Description

Simple

A medication used to treat ulcers, acid reflux, and conditions that cause the stomach to produce too much acid.

Clinical

A histamine H2 antagonist used to treat duodenal ulcers, Zollinger-Ellison syndrome, gastric ulcers, GERD, and erosive esophagitis.

Overview

Ranitidine is a commonly used drug, classified as a histamine H2-receptor antagonist, and belongs to the same drug class as [cimetidine] and [famotidine]. This drug helps to prevent and treat gastric-acid associated conditions, including ulcers, because of its ability to decrease gastric acid secretion.[2,11] Ranitidine is often referred to as Zantac, and is available in various forms, including tablet, injection, and effervescent tablet preparations.[11,14]

The prevalence of GERD is thought to be 10-20% in western countries.[4] Ranitidine has proven to be an effective treatmen... Read more

Pharmacology

Indication

This drug is used alone or with concomitant antacids for the following conditions: short-term treatment of active duodenal ulcer, treating gastric acid hypersecretion due to Zollinger-Ellison syndrome, systemic mastocytosis, and other conditions that may pathologically raise gastric acid levels. It... Read more

Pharmacodynamic

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.[ Read more

Mechanism of action

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) recep... Read more

Absorption

Ranitidine is rapidly absorbed with peak concentrations reached within 1-3 hours after administration, and varying greatly among patients. Bioavailability is about 50%-60% due to hepatic metabolism.[ Read more

Protein binding

The plasma protein binding of ranitidine is approximately 15%.[7, Read more

Volume of distribution

The volume of distribution is higher than body volume, and measures at approximately 1.4 L/kg.[7, Read more

Clearance

Renal clearance is about 410 mL/min according to FDA prescribing information.[11] Another resource mentions a plasma clearance of approximately 600 ml/min.[ Read more

Half life

The elimination half-life or ranitidine is about 2.5-3 hours.[7, Read more

Route of elimination

This drug is mainly excreted in the urine but also excreted in the feces.[7, Read more

Toxicity

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, respectively.[12]

Overdose inform... Read more

Adverse Effects

Contraindications

  • Regions: US
  • Patient Conditions:
      • Name: Known hypersensitivity to the drug or any of the ingredients
      • Drugbank Id: DBCOND0118758

Food Interactions

  • Take with or without food. The absorption is unaffected by food.

Interactions

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  • Paracetamol(acetaminophen)
  • Paxil(paroxetine)
  • Pamelor(nortriptyline)
  • Panadol(acetaminophen)
  • Patanol(olopatadine ophthalmic)
  • Pataday(olopatadine ophthalmic)
  • Parnate(tranylcypromine)
  • Pazeo(olopatadine ophthalmic)
(R)-warfarin
The serum concentration of (R)-warfarin can be increased when it is combined with Ranitidine.
(S)-Warfarin
The serum concentration of (S)-Warfarin can be increased when it is combined with Ranitidine.
2,5-Dimethoxy-4-ethylamphetamine
2,5-Dimethoxy-4-ethylamphetamine may decrease the sedative and stimulatory activities of Ranitidine.
2,5-Dimethoxy-4-ethylthioamphetamine
2,5-Dimethoxy-4-ethylthioamphetamine may decrease the sedative and stimulatory activities of Ranitidine.
4-Bromo-2,5-dimethoxyamphetamine
4-Bromo-2,5-dimethoxyamphetamine may decrease the sedative and stimulatory activities of Ranitidine.
4-Methoxyamphetamine
The metabolism of 4-Methoxyamphetamine can be decreased when combined with Ranitidine.
5-methoxy-N,N-dimethyltryptamine
The metabolism of 5-methoxy-N,N-dimethyltryptamine can be decreased when combined with Ranitidine.
6-O-benzylguanine
The metabolism of 6-O-benzylguanine can be decreased when combined with Ranitidine.
8-azaguanine
The metabolism of 8-azaguanine can be decreased when combined with Ranitidine.
8-chlorotheophylline
The metabolism of 8-chlorotheophylline can be decreased when combined with Ranitidine.
9-Deazaguanine
The metabolism of 9-Deazaguanine can be decreased when combined with Ranitidine.
9-Methylguanine
The metabolism of 9-Methylguanine can be decreased when combined with Ranitidine.
Abacavir
Ranitidine may decrease the excretion rate of Abacavir which could result in a higher serum level.
Abafungin
Ranitidine can cause a decrease in the absorption of Abafungin resulting in a reduced serum concentration and potentially a decrease in efficacy.
Abatacept
The metabolism of Ranitidine can be increased when combined with Abatacept.
Abiraterone
The serum concentration of Ranitidine can be increased when it is combined with Abiraterone.
Acarbose
Acarbose may decrease the excretion rate of Ranitidine which could result in a higher serum level.
Acebutolol
The metabolism of Acebutolol can be decreased when combined with Ranitidine.
Aceclofenac
Aceclofenac may decrease the excretion rate of Ranitidine which could result in a higher serum level.
Acefylline
The metabolism of Acefylline can be decreased when combined with Ranitidine.
15 References
  1. 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. 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. 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. 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. 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. 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. 7 . Roberts CJ: Clinical pharmacokinetics of ranitidine. Clin Pharmacokinet. 1984 May-Jun;9(3):211-21. doi: 10.2165/00003088-198409030-00003.PubMed: 6329583
  8. 8 . Gschwend MH, Guserle R, Erenmemisoglu A, Martin W, Tamur U, Kanzik I, Hincal AA: Pharmacokinetics and bioequivalence study of ranitidine film tablets in healthy male subjects. Arzneimittelforschung. 2007;57(6):315-9. doi: 10.1055/s-0031-1296625.PubMed: 17688076
  9. 9 . Caitlin C. Nugent; Jamie M. Terrell (2018). H2 Blockers- StatPearls. StatPearls Publishing.
  10. 10 . FDA drug approval package: Zantac Link
  11. 11 . FDA Approved Drug Products: ZANTAC (ranitidine hydrochloride) injection Link
  12. 12 . GlaxoSmithKline Canada Inc. Product Monograph: Zantac (ranitidine) Link
  13. 13 . Ranitidine product monograph Link
  14. 14 . Zantac injection FDA label File
  15. 15 . Zantac Canadian Monograph File