- Adverse effects
- Food Interactions
Ranitidine is a commonly used drug, classified as a _histamine H2-receptor antagonist_. This drug helps to prevent and treat gastric-acid related conditions, including ulcers, because of its ability to decrease gastric acid secretion [
Ranitidine is a commonly used drug, classified as a _histamine H2-receptor antagonist_. This drug helps to prevent and treat gastric-acid related conditions, including ulcers, because of its ability to decrease gastric acid secretion , [FDA label]. It is often referred to as _Zantac_, and is available in various forms, including a regular tablet, injection, and effervescent tablet [FDA label], .
One common use of this drug is to relieve the symptoms of gastric esophageal reflux disease (GERD) [FDA label], which often leads to heartburn symptoms and acid regurgitation. The prevalence of GERD is thought to be 10-20% in western countries . Ranitidine has proven to be an effective agent in relieving the above symptoms and is therefore widely used in GERD and other gastric-acid related conditions , [FDA label].
This drug is used alone or with concomitant antacids for the following conditions [FDA label]:
**... This drug is used alone or with concomitant antacids for the following conditions [FDA label]:
Treatment of active duodenal ulcer (short-term), maintenance therapy of duodenal ulcers after healing (reduced dose)
**Pathological hypersecretion of gastric acid**
Zollinger-Ellison syndrome, systemic mastocytosis, and other conditions causing gastric acid hypersecretion
Short term treatment of active gastric ulcer (benign), maintenance of healing after gastric acid ulcer therapy (reduced dose)
Treatment of GERD symptoms (symptoms usually improve within 24 hours), treatment of erosive esophagitis (endoscopically diagnosed) and maintenance of healing [FDA label]
Ranitidine decreases the secretion of gastric acid stimulated by food and drugs. It also reduces th...
Ranitidine decreases the secretion of gastric acid stimulated by food and drugs. It also reduces the secretion of gastric acid in hypersecretory conditions such as Zollinger-Ellison syndrome , [FDA label]. Marked improvements in the appearance of the esophageal tissues have been observed by endoscopic imaging after ranitidine therapy .
Mechanism of action
After a meal, the hormone gastrin, produced by cells in the lining of the stomach, stimulates the re... After a meal, the hormone gastrin, produced by cells in the lining of the stomach, stimulates the release of histamine, which then binds to histamine H2 receptors, leading to the secretion of gastric acid. Ranitidine reduces the secretion of gastric acid by reversible binding to histamine (H2) receptors, which are found on gastric parietal cells. This process leads to the inhibition of histamine binding to this receptor, leading to the reduction of gastric acid secretion. The relief of gastric-acid related symptoms can occur as soon as 60 minutes after administration of a single dose, and the effects can last from 4-10 hours, providing fast and effective symptomatic relief [3, 7]. Read more
Ranitidine is 50% absorbed after an oral tablet and both the syrup and effervescent tablet formulati... Ranitidine is 50% absorbed after an oral tablet and both the syrup and effervescent tablet formulations are found to be bioequivalent to the tablet form. After an intravenous (IV) injection, average peak levels of 440 to 545 ng/mL are attained about 2-3 hours after a single 150 mg dose. Food or antacids have limited effects on absorption. One clinical study found that the administration of a potent antacid (150 mmol) in subjects in the fasted state showed decreased absorption of ranitidine [FDA label]. Read more
Approximately 15% [FDA label]. Approximately 15% [FDA label].
Volume of distribution
The volume of distribution is approximately 1.4 L/kg [FDA label]. The volume of distribution is approximately 1.4 L/kg [FDA label].
Renal clearance is 78 about 410 mL/min [FDA label]. Clearance is decreased in the elderly and those... Renal clearance is 78 about 410 mL/min [FDA label]. Clearance is decreased in the elderly and those with impaired renal function [FDA label]. It is recommended to decrease the dose of ranitidine by one-half in patients with renal impairment . Read more
2.5-3 hours [FDA label]. The plasma half-life is longer for elderly patients population due to a dec... 2.5-3 hours [FDA label]. The plasma half-life is longer for elderly patients population due to a decrease in renal function, and is measured at 3-4 hours [FDA label]. Read more
Route of elimination
This drug is mainly excreted in the urine. About 30% of a single oral dose has been measured in the... This drug is mainly excreted in the urine. About 30% of a single oral dose has been measured in the urine as unchanged drug within 24 hours of ingestion [FDA label]. Read more
Oral doses of 1,000 mg/kg in mice and rats were not found to be lethal. Intravenous LD50... **LD50**
Oral doses of 1,000 mg/kg in mice and rats were not found to be lethal. Intravenous LD50 values in mice and rats were 77 and 83 mg/kg .
There has been limited experience with overdosage. Reported acute ingestions of up to 18 grams orally have been associated with temporary adverse effects that are similar to the normal adverse effects of this drug (see adverse effects section). Gait abnormalities and hypotension have also been observed. When overdose is suspected, attempt to remove unabsorbed ranitidine from the gastrointestinal tract, monitor the patient and provide supportive therapy as needed [FDA label].
Ranitidine is a pregnancy category B drug, meaning that animal studies have not shown harm caused by the drug to the fetus. Studies have been completed in rats and rabbits at doses reaching 160 times the human dose and have demonstrated that ranitidine does not exert effects on fertility or fetal growth. No sufficient and well-controlled studies in pregnant women have been performed. Because animal reproduction studies are not always reflective of human response, this drug should be used during pregnancy only if clearly required [FDA label].
Ranitidine has been detected in human breastmilk. Use caution ranitidine is given to a nursing mother [FDA label]. Read more
|Effect||Regions||Age Groups||Incidences||Evidence Type|
|Loss of libido||US||
|Acquired immune hemolytic anemia||US||
|Increases in serum creatinine||US||
|Pain at site of IM injection||US||
|Local burning at IM injection site||US||
|Local itching at IM injection site||US||
|Acute Interstitial Nephritis||US||
|Reversible mental confusion||US||
|Reversible blurred vision||US||
|Reversible involuntary motor disturbances||US||
|Premature Ventricular Beats||US||
- Avoid alcohol.
- Avoid excessive quantities of coffee or tea (Caffeine).
- Avoid milk, calcium containing dairy products, iron, antacids, or aluminum salts 2 hours before or 6 hours after using antacids while on this medication.
- Take without regard to meals.
- 1 . Mauran A, Goze T, Abadie D, Bondon-Guitton E, Chevrel P, Schmitt L, Montastruc JL, Montastruc F: Mania associated with ranitidine: a case report and review of literature. Fundam Clin Pharmacol. 2016 Aug;30(4):294-6. doi: 10.1111/fcp.12201. Epub 2016 May 5. [PubMed: 27083385]
- 2 . Grant SM, Langtry HD, Brogden RN: Ranitidine. An updated review of its pharmacodynamic and pharmacokinetic properties and therapeutic use in peptic ulcer disease and other allied diseases. Drugs. 1989 Jun;37(6):801-70. doi: 10.2165/00003495-198937060-00003. [PubMed: 2667937]
- 3 . Pettit M: Treatment of gastroesophageal reflux disease. Pharm World Sci. 2005 Dec;27(6):432-5. doi: 10.1007/s11096-005-4798-7. [PubMed: 16341949]
- 4 . Badillo R, Francis D: Diagnosis and treatment of gastroesophageal reflux disease. World J Gastrointest Pharmacol Ther. 2014 Aug 6;5(3):105-12. doi: 10.4292/wjgpt.v5.i3.105. [PubMed: 25133039]
- 5 . Sontag S, Robinson M, McCallum RW, Barwick KW, Nardi R: Ranitidine therapy for gastroesophageal reflux disease. Results of a large double-blind trial. Arch Intern Med. 1987 Aug;147(8):1485-91. [PubMed: 3307670]
- 6 . Vezzadini P, Bonora G, Tomassetti P, Pazzaglia M, Labo G: Medical treatment of Zollinger-Ellison syndrome with ranitidine. Int J Tissue React. 1983;5(4):339-43. [PubMed: 6323334]
- 7 . Caitlin C. Nugent; Jamie M. Terrell (2018). H2 Blockers- StatPearls. StatPearls Publishing.
- 8 . FDA drug approval package: Zantac [Link]
- 9 . Zantac injection FDA label [File]
- 10 . Zantac Canadian Monograph [File]
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