a601106
License data
  • US  FDA :  Ranitidine
Pregnancy
category
  • AU: B1
  • US: B (No risk in non-human studies)
Routes of
administration
By mouth, IV
ATC code
  • A02BA02 ( WHO )
    A02BA07 ( WHO ) (ranitidine bismuth citrate)
Legal status
Legal status
  • AU: S2 (Pharmacy only)
  • UK: General sales list (GSL, OTC)
  • US: OTC / Rx-only
Pharmacokinetic data
Bioavailability 50% (by mouth) [1]
Protein binding 15%
Metabolism Hepatic : FMOs , including FMO3 ; other enzymes
Onset of action 55–65 minutes (150 mg dose) [2]
55–115 minutes (75 mg dose) [2]
Elimination half-life 2–3 hours
Excretion 30–70% Renal
Identifiers
IUPAC name
  • N-(2-[(5-[(dimethylamino)methyl]furan-2-yl)methylthio]ethyl)-N’-methyl-2-nitroethene-1,1-diamine
CAS Number
  • 66357-35-5  ☑Y
PubChem CID
  • 3001055
IUPHAR/BPS
  • 1234
DrugBank
  • DB00863  ☑Y
ChemSpider
  • 4863  ☒N
UNII
  • 884KT10YB7
KEGG
  • D00422  ☑Y
ChEBI
  • CHEBI:8776  ☒N
ChEMBL
  • ChEMBL1790041  ☒N
ECHA InfoCard 100.060.283 Edit this at Wikidata
Chemical and physical data
Formula C13H22N4O3S
Molar mass 314.4 g/mol
3D model ( JSmol )
  • Interactive image
SMILES
  • [O-][N+](=O)C=C(NC)NCCSCc1ccc(o1)CN(C)C
InChI
  • InChI=1S/C13H22N4O3S/c1-14-13(9-17(18)19)15-6-7-21-10-12-5-4-11(20-12)8-16(2)3/h4-5,9,14-15H,6-8,10H2,1-3H3 ☒N
  • Key:VMXUWOKSQNHOCA-UHFFFAOYSA-N ☒N

 ☒N☑Y  (what is this?)    (verify)

Ranitidine, sold under the trade name Zantac among others, is a medication which decreases stomach acid production. [1] It is commonly used in treatment of peptic ulcer disease , gastroesophageal reflux disease , and Zollinger–Ellison syndrome . [1] There is also tentative evidence of benefit for hives . [3] It can be taken by mouth, by injection into a muscle , or into a vein . [1]

Common side effects include headaches and pain or burning if given by injection. [1] Serious side effects may include liver problems, a slow heart rate , pneumonia , and the potential of masking stomach cancer . [1] It is also linked to an increased risk of Clostridium difficile colitis . [4] It is generally safe in pregnancy . [1] Ranitidine is an H2 histamine receptor antagonist that works by blocking histamine and thus decreasing the amount of acid released by cells of the stomach. [1]

Ranitidine was discovered in 1976 and came into commercial use in 1981. [5] It is on the World Health Organization’s List of Essential Medicines , the most effective and safe medicines needed in a health system . [6] It is available as a generic medication. [1] The 2015 wholesale price in the developing world was about US$0.01–0.05 per pill. [7] In the United States it is about $0.05 per dose. [1]

Contents

  • 1 Medical uses
    • 1.1 Preparations
    • 1.2 Dosing
  • 2 Contraindication
  • 3 Adverse effects
    • 3.1 Central nervous system
    • 3.2 Cardiovascular
    • 3.3 Gastrointestinal
    • 3.4 Liver
    • 3.5 Lungs
    • 3.6 Blood
    • 3.7 Skin
  • 4 Warnings and precautions
    • 4.1 Disease-related concerns
    • 4.2 Pregnancy
    • 4.3 Lactation
    • 4.4 Children
    • 4.5 Drug tests
  • 5 Pharmacology
    • 5.1 Mechanism of action
    • 5.2 Pharmacokinetics
      • 5.2.1 Elderly
      • 5.2.2 Children
  • 6 History
  • 7 See also
  • 8 References
  • 9 External links

Medical uses[ edit ]

  • Relief of heartburn
  • Short-term and maintenance therapy of gastric and duodenal ulcers
  • Ranitidine can also be given with NSAIDs to reduce the risk of ulceration. Proton-pump inhibitors (PPIs) are more effective for the prevention of NSAID-induced ulcers. [8]
  • Pathologic gastrointestinal (GI) hypersecretory conditions such as Zollinger–Ellison syndrome
  • Gastroesophageal reflux disease (GERD)
  • Erosive esophagitis
  • Part of a multidrug regimen for Helicobacter pylori eradication to reduce the risk of duodenal ulcer recurrence
  • Recurrent postoperative ulcer
  • Upper GI bleeding
  • Prevention of acid-aspiration pneumonitis during surgery: ranitidine can be administered preoperatively to reduce the risk of aspiration pneumonia. The drug increases gastric pH , but generally has not effect on gastric volume. In a 2009 meta-analysis comparing the net benefit of proton pump inhibitors and ranitidine to reduce the risk of aspiration before anesthesia, ranitidine was found to be more effective than proton pump inhibitors in reducing the volume of gastric secretions. [9] Ranitidine may have an antiemetic effect when administered preoperatively.
  • Prevention of stress-induced ulcers in critically ill patients [10]
  • Used together with diphenhydramine as secondary treatment for anaphylaxis ; after first-line epinephrine . [11] [12]

Preparations[ edit ]

Certain preparations of ranitidine are available over the counter (OTC) in various countries. In the United States, 75- and 150-mg tablets are available OTC. Zantac OTC is manufactured by Sanofi Consumer Healthcare. (Previously manufactured by Boehringer Ingleheim) In Australia and the UK, packs containing seven or 14 doses of the 150-mg tablet are available in supermarkets, small packs of 150-mg and 300-mg tablets are schedule 2 pharmacy medicines . Larger doses and pack sizes still require a prescription.

Dosing[ edit ]

For ulcer treatment, a night-time dose is especially important — as the increase in gastric/duodenal pH promotes healing overnight when the stomach and duodenum are empty. Conversely, for treating reflux, smaller and more frequent doses are more effective.

Ranitidine used to be administered long-term for reflux treatment, sometimes indefinitely. However, PPIs have taken over this role. In addition, a fairly rapid tachyphylaxis can develop within six weeks of initiation of treatment, further limiting its potential for long-term use. [13]

People with Zollinger–Ellison syndrome have been given very high doses without any harm. [14]

Contraindication[ edit ]

Ranitidine is contraindicated for patients known to have hypersensitivity to the drug.

Adverse effects[ edit ]

The following adverse effects have been reported as events in clinical trials:

Central nervous system[ edit ]

Rare reports have been made of malaise , dizziness , somnolence , insomnia , and vertigo . In severely ill, elderly patients, cases of reversible mental confusion, agitation, depression, and hallucinations have been reported. [15] Ranitidine causes fewer CNS adverse reactions and drug interactions compared to cimetidine.[ citation needed ]

Cardiovascular[ edit ]

Arrhythmias such as tachycardia , bradycardia , atrioventricular block , and premature ventricular beats have also been reported. [15]

Gastrointestinal[ edit ]

All drugs in its class have the potential to cause vitamin B12 deficiency secondary to a reduction in food-bound vitamin B12 absorption. [16] Elderly patients taking H2 receptor antagonists are more likely to require B12 supplementation than those not taking such drugs. [17] H2 blockers may also reduce the absorption of drugs (azole antifungals, calcium carbonate) that require an acidic stomach. [18] In addition, multiple studies suggest the use of H2 receptor antagonists such as raniditine may increase the risk of infectious diarrhoea, including traveller’s diarrhoea and salmonellosis. [19] [20] [21] [22] [23] Finally, by suppressing acid-mediated breakdown of proteins, ranitidine may lead to an elevated risk of developing food or drug allergies, due to undigested proteins then passing into the gastrointestinal tract, where sensitisation occurs. Patients who take these agents develop higher levels of immunoglobulin E against food, whether they had prior antibodies or not. [24] Even months after discontinuation, an elevated level of IgE in six percent of patients was still found in this study.

Liver[ edit ]

Cholestatic hepatitis, liver failure, hepatitis, and jaundice have been noted, and require immediate discontinuation of the drug. [15] Blood tests can reveal an increase in liver enzymes or eosinophilia , although in rare instances, severe cases of hepatotoxicity may require a liver biopsy . [25]

Lungs[ edit ]

Ranitidine and other histamine H2 receptor antagonists may increase the risk of pneumonia in hospitalized patients. [26] They may also increase the risk of community-acquired pneumonia in adults and children. [27]

Blood[ edit ]

Thrombocytopenia is a rare but known side effect. Drug-induced thrombocytopenia usually takes weeks or months to appear, but may appear within 12 hours of drug intake in a sensitized individual. Typically, the platelet count falls to 80% of normal, and thrombocytopenia may be associated with neutropenia and anemia . [28]

Skin[ edit ]

Rash, including rare cases of erythema multiforme and rare cases of hair loss and vasculitis have been seen. [15]

Warnings and precautions[ edit ]

Disease-related concerns[ edit ]

With gastric malignancies, relief of symptoms due to the use of ranitidine does not exclude the presence of a gastric malignancy. In addition, with kidney or liver impairment, ranitidine must be used with caution. Finally, ranitidine should be avoided in patients with porphyria , as it may precipitate an attack. [29]

Pregnancy[ edit ]

This drug is rated pregnancy category B in the United States.

Lactation[ edit ]

Ranitidine enters breast milk, with peak concentrations seen at 5.5 hours after the dose in breast milk. Caution should be exercised when prescribed to nursing women. [30]

Children[ edit ]

In children, the use of gastric acid inhibitors has been associated with an increased risk for development of acute gastroenteritis and community-acquired pneumonia. [31] A cohort analysis including over 11,000 neonates reported an association of H2 blocker use and an increased incidence of necrotizing enterocolitis in very-low-birth-weight (VLBW) neonates. [32] In addition, about a sixfold increase in mortality, necrotizing enterocolitis , and infection (such as sepsis , pneumonia , urinary tract infection ) was reported in patients receiving ranitidine in a cohort analysis of 274 VLBW neonates. [33]

Drug tests[ edit ]

Ranitidine may return a false positive on some commercial drug testing kits. [34]

Pharmacology[ edit ]

Mechanism of action[ edit ]

Ranitidine is a competitive, reversible inhibitor of the action of histamine at the histamine H2 receptors found in gastric parietal cells. This results in decreased gastric acid secretion and gastric volume, and reduced hydrogen ion concentration.

Pharmacokinetics[ edit ]

Absorption: Oral: 50%

Protein binding: 15%

Metabolism: N-oxide is the principal metabolite.

Half-life elimination: With normal renal function, ranitidine taken orally has a half-life of 2.5–3.0 hours. If taken intravenously, the half-life is generally 2.0–2.5 hours in a patient with normal creatinine clearance.

Excretion: The primary route of excretion is the urine. In addition, about 30% of the orally administered dose is collected in the urine as non-absorbed drug in 24 hours.

Elderly[ edit ]

In the elderly population, the plasma half-life of ranitidine is prolonged to 3–4 hours secondary to decreased kidney function causing decreased clearance . [35]

Children[ edit ]

In general, studies of pediatric patients (aged 1 month to 16 years) have shown no significant differences in pharmacokinetic parameter values in comparison to healthy adults, when correction is made for body weight. [35]

History[ edit ]

Zantac (ranitidine) 300-mg tablets

Ranitidine was first prepared as AH19065 by John Bradshaw in the summer of 1977 in the Ware research laboratories of Allen & Hanburys , part of the Glaxo organization. [36] [37] Its development was a response to the first in class histamine H2 receptor antagonist, cimetidine , developed by Sir James Black at Smith, Kline and French , and launched in the United Kingdom as Tagamet in November 1976. Both companies would eventually become merged as GlaxoSmithKline following a sequence of mergers and acquisitions starting with the integration of Allen & Hanbury’s Ltd and Glaxo to form Glaxo Group Research in 1979, and ultimately with the merger of Glaxo Wellcome and SmithKline Beecham in 2000. Ranitidine was the result of a rational drug-design process using what was by then a fairly refined model of the histamine H2 receptor and quantitative structure-activity relationships .

Glaxo refined the model further by replacing the imidazole ring of cimetidine with a furan ring with a nitrogen -containing substituent, and in doing so developed ranitidine. Ranitidine was found to have a far-improved tolerability profile (i.e. fewer adverse drug reactions ), longer-lasting action, and 10 times the activity of cimetidine. Ranitidine has 10% of the affinity that cimetidine has to CYP450 , so it causes fewer side effects, but other H2 blockers famotidine and nizatidine have no CYP450 significant interactions. [38]

Ranitidine was introduced in 1981 and was the world’s biggest-selling prescription drug by 1987. It has since largely been superseded by the even more effective proton-pump inhibitors, with omeprazole becoming the biggest-selling drug for many years. When omeprazole and ranitidine were compared in a study of 144 people with severe inflammation and erosions or ulcers of the esophagus, 85% of those treated with omeprazole healed within eight weeks, compared to 50% of those given ranitidine. In addition, the omeprazole group reported earlier relief of heartburn symptoms. [39]

See also[ edit ]

  • Famotidine (trade names Pepcid, Pepcidine) — another popular H2 receptor antagonist
  • Nizatidine

References[ edit ]

  1. ^ a b c d e f g h i j “Ranitidine” . The American Society of Health-System Pharmacists. Archived from the original on 2017-09-09. Retrieved Dec 1, 2015.

  2. ^ a b Gardner JD, Ciociola AA, Robinson M, McIsaac RL (July 2002). “Determination of the time of onset of action of ranitidine and famotidine on intra-gastric acidity”. Aliment. Pharmacol. Ther. 16 (7): 1317–1326. doi : 10.1046/j.1365-2036.2002.01291.x . PMID   12144582 .
  3. ^ Fedorowicz, Z; van Zuuren, EJ; Hu, N (14 March 2012). “Histamine H2-receptor antagonists for urticaria”. The Cochrane Database of Systematic Reviews. 3 (3): CD008596. doi : 10.1002/14651858.CD008596.pub2 . PMID   22419335 .
  4. ^ Tleyjeh, IM; Abdulhak, AB; Riaz, M; Garbati, MA; Al-Tannir, M; Alasmari, FA; Alghamdi, M; Khan, AR; Erwin, PJ; Sutton, AJ; Baddour, LM (2013). “The association between histamine 2 receptor antagonist use and Clostridium difficile infection: a systematic review and meta-analysis” . PLOS ONE. 8 (3): e56498. doi : 10.1371/journal.pone.0056498 . PMC   3587620 . PMID   23469173 .
  5. ^ Fischer, Janos; Ganellin, C. Robin (2006). Analogue-based Drug Discovery . John Wiley & Sons. p. 444. ISBN   9783527607495 . Archived from the original on 2016-12-20.
  6. ^ “WHO Model List of Essential Medicines (19th List)” (PDF). World Health Organization. April 2015. Archived (PDF) from the original on 13 December 2016. Retrieved 8 December 2016.
  7. ^ “Ranitidine” . International Drug Price Indicator Guide. Archived from the original on 10 May 2017. Retrieved 1 December 2015.
  8. ^ “Reflux Remedies: ranitidine” . PharmaSight OTC Health. PharmaSight.org. Archived from the original on 12 January 2013. Retrieved 16 November 2011.
  9. ^ Clark, K.; Lam, L. T.; Gibson, S.; Currow, D. (2009). “The effect of ranitidine versus proton pump inhibitors on gastric secretions: a meta-analysis of randomised control trials”. Anaesthesia. 64 (6): 652–657. doi : 10.1111/j.1365-2044.2008.05861.x . PMID   19453319 .
  10. ^ Dellinger, R. Phillip; et al. (2013). “Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock, 2012” . Intensive Care Medicine. 39 (2): 165–228. doi : 10.1007/s00134-012-2769-8 . PMC   4969965 . PMID   23361625 .
  11. ^ Tang, Angela (October 2003). “A Practical Guide to Anaphylaxis” . American Family Physician. 68 (7): 1325–1332. Archived from the original on 10 January 2017. Retrieved 3 February 2017.
  12. ^ “Anaphylaxis: Diagnosis and Management in the Rural Emergency Department” (PDF). American Journal of Clinical Medicine. Archived (PDF) from the original on 14 August 2016. Retrieved 3 February 2017.
  13. ^ Lightdale, J. R.; Gremse, D. A.; Heitlinger, L. A.; Cabana, M.; Gilger, M. A.; Gugig, R.; Hill, I. D. (2013). “Gastroesophageal reflux: management guidance for the pediatrician”. Pediatrics. 131 (5): e1684–e1695. doi : 10.1542/peds.2013-0421 . PMID   23629618 .
  14. ^ “Ranitidine Drug Information” . Lexicomp. Archived from the original on 20 April 2014. Retrieved 20 April 2014.
  15. ^ a b c d “ZANTAC Drug Insert” (PDF). GlaxoSmithKline. Archived (PDF) from the original on 20 April 2014. Retrieved 19 April 2014.
  16. ^ Force R. W., Nahata M. C. (1992). “Effect of histamine H2-receptor antagonists on vitamin B12 absorption”. The Annals of Pharmacotherapy. 26 (10): 1283–1286. doi : 10.1177/106002809202601018 . PMID   1358279 .
  17. ^ Mitchell SL, Rockwood K (2001). “The association between antiulcer medication and initiation of cobalamin replacement in older persons”. J Clin Epidemiol . 54 (5): 531–534. doi : 10.1016/S0895-4356(00)00340-1 .
  18. ^ “Reflux Remedies: ranitidine” . PharmaSight OTC Health. PharmaSight.org. Archived from the original on 21 August 2017. Retrieved 16 November 2011.
  19. ^ Cobelens FG, Leentvarr-Kuijpers A, Kleijnen J, Coutinho RA (1998). “Incidence and risk factors of diarrhoea in Dutch travellers: Consequences for priorities in pre-travel health advice”. Trop Med Intern Health. 3: 896–903.
  20. ^ Neal KR, Briji SO, Slack RC, et al. (1994). “Recent treatment with H2-antagonists and antibiotics and gastric surgery as risk factors for Salmonella infection” . Br Med J . 308 (6922): 176. doi : 10.1136/bmj.308.6922.176 . PMC   2542523 . PMID   7906170 .
  21. ^ Neal KR, Scott HM, Slack RC, Logan RF (1996). “Omeprazole as a risk factor for Campylobacter gastroenteritis: Case-control study” . BMJ . 312 (7028): 414–415. doi : 10.1136/bmj.312.7028.414 . PMC   2350063 . PMID   8601113 .
  22. ^ Wickramasinghe LS, Basu SK (1984). “Salmonellosis during treatment with ranitidine”. Br Med J . 289 (6454): 1272. doi : 10.1136/bmj.289.6454.1272 .
  23. ^ Ruddell WS, Axon AT, Findlay JM, et al. (1980). “Effect of cimetidine on gastric bacterial flora”. Lancet . i (8170): 672–674. doi : 10.1016/s0140-6736(80)92826-3 .
  24. ^ Untersmayr E, Bakos N, Scholl I, et al. (2005). “Anti-ulcer drugs promote IgE formation toward dietary antigens in adult patients”. FASEB J. 19 (6): 656–658. doi : 10.1096/fj.04-3170fje . PMID   15671152 .
  25. ^ “Ranitidine: Hepatotoxicity” . NIH official website. June 28, 2016. Archived from the original on August 28, 2016. Retrieved August 25, 2016.
  26. ^ Mallow S, Rebuck JA, Osler T, et al. (2004). “Do proton pump inhibitors increase the incidence of nosocomial pneumonia and related infectious complications when compared with histamine-2 receptor antagonists in critically ill trauma patients?”. Curr Surg. 61 (5): 452–458. doi : 10.1016/j.cursur.2004.03.014 . PMID   15475094 .
  27. ^ Canani RB, Cirillo P, Roggero P, Romano C, Malamisura B, Terrin G, Passariello A, Manguso F, Morelli L, Guarino A (May 2006). “Therapy with gastric acidity inhibitors increases the risk of acute gastroenteritis and community-acquired pneumonia in children”. Pediatrics. 117 (5): e817–20. doi : 10.1542/peds.2005-1655 . PMID   16651285 .
  28. ^ Amit V Bangia; Narendra Kamath; Vidushi Mohan (2011). “Ranitidine-induced thrombocytopenia: A rare drug reaction” . Indian J Pharmacol. 43 (1): 76–7. doi : 10.4103/0253-7613.75676 . PMC   3062128 . PMID   21455428 .
  29. ^ “Ranitidine Drug Information” . Lexicomp. Archived from the original on 20 April 2014. Retrieved 19 April 2014.
  30. ^ “Ranitidine” . Lexicomp. Archived from the original on 20 April 2014. Retrieved 19 April 2014.
  31. ^ Canani, RB; Cirillo, P; Roggero, P; et al. (2006). “Therapy With Gastric Acidity Inhibitors Increases the Risk of Acute Gastroenteritis and Community-Acquired Pneumonia in Children”. Pediatrics. 117 (5): e817–20. doi : 10.1542/peds.2005-1655 . PMID   16651285 .
  32. ^ Guillet, R; Stoll, BJ; Cotten, CM; et al. (2006). “Association of H2-Blocker Therapy and Higher Incidence of Necrotizing Enterocolitis in Very Low Birth Weight Infants”. Pediatrics. 117 (2): 137–42. doi : 10.1542/peds.2005-1543 . PMID   16390920 .
  33. ^ Terrin, G; Passariello, A; De Curtis, M; et al. (2012). “Ranitidine Is Associated With Infections, Necrotizing Enterocolitis, and Fatal Outcome in Newborns”. Pediatrics. 129 (1): 40–5. doi : 10.1542/peds.2011-0796 . PMID   22157140 .
  34. ^ Brahm, NC; Yeager, LL; Fox, MD; Farmer, KC; Palmer, TA (15 August 2010). “Commonly prescribed medications and potential false-positive urine drug screens”. American Journal of Health-System Pharmacy. 67 (16): 1344–50. doi : 10.2146/ajhp090477 . PMID   20689123 .
  35. ^ a b “Zantac Package Insert” (PDF). FDA. Archived (PDF) from the original on 2014-04-20.
  36. ^ Lednicer, Daniel (Editor). Chronicles of Drug Discovery. ACS Professional Reference Books, Volume 3, pages 45-81 1993. ISBN   0-8412-2733-0 .
  37. ^ US patent US4128658, “Aminoalkyl furan derivatives”, 1978
  38. ^
    Laurence Brunton; John Lazo; Keith Parker (August 2005). Goodman & Gilman’s The Pharmacological Basis of Therapeutics (11 ed.). McGraw-Hill. p. 972. doi : 10.1036/0071422803 . ISBN   978-0-07-142280-2 . Archived from the original on 2016-04-11.
  39. ^ Pelot, Daniel, (M.D.). “Digestive System : New Drug for Heartburn“. The New Book of Knowledge : Medicine & Health, Grolier : Danbury, Connecticut. 1990. p.262. ISBN   0-7172-8244-9 . Library of Congress 82-645223

External links[ edit ]

  • U.S. National Library of Medicine: Drug Information Portal – Ranitidine
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      Ranitidine Hcl Tablet Peptic Ulcer Agents

      COMMON BRAND(S): Zantac

      GENERIC NAME(S): Ranitidine Hcl

      Read Reviews (116) Find Lowest Prices

      • Uses
      • Side Effects
      • Precautions
      • Interactions
      • Overdose
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      Uses

      Uses

      Ranitidine is used to treat ulcers of the stomach and intestines and prevent them from coming back after they have healed. This medication is also used to treat certain stomach and throat ( esophagus ) problems (such as erosive esophagitis , gastroesophageal reflux disease- GERD , Zollinger -Ellison syndrome). It works by decreasing the amount of acid your stomach makes. It relieves symptoms such as cough that doesn’t go away, stomach pain , heartburn , and difficulty swallowing. Ranitidine belongs to a class of drugs known as H2 blockers.

      This medication is also available without a prescription. It is used to prevent and treat heartburn and other symptoms caused by too much acid in the stomach (acid indigestion ). If you are taking this medication for self-treatment, it is important to read the manufacturer’s package instructions carefully so you know when to consult your doctor or pharmacist .

      How to use Ranitidine Hcl Tablet Peptic Ulcer Agents

      Take this medication by mouth with or without food as directed by your doctor, usually once or twice daily. It may be prescribed 4 times a day for some conditions. If you are taking this medication once daily, it is usually taken after the evening meal or before bedtime .

      The dosage and length of treatment are based on your medical condition and response to therapy. In children, dosage may also be based on body weight . Follow your doctor’s instructions carefully. You may take other medications (e.g., antacids) for your condition as recommended by your doctor.

      Take this medication regularly in order to get the most benefit from it. To help you remember, take it at the same time(s) each day. Do not increase your dose or take it more often than prescribed. Do not stop taking this without your doctor’s approval because this may delay healing of the ulcer.

      If you are using nonprescription ranitidine for self-treatment of acid indigestion or heartburn , take 1 tablet by mouth with a glass of water as needed. To prevent heartburn , take 1 tablet by mouth with a glass of water 30-60 minutes before eating food or drinking beverages that cause heartburn . Do not take more than 2 tablets in 24 hours unless directed by your doctor. Do not take for more than 14 days in a row without talking with your doctor.

      Tell your doctor if your condition does not improve or if it worsens.

      Related Links

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      Side Effects

      Side Effects

      Headache , constipation or diarrhea may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

      If your doctor has directed you to use this medication , remember that he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

      Tell your doctor right away if you have any serious side effects, including: blurred vision , mental/mood changes (e.g., agitation, confusion, depression , hallucinations ), easy bleeding/bruising, enlarged breasts , severe tiredness, fast/slow/irregular heartbeat, signs of infection (such as sore throat that doesn’t go away, fever, chills), severe stomach / abdominal pain , dark urine, yellowing skin / eyes .

      A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction , including: rash , itching /swelling (especially of the face/ tongue /throat), severe dizziness , trouble breathing .

      This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

      In the US –

      Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

      In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

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      Precautions

      Precautions

      Before taking ranitidine , tell your doctor or pharmacist if you are allergic to it; or to other H2 blockers (e.g., cimetidine , famotidine ); or if you have any other allergies . This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

      Before using this medication , tell your doctor or pharmacist your medical history, especially of: a certain blood disorder ( porphyria ), immune system problems, kidney problems, liver problems, lung diseases (e.g., asthma , chronic obstructive pulmonary disease – COPD ), other stomach problems (e.g., tumors).

      Some symptoms may actually be signs of a more serious condition. Get medical help right away if you have: heartburn with lightheadedness / sweating / dizziness , chest/jaw/arm/ shoulder pain (especially with shortness of breath, unusual sweating ), unexplained weight loss .

      In addition, before you self-treat with this medication, get medical help right away if you have any of these signs of a serious condition: trouble/pain swallowing food, bloody vomit, vomit that looks like coffee grounds, bloody/black stools, heartburn for over 3 months, frequent chest pain , frequent wheezing (especially with heartburn ), nausea / vomiting , stomach pain .

      Do not use to treat children younger than 12 unless directed by the doctor.

      Older adults may be more sensitive to the side effects of this drug, especially confusion.

      Ranitidine should be used only when clearly needed during pregnancy . Discuss the risks and benefits with your doctor.

      Ranitidine passes into breast milk. Consult your doctor before breast -feeding.

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      Interactions

      Interactions

      Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions . Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist . Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

      Some products need stomach acid so that the body can absorb them properly. Ranitidine decreases stomach acid, so it may change how well these products work. Some affected products include atazanavir , dasatinib , delavirdine , certain azole antifungals (such as itraconazole , ketoconazole ), pazopanib, among others.

      Do not use this medication with other products that contain ranitidine or other H2 blockers ( cimetidine , famotidine , nizatidine).

      This medication may interfere with certain laboratory tests (including certain urine protein tests), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.

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      Overdose

      Overdose

      If someone has overdosed and has serious symptoms such as passing out or trouble breathing , call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include difficulty walking, severe dizziness / fainting .

      Notes

      Do not share this medication with others.

      Lifestyle changes such as stress reduction programs, stopping smoking , limiting alcohol, and diet changes (such as avoiding caffeine and certain spices) may help this medication work better. Talk to your doctor or pharmacist about lifestyle changes that might benefit you.

      Laboratory and/or medical tests (e.g., endoscopy , kidney function tests) may be performed to monitor your progress or check for side effects. Consult your doctor for more details.

      Missed Dose

      If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip themissed dose and resume your usual dosing schedule. Do not double the dose to catch up.

      Storage

      Store the US product in a tightly closed container at room temperature between 59-86 degrees F (15-30 degrees C) away from moisture and light. Store the nonprescription medication at room temperature between 68-86 degrees F (20-30 degrees C).

      Store the Canadian product in a tightly closed container between 35.6 and 86 degrees F (2 and 30 degrees C) away from moisture and light.

      Do not store in the bathroom. Keep all medicines away from children and pets.

      Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.Information last revised July 2016. Copyright(c) 2016 First Databank, Inc.

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      Images

      ranitidine 150 mg tablet


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      ranitidine 150 mg tablet


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      ranitidine 300 mg tablet

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      ranitidine 150 mg tablet


      ranitidine 150 mg tableticonicon
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      ranitidine 150 mg tablet

      ranitidine 150 mg tablet

      color
      pink
      shape
      round
      imprint
      GG 705

      This medicine is a pink, round, film-coated, tablet imprinted with “GG 705”.

      ‹ Back to Gallery

      ranitidine 300 mg tablet

      ranitidine 300 mg tablet

      color
      orange
      shape
      round
      imprint
      GG 706

      This medicine is a orange, round, film-coated, tablet imprinted with “GG 706”.

      ‹ Back to Gallery

      ranitidine 150 mg tablet

      ranitidine 150 mg tablet

      color
      beige
      shape
      round
      imprint
      logo and 4357, 150

      This medicine is a beige, round, film-coated, tablet imprinted with “logo and 4357” and “150”.

      ‹ Back to Gallery

      ranitidine 300 mg tablet

      ranitidine 300 mg tablet

      color
      beige
      shape
      oval
      imprint
      logo and 4358, 300

      This medicine is a beige, oval, tablet imprinted with “logo and 4358” and “300”.

      ‹ Back to Gallery

      ranitidine 150 mg tablet

      ranitidine 150 mg tablet

      color
      orange
      shape
      round
      imprint
      IP 253

      This medicine is a orange, round, film-coated, tablet imprinted with “IP 253”.

      ‹ Back to Gallery

      ranitidine 150 mg tablet

      ranitidine 150 mg tablet

      color
      pink
      shape
      oval
      imprint
      9R

      This medicine is a pink, oval, tablet imprinted with “9R”.

      ‹ Back to Gallery

      ranitidine 150 mg tablet

      ranitidine 150 mg tablet

      color
      pink
      shape
      round
      imprint
      G 51, 150

      This medicine is a pink, round, film-coated, tablet imprinted with “G 51” and “150”.

      ‹ Back to Gallery

      ranitidine 300 mg tablet

      ranitidine 300 mg tablet

      color
      yellow
      shape
      oblong
      imprint
      IP 254

      This medicine is a yellow, oblong, film-coated, tablet imprinted with “IP 254”.

      ‹ Back to Gallery

      ranitidine 150 mg tablet

      ranitidine 150 mg tablet

      color
      pink
      shape
      round
      imprint
      R150

      This medicine is a pink, round, tablet imprinted with “R150”.

      ‹ Back to Gallery

      ranitidine 300 mg tablet

      ranitidine 300 mg tablet

      color
      pink
      shape
      round
      imprint
      G 51, 300

      This medicine is a pink, round, film-coated, tablet imprinted with “G 51” and “300”.

      ‹ Back to Gallery

      ranitidine 300 mg tablet

      ranitidine 300 mg tablet

      color
      brown
      shape
      round
      imprint
      S 430

      This medicine is a brown, round, film-coated, tablet imprinted with “S 430”.

      ‹ Back to Gallery

      ranitidine 150 mg tablet

      ranitidine 150 mg tablet

      color
      brown
      shape
      round
      imprint
      S 429

      This medicine is a brown, round, film-coated, tablet imprinted with “S 429”.

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