Ranitidine

Overview of Ranitidine

Ranitidine is an H2 histamine receptor antagonist used to decrease stomach acid production. It is commonly prescribed for the treatment and prevention of ulcers in the stomach and intestines, gastroesophageal reflux disease (GERD), and Zollinger-Ellison syndrome. It may also be used to treat conditions where a reduction of stomach acid is necessary.

Pharmacological Properties

Ranitidine works by selectively blocking H2 histamine receptors on the cells in the stomach lining that produce acid, thereby reducing the volume and concentration of the stomach secretions. Its onset of action typically occurs within one hour, with effects lasting up to 12 hours. Ranitidine is absorbed in the small intestine and is metabolized in the liver to its active metabolite, ranitidine N-oxide.

Available Dosage Forms

Ranitidine is available in various dosage forms including tablets, effervescent tablets, capsules, and injectable solutions. Oral formulations can be found in over-the-counter and prescription strengths, typically ranging from 75mg to 300mg. Parenteral administration is reserved for inpatient settings or when oral administration is not feasible.

Dosing Guidelines

Dosing of ranitidine depends on the specific condition being treated. For adults with peptic ulcer disease, the typical dose is 150 mg twice daily or 300 mg at bedtime. For GERD, the usual dose is 150 mg twice daily. Dosing adjustments may be required for individuals with renal impairment. Pediatric dosing is based on the child’s weight and the specific indication.

Administration Instructions

Ranitidine tablets and capsules should be swallowed whole, not crushed, split, or chewed, and can be taken with or without food. It is important to follow administration instructions carefully to ensure maximum efficacy and minimize potential side effects. Patients receiving effervescent tablets should dissolve the tablet completely in water before ingestion.

Drug Interactions

Ranitidine may interact with certain medications such as warfarin, ketoconazole, triazolam, and glipizide. It can affect the absorption of drugs that require an acidic environment. Patients should inform their healthcare provider of all medications, including over-the-counter drugs and supplements, they are currently taking to prevent potential interactions.

Adverse Reactions and Side Effects

Common side effects of ranitidine include headaches, dizziness, constipation, or diarrhea. While rare, serious side effects such as liver enzyme elevations, blood count changes, and acute porphyria have been reported. If side effects become severe or persistent, patients should contact their healthcare provider immediately.

Special Populations Considerations

Pregnant and breastfeeding women should only use ranitidine if absolutely necessary and directed by a healthcare provider. Caution is also advised in the elderly due to the increased risk of renal impairment. Dose adjustments are frequently necessary in patients with moderate to severe renal dysfunction to prevent accumulation of the drug and potential toxicity.

Patient Monitoring and Follow-up

Patients taking ranitidine for peptic ulcer disease should have follow-up evaluations to assess for ulcer healing and symptom resolution. For chronic conditions, periodic assessments by a healthcare provider are recommended to monitor for efficacy and any adverse effects. Renal function should be monitored regularly in populations at risk for renal impairment.

Storage and Handling

Ranitidine should be stored at room temperature, away from light and moisture. Oral solutions should not be frozen and should be used within a specified period once the bottle is opened. Proper handling also entails verifying expiration dates and ensuring the integrity of the medication’s packaging.

Disposal Guidelines

Expired or no longer needed ranitidine should be disposed of safely. It is important not to flush medications down the toilet or pour them into drainage systems unless specifically instructed to do so. Many localities have medicine take-back programs to aid in the proper disposal of unused medications.

Patient Counselling Information

Healthcare providers should inform patients about the potential benefits and risks associated with ranitidine use. Patients should be educated on properly taking the medication, the importance of adhering to prescribed dosing schedules, recognizing potential side effects, and the need for periodic monitoring by their healthcare provider.