Ranitidine Injection Shortage
Last Updated: March 21, 2017
- West-Ward discontinued ranitidine injection in September 2014.
- Covis had Zantac on shortage due to capacity issues at the manufacturer.
- IGI laboratories acquired Zantac injection from Covis in October 2015. IGI was renamed Teligent. Teligent has Zantac injection available.
- Zydus has ranitidine injection available.
- Oral ranitidine products are not affected by this shortage.
- Zantac solution for injection, Teligent, 25 mg/mL, 2 mL vial, 10 count, NDC 24987-0362-10
- Zantac solution for injection, Teligent, 25 mg/mL, 40 mL vial, 1 count, NDC 24987-0364-01
- Zantac solution for injection, Teligent, 25 mg/mL, 6 mL vial, 1 count, NDC 24987-0363-01
- Ranitidine solution for injection, Zydus, 25 mg/mL, 2 mL vial, 10 count, NDC 68382-0422-02
- Ranitidine solution for injection, Zydus, 25 mg/mL, 6 mL vial, 1 count, NDC 68382-0423-06
Estimated Resupply Dates
- All marketed presentations are available.
Implications for Patient Care
- Ranitidine is a histamine type-2 receptor antagonist, or H2 blocker, which reduces gastric acid secretion in response to physiologic and dietary stimuli. Ranitidine injection is used for patients with hypersecretory conditions, intractable ulcers, or for patients who cannot receive oral therapy.
- Ensure patients receive an appropriate alternative based on their specific clinical indication.
- The drug interaction profile differs between the H2 blocker class and the proton pump inhibitors (PPIs). Evaluate the patient's medication profile for drug interactions when switching between different drug classes.
Alternative Agents & Management
- Use oral H2 blocker therapy whenever possible.
- In patients who require IV therapy, famotidine injection may be an alternative to ranitidine injection. If IV H2 blockers are not available, consider therapy with an injectable proton pump inhibitor.
- Table 1 summarizes potential alternatives in selected clinical situations.
Table 1. Recommendations for Acid Suppressive Therapy In Adults in Specific Clinical Situations CLINICAL SITUATION RECOMMENDATIONS Adult with active duodenal ulcer, but unable to take oral medication5-6 Ranitidine 50 mg IV every 8 hours
Famotidine 20 mg IV every 12 hours
Gastrointestinal bleeding: prevention or treatment 10-18,5,7-9 Ranitidine 6.25-10 mg/hour continuous IV infusion
Famotidine 20 mg IV every 12 hours or
1.7-4 mg/hour continuous IV infusion
Esomeprazole IV 80 mg bolus followed by a constant infusion of 8 mg/hr for 72 hours
Pantoprazole IV 80 mg bolus followed by a constant infusion of 8 mg/hr for 72 hours
Hypersecretory conditions10-17,5,7-9 Ranitidine 50 mg every 6-8 hours or
1-2.5 mg/kg/hour continuous IV infusion
Famotidine 20 mg IV every 6 hours
Esomeprazole 20 - 40 mg IV every 24 hours
Pantoprazole IV 80 mg every 12 hours or 80 mg every 8 hours (doses > 240 mg/day or for > 6 days have not been studied)
Adjust doses to achieve desired response.
- West-Ward, (personal communications). July 25, August 5, November 26, 2014; and July 14, 2015.
- Covis Pharma (personal communications). July 29, September 5, October 13, November 10, December 3, 16, and 30, 2014; February 5, May 4, July 14, and September 21, 2015.
- Teligent (personal communications). October 20, and November 2, 2015; January 26, April 8, July 12, August 11, September 29, November 2, December 19, 2016; January 4 and 31, February 10 and 17, and March 17, 2017.
- Zydus (personal communications). February 17, May 8, July 14, and September 21, 2015; January 26, April 11, July 12, August 10, October 19, December 19, 2016; February 10, and March 21, 2017.
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Updated March 21, 2017 by Michelle Wheeler, PharmD, Drug Information Specialist. Created September 21, 2015 by Michelle Wheeler, PharmD, Drug Information Specialist. Copyright 2017, Drug Information Service, University of Utah, Salt Lake City, UT.
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