Ranitidine

Ranitidine is a histamine H-2 receptor antagonist similar to cimetidine and famotidine. Competitively inhibits the binding of histamine to receptors on gastric parietal cells (designated as the H-2 receptor), thus reducing basal and nocturnal gastric acid secretion. It also decreases the amount of gastric acid released in response to stimuli such as food, caffeine, insulin etc. Ranitidine is 5-12 times as potent as cimetidine as a histamine receptor antagonist while having less affinity than cimetidine for the cytochrome hepatic enzyme system. As a result, ranitidine is much less likely than cimetidine to interact with other drugs, although drug interactions with ranitidine do exist. Similar to other H2-receptor antagonists, the main use of ranitidine is in the treatment of gastrointestinal disorders. In June 1983 ranitidine was approved by the FDA for use in managemnt of duodenal ulcer and hypersecretory states. Ranitidine is administered orally and by intravevous injection or infusion.


Adult Dose
Dose: 150 mg
Single Dose: 150 (150)
Frequency: 8 hourly
Route: PO,IV,IM
Instructions:
Neonatal
Dose: 0.5 mg/kg
Single Dose: 0.5 (0.5)
Frequency: 6 hourly
Route: Intravenous
Instructions:
Paedriatic
Dose: 0.5 to 1 mg/kg
Single Dose: 0.75 (0.75)
Frequency: 6 hourly
Route: Intramuscular
Instructions:
Characteristics
Ranitidine Bismutrex, Ranitidine Bismutrex, Ranitidine Bismutrex are the derivatives of Ranitidine. It is of Synthetic origin and belongs to Furanyl Amine. It belongs to H2-antagonist pharmacological group on the basis of mechanism of action and also classified in Histamine (H-2) Antagonists pharmacological group.The Molecular Weight of Ranitidine is 350.90. Its pKa is 2.3, 8.2.
Contraindications
Ranitidine is contraindicated in conditions like Hypersensitivity,Pregnancy,Porphyria,Breast feeding,Pain and inflammation (rheumatic disease).
Effects
The severe or irreversible adverse effects of Ranitidine, which give rise to further complications include Thrombocytopenia, Hepatitis, Hepatomegaly, Stevens johnson syndrome, Bradycardia, AV-block, Leucopenia, Acute pancreatitis, Pancytopenia, Marrow hypoplasia.The symptomatic adverse reactions produced by Ranitidine are more or less tolerable and if they become severe, they can be treated symptomatically, these include Dizziness, Tiredness, Headache, Nausea, Diarrhea, Fever, Constipation, Rashes, Confusion, Erythema, Dysuria, Hallucination, Impotence, Darkening of stool and tongue, Depression, Arthralgia, Gynecomastia, Agitation, Anaphylactic shock.
Indications
'Ranitidine is primarily indicated in conditions like Benign gastric and duodenal ulceration, Benign gastric ulcer, Chronic episodic dyspepsia, Duodenal ulcer, Duodenal ulceration, Duodenal ulceration associated with H. Pylori, Gastric acid reduction (surgical procedures), Gastric acidity, Gastro-oesophageal reflux disease, Heart burn, Long-term treatment of healed gastro-oesophageal reflux disease, NSAID-associated ulceration, Peptic ulcer, Post-operative ulcer, Prophylaxis of acid aspiration in obstetric patients, Prophylaxis of NSAID-associated gastric or duodenal ulcer, Prophylaxis of NSAID-induced duodenal ulcer, Prophylaxis of NSAID-induced ulcer, Prophylaxis of recurrent haemorrhage, Prophylaxis of stress ulceration, Reflux oesophagitis, Zollinger-ellison syndrome, and can also be given in adjunctive therapy as an alternative drug of choice in Helicobacter pylori infection, Long-term treatment of healed reflux oesophagitis, Long-term treatment of reflux oesophagitis, Moderate to severe reflux oesophagitis, Prophylaxis of acid aspiration in obstetrics, Prophylaxis of mendelson''s syndrome, Surgical procedures.'
Interactions
Ranitidine is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementAlendronate (Na)Intravenous Radministration of Ranitidine was shown to double the bioavailablity of oral Alendronate (Na).Aluminium Hydroxide and OxideCeftibutenDabrafenibH2-receptor antagonists may alter the solubility of dabrafenib and reduce its bioavailabilityKetoconazoleRanitidine increases gastric pH and decrease the absorption of ketoconazole thus reduces its bioavailability upto 75% to 80% results decreased plasma level.ModerateCo-administration is not recommended.Metformin (HCl)Ranitidine reduces the excretion of metformin by competing for renal tubular transport results in increased level of metformin may lead to lactic acidosis.ModerateSlowly reduce the dose of metformin. Closely monitor the blood glucose level. Patient should notify to physician if experience signs of lactic acidosis.MidazolamNaproxenRanitidine increases the dissolution rate of enteric-coated naproxen so, drug release in stomach instead of small intestine.ModerateCombination should be avoidedin patient taking enteric-coated formulation.PramipexoleRanitidine decrease the clearance of pramipexole by ~20%.Sodium DiatrizoateShould not be use concurrently without informing doctor.SucralfateTolazoline (HCl) These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.
Interfrence
Liver Function Test (LFT)
Risks
Drug should not be given to Pregnant Mothers, patients suffering from Kidney dysfunction, patients suffering from Liver Malfunction, Geriatrics, and Neonates.If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.
Storage
Caps Store at room temperature, Below 25°C or in refrigerator. Do not Freeze. Protect from Sunlight and Moisture. Tab Store Below 40°C. Protect from Sunlight and Moisture.
Warnings
Ranitidine should be used with caution in patients with impaired kidney or liver function. Intravenous injection should be given slowly and intravenous infusion is recommended in patients with cardiovascular impairment. Exclude the possibility of malignancy in gastric ulcer before instituting therapy. Regular supervision of patient with peptic ulcer and on non-steroidal anti-inflammatory drugs is recommended, especially if eldery.Should be avoided in the patient with history of acute porphyria.Ranitidine Bismuth Citrate should be used with caution in hepatic impairment, in renal impairment, pregnancy, breast feeding.H2 receptor antagonists might mask the symptoms of gastric cancer; perticular care is required in those whose symptoms change and in those who are middle-aged or over.
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