Ranitidinum

Description

Histamine H2 receptor blocker. Inhibits basal and stimulated gastric acid secretion.

Indications

Treatment of duodenal and gastric ulcers; prevention of peptic ulcers associated with nonsteroidal anti-inflammatory drugs; treatment of gastroesophageal reflux disease; treatment of Zollinger-Ellison syndrome and postoperative ulcers; prevention of acid aspiration (Mendelson’s) syndrome, especially at risk due to childbirth or general anesthesia; treatment of peptic ulcers associated with Helicobacter pylori (in combination with other drugs); treatment of chronic episodic dyspepsia with pain in the epigastric area or behind the sternum; prevention of recurrent bleeding from peptic ulcers; prevention of stress-related gastric and intestinal bleeding in severely ill patients.

Contraindications

Hypersensitivity to the active substance or any excipient.

Dosage

Adults. Duodenal or gastric ulcer: 150 mg twice daily or 300 mg once daily before bedtime for 4 weeks, then if necessary – another 4 weeks. Ulcers associated with NSAIDs may require 8 weeks of treatment. Prevention of NSAID-related ulcers: 150 mg twice daily. Duodenal ulcer associated with Helicobacter pylori: 300 mg of ranitidine once daily before bedtime or 150 mg twice daily, together with 750 mg of amoxicillin and 500 mg of metronidazole three times daily for 2 weeks, then ranitidine for another 2 weeks; if the condition improved after short-term treatment and the ulcer tends to recur – 150 mg once daily before bedtime for maintenance therapy.
Symptomatic treatment of gastroesophageal reflux disease: 150 mg twice daily for 2 weeks. Treatment of gastroesophageal reflux disease: 150 mg twice daily or 300 mg before bedtime for up to 8 weeks, if necessary – 12 weeks. In cases of moderate or severe esophagitis, 150 mg four times daily for up to 12 weeks.
Resolved esophagitis: if long-term treatment is needed – 150 mg twice daily.
Zollinger-Ellison syndrome: initially 150 mg three times daily, then adjust as needed, with a maximum daily dose of 6 g.
Chronic episodic dyspepsia: 150 mg three times daily for 6 weeks.
Prevention of recurrent bleeding from peptic ulcers or prevention of stress-related gastric and intestinal bleeding in severely ill patients: 150 mg twice daily (instead of injectable ranitidine, once oral feeding begins).
Acid aspiration (Mendelson’s) syndrome: 150 mg in the evening or 2 hours before general anesthesia; for pregnant women – 150 mg every 6 hours at the onset of labor.

Children. Treatment of duodenal ulcers: 2-4 mg/kg twice daily, maximum daily dose – 300 mg.
IFN. 150 mg once daily before bedtime, no need to adjust maintenance therapy doses, if necessary increase to 150 mg twice daily.
KFN. Reduce the dose.

Adverse reactions

Most common: nausea, diarrhea; headache, dizziness; rash; fatigue.
Others: constipation, nausea, vomiting, abdominal pain; pancreatitis; hepatitis (with or without jaundice), increased liver transaminases and alkaline phosphatase concentration; confusion, agitation, depression, hallucinations; allergic reactions (bronchospasm, fever, rash, eosinophilia, anaphylaxis); bradycardia, tachycardia, AV block; joint and muscle pain; blood disorders (agranulocytosis, leukopenia, thrombocytopenia, aplastic anemia, pancytopenia); impaired accommodation; alopecia; gynecomastia.

Pregnancy

Risk category – BM. Can only be used in essential cases where the expected therapeutic effect outweighs the risk to the fetus.

Breastfeeding

Enters breast milk and can accumulate. Can only be used in essential cases.

Warnings
Use with caution in cases of IFN, KFN, porphyria. May mask symptoms of stomach cancer (especially important to investigate if there is a change in symptoms or if the patient is of middle or older age).

Source | Drug Guide | Lithuanian University of Health Sciences | Institute of Physiology and Pharmacology | Doctor of Medical Sciences Rimas Jankūnas, Doctor of Medical Sciences Arvydas Milašius | Clinic of Internal Diseases | Doctor of Medical Sciences Palmira Leišytė