Ranitidine

By

Generic Name: Ranitidine Brand Name(s): Generics only. No brands available. Avability: Rx, OTC Pregnancy Category: B

Uses

What is Ranitidine used for?

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.

How should I take Ranitidine?

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.

Measure the dose carefully using a measuring spoon or a special medication spoon available from your pharmacist. Do not use household spoons or you may not get the correct dose.

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.

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

How do I store Ranitidine?

Ranitidine is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Ranitidine in the bathroom or the freezer. There may be different brands of Ranitidine that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Ranitidine down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Ranitidine?

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.

Measure the dose carefully using a measuring spoon or a special medication spoon available from your pharmacist. Do not use household spoons or you may not get the correct dose.

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.

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

Is it safe during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this Ranitidine during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Ranitidine. Ranitidine is pregnancy risk category B according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Side effects

What side effects can occur from Ranitidine?

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.

This liquid product may contain alcohol. Caution is advised if you have diabetes, alcohol dependence or liver disease. Ask your doctor or pharmacist about the safe use of this product.

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.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Ranitidine?

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.

Ranitidine may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Ranitidine?

Ranitidine may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Ranitidine?

Ranitidine may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Ranitidine.

What is the dose of Ranitidine for an adult?

Usual Adult Dose for Duodenal Ulcer

ORAL:

-Treatment dose: 150 mg orally 2 times a day OR 300 mg orally once a day after the evening meal or at bedtime

-Maintenance dose: 150 mg orally once a day at bedtime

-Duration of therapy: 8 weeks (treatment); up to 1 year (maintenance)

PARENTERAL:

IM or IV (bolus or intermittent infusion) Injection:

-Usual dose: 50 mg IM or IV every 6 to 8 hours

-Maximum dose: 400 mg/day

Continuous IV Infusion:

-Usual rate: 6.25 mg/hour

Comments:

-Patients may use antacids to treat pain.

-Both once or 2 times a day oral dosing regimens were shown to be effective in inhibiting gastric acid secretion.

-Injectable formulations do not require dilution when given as an IM injection.

-Intermittent IV bolus injections should be diluted up to 2.5 mg/mL and injected at a rate of up to 4 mL/min.

-Intermittent IV infusions should be diluted up to a concentration of 0.5 mg/mL and infused at a rate of up to 5 to 7 mL/min (approximately 15 to 20 minutes).

-Most patients receiving oral formulations heal within 4 weeks; there are no safety data for the treatment of uncomplicated duodenal ulcer beyond 8 weeks. Studies have not been conducted to assess safety in oral maintenance therapy longer than 1 year.

Uses:

-Short-term treatment of active duodenal ulcer

-Maintenance therapy for duodenal ulcer patients at reduced dosage after healing of acute ulcers

-Some hospitalized patients with intractable duodenal ulcers

Usual Adult Dose for Dyspepsia

ORAL (OVER-THE-COUNTER FORMULATIONS):

-Symptom relief: 75 to 150 mg orally with a glass of water

-Symptom prevention: 75 to 150 mg orally with a glass of water 30 to 60 minutes before a meal

-Maximum dose: 2 tablets/day

-Duration of therapy: Up to 14 days (self-treatment)

Uses:

-Relief of heartburn associated with acid indigestion and sour stomach

-Relief of heartburn associated with acid indigestion and sour stomach brought on by eating/drinking certain foods and beverages

Usual Adult Dose for Erosive Esophagitis

ORAL:

-Treatment dose: 150 mg orally 4 times a day

-Maintenance dose: 150 mg orally 2 times a day

-Duration of therapy: Up to 48 weeks (maintenance)

Comments:

-Symptomatic relief usually starts within 24 hours of starting oral treatment.

-Placebo-controlled studies included use of maintenance doses for up to 48 weeks.

Use:

-Treatment of endoscopically diagnosed erosive esophagitis

Usual Adult Dose for Zollinger-Ellison Syndrome

ORAL:

-Initial dose: 150 mg orally 2 times a day

-Maximum dose: Up to 6 g/day

PARENTERAL:

Continuous IV Infusion:

-Initial rate: 1 mg/kg/hr

-Titration: After 4 hours, if gastric acid output is greater than 10 mEq/hr or the patient is symptomatic, the dose should be increased in 0.5 mg/kg/hr increments and acid levels should be re-measured

-Maximum dose: 2.5 mg/kg/hr

-Maximum rate: 220 mg/hr

Comment:

-Continuous IV infusions should be diluted to a concentration of 2.5 mg/mL or less.

Uses:

-Treatment of pathological hypersecretory conditions (e.g., Zollinger-Ellison syndrome, systemic mastocytosis)

-Alternative to oral formulations for short-term use in some hospitalized patients who are unable to take oral medications

Usual Adult Dose for Pathological Hypersecretory Conditions

ORAL:

-Initial dose: 150 mg orally 2 times a day

-Maximum dose: Up to 6 g/day

PARENTERAL:

Continuous IV Infusion:

-Initial rate: 1 mg/kg/hr

-Titration: After 4 hours, if gastric acid output is greater than 10 mEq/hr or the patient is symptomatic, the dose should be increased in 0.5 mg/kg/hr increments and acid levels should be re-measured

-Maximum dose: 2.5 mg/kg/hr

-Maximum rate: 220 mg/hr

Comment:

-Continuous IV infusions should be diluted to a concentration of 2.5 mg/mL or less.

Uses:

-Treatment of pathological hypersecretory conditions (e.g., Zollinger-Ellison syndrome, systemic mastocytosis)

-Alternative to oral formulations for short-term use in some hospitalized patients who are unable to take oral medications

Usual Adult Dose for Gastroesophageal Reflux Disease

ORAL:

-Usual dose: 150 mg orally 2 times a day

Comment:

-Symptomatic relief usually starts within 24 hours of starting oral treatment.

Use:

-Treatment of gastroesophageal reflux disease

Usual Adult Dose for Gastric Ulcer

ORAL:

-Treatment dose: 150 mg orally 2 times a day

-Maintenance dose: 150 mg orally once a day at bedtime

Comments:

-Most patients heal within 6 weeks; there are no safety data for the treatment of uncomplicated, benign gastric ulcer beyond 6 weeks.

Uses:

-Short-term treatment of active, benign gastric ulcer

-Maintenance therapy for gastric ulcer patients at reduced dosage after healing of acute ulcers

Renal Dose Adjustments

CrCl less than 50 mL/min:

Oral: 150 mg orally every 24 hours. The frequency of dosing may be increased with caution.

Parenteral:

-IM/IV: 50 mg IM/IV every 18 to 24 hours. The frequency of dosing may be increased to every 12 hours (or further) with caution.

Dose Adjustments

Elderly patients: Since elderly patients are more likely to have decreased renal function, dose selection should be made cautiously, and an increased frequency of renal function monitoring should be considered.

Dialysis

Hemodialysis: The dosing schedule should be adjusted to coincide with the end of hemodialysis.

Other Comments

Administration advice:

-Oral solution and syrup formulations may contain alcohol, which could have deleterious effects in younger patients.

-Effervescent tablets should be placed in a glass of water and allowed to dissolve completely before administration.

Storage requirements:

-The manufacturer product information should be consulted.

Reconstitution/preparation techniques:

-The manufacturer product information should be consulted.

IV compatibility:

-The manufacturer product information should be consulted.

General:

-Drug concentrations of approximately 36 to 94 ng/mL are needed to inhibit 50% of stimulated gastric acid secretion.

-Studies have demonstrated that duodenal ulcer treatment doses of 100 mg orally 2 times a day were equivalent in efficacy to 150 mg orally 2 times a day.

-This drug is not labeled to treat patients with complications associated with reflux esophagitis (e.g., esophageal stricture, Barrett’s esophagus).

-Patients receiving long-term treatment should be reassessed periodically.

Monitoring:

-ALT levels, especially in patients receiving high IV doses for at least 5 days

-Renal function, especially in elderly patients and/or those with renal dysfunction

Patient advice:

-Patients should be instructed to contact their healthcare provider if symptoms do not improve or worsen during treatment.

-Advise patients to speak to their healthcare provider if they become pregnant, intend to become pregnant, or are breastfeeding.

What is the dose of Ranitidine for a child?

Usual Pediatric Dose for Duodenal Ulcer

Less than 1 month AND with Extracorporeal membrane oxygenation (ECMO):

PARENTERAL:

-2 mg/kg IV every 12 to 24 hours OR as a continuous infusion

1 month to 16 years:

ORAL:

-Treatment dose: 2 to 4 mg/kg orally 2 times a day

-Maximum treatment dose: 300 mg/day

-Maintenance dose: 2 to 4 mg/kg orally once a day

-Maximum maintenance dose: 150 mg/day

PARENTERAL:

-Usual dose: 2 to 4 mg/kg IV, divided and given every 6 to 8 hours OR as a continuous infusion

-Maximum dose: 50 mg/dose

16 years and older:

ORAL:

-Treatment dose: 150 mg orally 2 times a day OR 300 mg orally once a day after the evening meal or at bedtime

-Maintenance dose: 150 mg orally once a day at bedtime

-Duration of therapy: 8 weeks (treatment); up to 1 year (maintenance)

PARENTERAL:

IM or IV (bolus or intermittent infusion) Injection:

-Usual dose: 50 mg IM or IV every 6 to 8 hours

-Maximum dose: 400 mg/day

Continuous IV Infusion:

-Usual rate: 6.25 mg/hour

Comments:

-Patients younger than 1 month with ECMO who were given doses of 2 mg/kg had a gastric pH of greater than 4 for at least 15 hours.

-Placebo-controlled studies included use of maintenance doses for up to 48 weeks.

-Injectable formulations do not require dilution when given as an IM injection.

-Intermittent IV bolus injections should be diluted up to 2.5 mg/mL and injected at a rate of up to 4 mL/min.

-Intermittent IV infusions should be diluted up to a concentration of 0.5 mg/mL and infused at a rate of up to 5 to 7 mL/min (approximately 15 to 20 minutes).

Uses:

-Alternative to oral formulations for short-term use in some hospitalized patients who are unable to take oral medications

-Short-term treatment of active duodenal ulcer

-Maintenance therapy for duodenal ulcer patients at reduced dosage after healing of acute ulcers

-Some hospitalized patients with intractable duodenal ulcers

Usual Pediatric Dose for Gastric Ulcer

Less than 1 month AND with Extracorporeal membrane oxygenation (ECMO):

PARENTERAL:

-2 mg/kg IV every 12 to 24 hours OR as a continuous infusion

1 month to 16 years:

ORAL:

-Treatment dose: 2 to 4 mg/kg orally 2 times a day

-Maximum treatment dose: 300 mg/day

-Maintenance dose: 2 to 4 mg/kg orally once a day

-Maximum maintenance dose: 150 mg/day

PARENTERAL:

-Usual dose: 2 to 4 mg/kg IV, divided and given every 6 to 8 hours OR as a continuous infusion

-Maximum dose: 50 mg/dose

16 years and older:

ORAL:

-Treatment dose: 150 mg orally 2 times a day OR 300 mg orally once a day after the evening meal or at bedtime

-Maintenance dose: 150 mg orally once a day at bedtime

-Duration of therapy: 8 weeks (treatment); up to 1 year (maintenance)

PARENTERAL:

IM or IV (bolus or intermittent infusion) Injection:

-Usual dose: 50 mg IM or IV every 6 to 8 hours

-Maximum dose: 400 mg/day

Continuous IV Infusion:

-Usual rate: 6.25 mg/hour

Comments:

-Patients younger than 1 month with ECMO who were given doses of 2 mg/kg had a gastric pH of greater than 4 for at least 15 hours.

-Placebo-controlled studies included use of maintenance doses for up to 48 weeks.

-Injectable formulations do not require dilution when given as an IM injection.

-Intermittent IV bolus injections should be diluted up to 2.5 mg/mL and injected at a rate of up to 4 mL/min.

-Intermittent IV infusions should be diluted up to a concentration of 0.5 mg/mL and infused at a rate of up to 5 to 7 mL/min (approximately 15 to 20 minutes).

Uses:

-Alternative to oral formulations for short-term use in some hospitalized patients who are unable to take oral medications

-Short-term treatment of active duodenal ulcer

-Maintenance therapy for duodenal ulcer patients at reduced dosage after healing of acute ulcers

-Some hospitalized patients with intractable duodenal ulcers

Usual Pediatric Dose for Gastroesophageal Reflux Disease

1 month to 16 years:

ORAL:

-Usual dose: 5 to 10 mg/kg/day orally, given in 2 divided doses

16 years and older:

ORAL:

-Usual dose: 150 mg orally 2 times a day

Comments:

-Symptomatic relief usually starts within 24 hours of starting oral treatment.

-Placebo-controlled studies included use of maintenance doses for up to 48 weeks.

Use:

-Treatment of gastroesophageal reflux disease

Usual Pediatric Dose for Erosive Esophagitis

1 month to 16 years:

ORAL:

-Usual dose: 5 to 10 mg/kg/day, given in 2 divided doses

16 years and older:

ORAL:

-Treatment dose: 150 mg orally 4 times a day

-Maintenance dose: 150 mg orally 2 times a day

-Duration of therapy: Up to 48 weeks (maintenance)

Comments:

-Symptomatic relief usually starts within 24 hours of starting oral treatment.

-Placebo-controlled studies included use of maintenance doses for up to 48 weeks.

Use:

-Treatment of endoscopically diagnosed erosive esophagitis

Usual Pediatric Dose for Dyspepsia

12 years and older:

ORAL (OVER-THE-COUNTER FORMULATIONS):

-Symptom relief: 75 mg orally with a glass of water

-Symptom prevention: 75 mg orally with a glass of water 30 to 60 minutes before a meal

-Maximum dose: 150 mg/day

-Duration of therapy: Up to 14 days (self-treatment)

Uses:

-Relieve heartburn associated with acid indigestion and sour stomach

-Relieve heartburn associated with acid indigestion and sour stomach brought on by eating/drinking certain foods and beverages

Precautions

This drug is not recommended for use in children when used to treat pathological hypersecretory conditions or to maintain healing of erosive esophagitis. In the treatment of other indications, safety and efficacy have not been established in patients younger than 1 month (prescription-only formulations) and 12 years (over-the-counter formulations).

How is Ranitidine available?

Ranitidine is available in the following dosage forms and strengths:

  • Oral tablet,
  • Oral syrup,
  • Injectable solution,
  • Oral tablet, effervescent,
  • Oral capsule,
  • Intravenous solution,
  • Oral granule, effervescent,
  • Compounding powder.

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Ranitidine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Review Date: August 10, 2018 | Last Modified: August 10, 2018

You might also like