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Ranitidine

Medically reviewed by Drugs.com. Last updated on Jul 31, 2020.

Pronunciation

(ra NI ti deen)

Index Terms

  • Ranitidine HCl
  • Ranitidine Hydrochloride

Pharmacologic Category

  • Histamine H2 Antagonist

Pharmacology

Competitive inhibition of histamine at H2-receptors of the gastric parietal cells, which inhibits gastric acid secretion, gastric volume, and hydrogen ion concentration are reduced. Does not affect pepsin secretion, pentagastrin-stimulated intrinsic factor secretion, or serum gastrin.

Absorption

Oral: 50%; IM: Rapid

Distribution

Vd: Minimally penetrates the blood-brain barrier

Infants, Children, and Adolescents: IV, Oral: 1 to 2.3 L/kg

Adults: ~1.4 L/kg in patients with normal renal function; 1.76 L/kg in patients with CrCl 25 to 35 mL/minute

Metabolism

Hepatic (minor) to N-oxide, S-oxide, and N-desmethyl metabolites

Excretion

Urine (as unchanged drug): Oral: 30%, IV: 70%; feces (as metabolites)

Time to Peak

Serum: Oral: 2 to 3 hours; IM: ≤15 minutes

Half-Life Elimination

Neonates (receiving ECMO): IV: 6.6 hours

Infants, Children, and Adolescents: IV: 1.7 to 2.4 hours

Adults:

Oral: Normal renal function: 2.5 to 3 hours; Elderly: 3 to 4 hours

IV: Normal renal function: 2 to 2.5 hours; CrCl 25 to 35 mL/minute: 4.8 hours; Elderly: 3.1 hours

Protein Binding

~15%

Special Populations: Renal Function Impairment

Plasma half-life, clearance, and volume of distribution are all altered in proportion to creatinine clearance.

Special Populations: Hepatic Function Impairment

Alterations in half-life, distribution, clearance, and bioavailability are minor but clinically insignificant.

Special Populations: Elderly

Total clearance is lowered.

Special Populations: Children

In pediatric cardiac failure, clearance may be reduced. In a prospective population pharmacokinetic study of critically ill pediatric patients (n=78; age range: 15 days to 15.51 years), cardiac failure/surgery was found to reduce clearance by a factor of 0.463 (Hawwa 2013).

Use: Labeled Indications

Oral:

Gastroesophageal reflux disease: Treatment of gastroesophageal reflux disease (GERD).

Heartburn (OTC only): Relief and prevention of heartburn associated with acid indigestion and sour stomach.

Peptic ulcer disease: Treatment of active duodenal or gastric ulcers.

Injection:

Patients not able to take oral medication: As an alternative to the oral ranitidine dosage form for short-term (eg, GERD, peptic ulcer disease) use in patients who are unable to take oral medication.

Contraindications

Hypersensitivity to ranitidine or any component of the formulation

OTC labeling: When used for self-medication (OTC), do not use if trouble or pain when swallowing food, vomiting with blood, or bloody or black stools, allergic to ranitidine or other acid reducers. Do not use with other acid reducers. Do not use 150 mg tablet with kidney disease without medical advice.

Documentation of allergenic cross-reactivity for histamine H2 antagonists is limited. However, because of similarities in chemical structure and/or pharmacologic actions, the possibility of cross-sensitivity cannot be ruled out with certainty.

Dosing: Adult

Note: As of April 2020, all prescription (including oral and injectable) and OTC ranitidine formulations have been withdrawn from the US market.

Duodenal ulcer:

Oral: Treatment: 150 mg twice daily, or 300 mg once daily after the evening meal or at bedtime; maintenance of healing: 150 mg once daily at bedtime.

IM: 50 mg every 6 to 8 hours.

IV:

Intermittent bolus or infusion: 50 mg every 6 to 8 hours (if increased doses are necessary utilize more frequent administration up to a maximum of 400 mg/day).

Continuous IV infusion: 6.25 mg/hour.

Gastric ulcer, benign: Oral: 150 mg twice daily; maintenance of healing: 150 mg once daily at bedtime.

Gastroesophageal reflux disease: Oral: 150 mg twice daily.

Heartburn prevention or relief (OTC labeling): Oral:

Prevention: 75 to 150 mg 30 to 60 minutes before eating food or drinking beverages that cause heartburn (maximum: 2 doses/day); do not use for more than 14 days.

Relief of symptoms: 75 mg to 150 mg up to twice daily (maximum: 2 doses/day); do not use for more than 14 days.

Dosing: Geriatric

Refer to adult dosing (use caution with dose selection).

Dosing: Pediatric

Note: As of April 2020, all prescription (including oral and injectable) and OTC ranitidine formulations have been withdrawn from the US market.

Duodenal or gastric ulcer:

Treatment:

Infants, Children, and Adolescents ≤16 years:

Oral: 4 to 8 mg/kg/day divided twice daily; maximum daily dose: 300 mg/day.

IV: 2 to 4 mg/kg/day divided every 6 to 8 hours; maximum dose: 50 mg/dose.

Adolescents >16 years:

Oral:

Duodenal ulcer: 150 mg twice daily or 300 mg once daily after the evening meal or at bedtime.

Gastric ulcer: 150 mg twice daily.

IV, IM: 50 mg every 6 to 8 hours.

Maintenance:

Infants, Children, and Adolescents ≤16 years: Oral: 2 to 4 mg/kg/day once daily; maximum daily dose: 150 mg/day.

Adolescents >16 years: Oral: 150 mg once daily at bedtime.

Erosive esophagitis:

Infants, Children, and Adolescents ≤16 years: Oral: 5 to 10 mg/kg/day divided twice daily; maximum dose: 150 mg/dose.

Adolescents >16 years: Oral:

Treatment: 150 mg 4 times daily.

Maintenance: 150 mg twice daily.

GI bleed or stress ulcer; prophylaxis: Limited data available; dosing regimens variable:

Intermittent IV infusion:

Infants: 2 to 6 mg/kg/day divided every 8 hours (ASHP 1999; Crill 1999).

Children and Adolescents: 2 to 6 mg/kg/day divided every 6 hours; maximum daily dose: 300 mg/day (ASHP 1999; Crill 1999; Yildizdas 2002).

Continuous IV infusion: Infants, Children, and Adolescents: Initial: 0.15 to 0.5 mg/kg/dose for 1 dose, followed by infusion of 0.08 to 0.2 mg/kg/hour (2 to 5 mg/kg/day) (Kliegman 2007; Lugo 2001; Osteyee 1994).

Gastroesophageal reflux disease: Note: Guidelines recommend a 4- to 8-week treatment course; if improvement seen after 4 to 8 weeks, consider possible wean; if no response after 4 to 8 weeks, reevaluate diagnosis and consider referral to pediatric GI specialist (NASPGHAN/ESPGHAN [Rosen 2018]).

Infants, Children, and Adolescents: Oral: 5 to 10 mg/kg/day in 2 to 3 divided doses; maximum daily dose: 300 mg/day (AAP [Lightdale 2013]; NASPGHAN/ESPGHAN [Rosen 2018]).

Heartburn: OTC labeling: Note: Do not use for more than 14 days.

Prevention: Children ≥12 years and Adolescents: Oral: 75 to 150 mg 30 to 60 minutes before eating food or drinking beverages which cause heartburn; maximum daily dose: 2 doses/day.

Relief of symptoms: Children ≥12 years and Adolescents: Oral: 75 to 150 mg twice daily; maximum daily dose: 2 doses/day.

Pathological hypersecretory conditions (eg, Zollinger-Ellison): Note: Proton pump inhibitors are the preferred agents (Kliegman 2020).

Adolescents >16 years:

Oral: 150 mg twice daily; adjust dose or frequency as clinically indicated; doses of up to 6 g/day have been used.

Continuous IV infusion: Initial: 1 mg/kg/hour; measure gastric acid output at 4 hours, if >10 mEq/hour or if patient is symptomatic, increase dose in increments of 0.5 mg/kg/hour; doses of up to 2.5 mg/kg/hour (or 220 mg/hour) have been used.

Anaphylaxis, adjunct therapy: Note: Should not be used as monotherapy or as first-line therapy (AAAAI/ACAAI [Campbell 2014]; iCAALL [Simons 2014]; WAO [Simons 2015]).

Infants, Children, and Adolescents: IV: 1 mg/kg/dose; maximum dose: 50 mg/dose (AAAAI/ACAAI [Lieberman 2010]; Canadian Paediatric Society [Cheng 2011]).

Reconstitution

Intermittent bolus injection: Dilute in NS or other compatible IV solution to a maximum concentration of 2.5 mg/mL (20 mL).

Intermittent IV infusion: Dilute in D5W or other compatible IV solution to a maximum concentration of 0.5 mg/mL (100 mL).

IM: No dilution necessary.

Administration

Injection may be administered IM or IV:

IM: Injection is administered undiluted

IV: Must be diluted; may be administered intermittent bolus or intermittent IV infusion

Intermittent bolus: Manufacturer recommends a maximum rate of administration of 10 mg/minute (infuse over at least 5 minutes); however, in adults may also be administered at a maximum rate of 25 mg/minute (or over 2 minutes) if necessary (Coursin 1988; Goelzer 1988; Smith 1987).

Intermittent IV infusion: Administer over a maximum rate of 2.5 to 3.5 mg/minute (infuse over at least 15 to 20 minutes)

Dietary Considerations

Some products may contain phenylalanine and/or sodium. Oral dosage forms may be taken with or without food.

Storage

Capsules, tablets: Store between 20°C and 25°C (68°F and 77°F). Protect from light. Protect from moisture.

Injection: Store intact vials between 4°C and 25°C (39°F to 77°F); excursion permitted to 30°C (86°F). Protect from light; do not freeze. Avoid excessive heat (brief exposure up to 40°C does not affect the product). Undiluted solution is a clear, colorless to yellow color; slight darkening does not affect potency. Stable for 48 hours at room temperature when diluted for infusion in commonly used IV solutions (eg, NS, D5W, D10W, Ringer's lactate injection, sodium bicarbonate 5% injection).

Syrup: Store between 20°C and 25°C (68°F and 77°F); excursions permitted to 15°C to 30°C (59°F to 86°F). Do not freeze. Protect from light.

Drug Interactions

Acalabrutinib: Histamine H2 Receptor Antagonists may decrease the serum concentration of Acalabrutinib. Management: To minimize the potential for a significant interaction, separate administration of these agents by giving acalabrutinib 2 hours before ingestion of a histamine-2 receptor antagonist. Consider therapy modification

Atazanavir: Histamine H2 Receptor Antagonists may decrease the serum concentration of Atazanavir. Management: Specific dose limitations and administration guidelines exist; consult full interaction monograph or atazanavir prescribing information. Consider therapy modification

Bosutinib: Histamine H2 Receptor Antagonists may decrease the serum concentration of Bosutinib. Management: Administer histamine H2 receptor antagonists more than 2 hours before or after bosutinib. Consider therapy modification

Cefditoren: Histamine H2 Receptor Antagonists may decrease the serum concentration of Cefditoren. Management: Concomitant use of cefditoren with H2-antagonists and antacids is not recommended. Consider alternative methods to control acid reflux (eg, diet modification) or alternative antimicrobial therapy if use of H2-antagonists can not be avoided. Consider therapy modification

Cefpodoxime: Histamine H2 Receptor Antagonists may decrease the absorption of Cefpodoxime. Separate oral doses by at least 2 hours. Monitor therapy

Cefuroxime: Histamine H2 Receptor Antagonists may decrease the absorption of Cefuroxime. Separate oral doses by at least 2 hours. Avoid combination

Cysteamine (Systemic): Histamine H2 Receptor Antagonists may diminish the therapeutic effect of Cysteamine (Systemic). Monitor therapy

Dacomitinib: Histamine H2 Receptor Antagonists may decrease the serum concentration of Dacomitinib. Management: Administer dacomitinib at least 6 hours before or 10 hours after an histamine H2-receptor antagonist (H2RA). Consider therapy modification

Dasatinib: Histamine H2 Receptor Antagonists may decrease the absorption of Dasatinib. Management: Antacids (taken 2 hours before or after dasatinib administration) can be used in place of H2-antagonists if some acid-reducing therapy is needed. Avoid combination

Delavirdine: Histamine H2 Receptor Antagonists may decrease the serum concentration of Delavirdine. Management: Chronic therapy with H2-antagonists should be avoided in patients who are being treated with delavirdine. The clinical significance of short-term H2-antagonist therapy with delavirdine is uncertain, but such therapy should be undertaken with caution. Avoid combination

Dexmethylphenidate: Histamine H2 Receptor Antagonists may increase the absorption of Dexmethylphenidate. Specifically, H2-antagonists may interfere with the normal release of drug from the extended-release capsules (Focalin XR brand), which could result in both increased absorption (early) and decreased delayed absorption. Monitor therapy

Doxofylline: RaNITIdine (Withdrawn from US Market) may increase the serum concentration of Doxofylline. Monitor therapy

Enoxacin: Histamine H2 Receptor Antagonists may decrease the absorption of Enoxacin. Monitor therapy

Erdafitinib: May increase the serum concentration of OCT2 Substrates. Monitor therapy

Erlotinib: Histamine H2 Receptor Antagonists may decrease the serum concentration of Erlotinib. Management: Avoid H2-antagonists in patients receiving erlotinib when possible. If concomitant treatment cannot be avoided, erlotinib should be dosed once daily, 10 hours after and at least 2 hours before H2-antagonist dosing. Consider therapy modification

Fosamprenavir: Histamine H2 Receptor Antagonists may decrease the serum concentration of Fosamprenavir. Cimetidine may also inhibit the metabolism of the active metabolite amprenavir, making its effects on fosamprenavir/amprenavir concentrations difficult to predict. Monitor therapy

Gefitinib: Histamine H2 Receptor Antagonists may decrease the serum concentration of Gefitinib. Management: Administer gefitinib at least 6 hours before or 6 hours after administration of a histamine H2-antagonist, and closely monitor clinical response to gefitinib. Consider therapy modification

Indinavir: Histamine H2 Receptor Antagonists may decrease the serum concentration of Indinavir. Monitor therapy

Iron Preparations: Histamine H2 Receptor Antagonists may decrease the absorption of Iron Preparations. Exceptions: Ferric Carboxymaltose; Ferric Citrate; Ferric Derisomaltose; Ferric Gluconate; Ferric Hydroxide Polymaltose Complex; Ferric Pyrophosphate Citrate; Ferumoxytol; Iron Dextran Complex; Iron Sucrose. Monitor therapy

Itraconazole: Histamine H2 Receptor Antagonists may increase the serum concentration of Itraconazole. Histamine H2 Receptor Antagonists may decrease the serum concentration of Itraconazole. Management: Administer Sporanox brand itraconazole at least 2 hours before or 2 hours after administration of any histamine H2 receptor antagonists (H2RAs). Exposure to Tolsura brand itraconazole may be increased by H2RAs; consider itraconazole dose reduction. Consider therapy modification

Ketoconazole (Systemic): Histamine H2 Receptor Antagonists may decrease the serum concentration of Ketoconazole (Systemic). Management: Administer oral ketoconazole at least 2 hours prior to use of any H2-receptor antagonist. Monitor patients closely for signs of inadequate clinical response to ketoconazole. Consider therapy modification

Ledipasvir: Histamine H2 Receptor Antagonists may decrease the serum concentration of Ledipasvir. Management: Administer H2 receptor antagonist doses less than or comparable to famotidine 40 mg twice daily simultaneously or 12 hours prior to ledipasvir. The effect of administering H2 receptor antagonists at other time intervals is unknown and not recommended. Consider therapy modification

Lumacaftor and Ivacaftor: May decrease the serum concentration of RaNITIdine (Withdrawn from US Market). Lumacaftor and Ivacaftor may increase the serum concentration of RaNITIdine (Withdrawn from US Market). Monitor therapy

Mesalamine: Histamine H2 Receptor Antagonists may diminish the therapeutic effect of Mesalamine. Histamine H2-Antagonist-mediated increases in gastrointestinal pH may cause the premature release of mesalamine from specific sustained-release mesalamine products. Management: Consider avoiding concurrent administration of high-dose histamine H2-receptor antagonists with sustained-release mesalamine products. Consider therapy modification

Methylphenidate: Histamine H2 Receptor Antagonists may increase the absorption of Methylphenidate. Specifically, H2-antagonists may interfere with the normal release of drug from the extended-release capsules (Ritalin LA brand), which could result in both increased absorption (early) and decreased delayed absorption. Monitor therapy

Multivitamins/Minerals (with ADEK, Folate, Iron): Histamine H2 Receptor Antagonists may decrease the serum concentration of Multivitamins/Minerals (with ADEK, Folate, Iron). Specifically, the absorption of iron may be impaired by H2-antagonists. Monitor therapy

Nelfinavir: Histamine H2 Receptor Antagonists may decrease serum concentrations of the active metabolite(s) of Nelfinavir. Histamine H2 Receptor Antagonists may decrease the serum concentration of Nelfinavir. Concentrations of the active M8 metabolite may also be reduced. Monitor therapy

Neratinib: Histamine H2 Receptor Antagonists may decrease the serum concentration of Neratinib. Specifically, histamine H2 receptor antagonists may reduce neratinib absorption. Management: Administer neratinib at least 2 hours before or 10 hours after administration of a histamine H2 receptor antagonist to minimize the impact of this interaction. Consider therapy modification

Nilotinib: Histamine H2 Receptor Antagonists may decrease the serum concentration of Nilotinib. Management: The nilotinib dose should be given 10 hours after or 2 hours before the H2 receptor antagonist in order to minimize the risk of a significant interaction. Consider therapy modification

Octreotide: Histamine H2 Receptor Antagonists may decrease the serum concentration of Octreotide. Monitor therapy

PAZOPanib: Histamine H2 Receptor Antagonists may decrease the serum concentration of PAZOPanib. Management: Avoid the use of histamine H2-antagonists in combination with pazopanib. Strategies to minimize the expected interaction between these agents (eg, dose separation) have not been investigated. Avoid combination

Pexidartinib: Histamine H2 Receptor Antagonists may decrease the serum concentration of Pexidartinib. Management: Administer pexidartinib 2 hours before or 10 hours after histamine H2 receptor antagonists. Consider therapy modification

Posaconazole: Histamine H2 Receptor Antagonists may decrease the serum concentration of Posaconazole. Management: Avoid concurrent use of oral suspension with H2-antagonists whenever possible. Monitor patients closely for decreased antifungal effects if this combination is used. Delayed-release posaconazole tablets may be less likely to interact. Consider therapy modification

Prasugrel: RaNITIdine (Withdrawn from US Market) may decrease serum concentrations of the active metabolite(s) of Prasugrel. Monitor therapy

Procainamide: RaNITIdine (Withdrawn from US Market) may increase the serum concentration of Procainamide. Ranitidine may also increase the concentration of the active N-acetyl-procainamide (NAPA) metabolite. Monitor therapy

Rilpivirine: Histamine H2 Receptor Antagonists may decrease the serum concentration of Rilpivirine. Management: Administer histamine H2 receptor antagonists at least 12 hours before or 4 hours after rilpivirine. Consider therapy modification

Risedronate: Histamine H2 Receptor Antagonists may increase the serum concentration of Risedronate. This applies specifically to delayed-release risedronate. Avoid combination

Saquinavir: Histamine H2 Receptor Antagonists may increase the serum concentration of Saquinavir. Monitor therapy

Secretin: Histamine H2 Receptor Antagonists may diminish the diagnostic effect of Secretin. Specifically, use of H2-Antagonists may cause a hyperresponse in gastrin secretion in response to secretin stimulation testing, falsely suggesting gastrinoma. Management: Avoid concomitant use of histamine H2-antagonists (H2RAs) and secretin. Discontinue H2RAs at least 2 days prior to secretin administration. Consider therapy modification

Selpercatinib: Histamine H2 Receptor Antagonists may decrease the serum concentration of Selpercatinib. Management: Coadministration of selpercatinib and H2 receptor antagonists should be avoided. If coadministration cannot be avoided, selpercatinib should be administered 2 hours before or 10 hours after H2 receptor antagonists. Consider therapy modification

Sulfonylureas: RaNITIdine (Withdrawn from US Market) may increase the serum concentration of Sulfonylureas. Monitor therapy

Tafenoquine: May increase the serum concentration of OCT2 Substrates. Management: Avoid use of OCT2 substrates with tafenoquine, and if the combination cannot be avoided, monitor closely for evidence of toxicity of the OCT2 substrate and consider a reduced dose of the OCT2 substrate according to that substrate's labeling. Consider therapy modification

Triazolam: RaNITIdine (Withdrawn from US Market) may increase the serum concentration of Triazolam. Monitor therapy

Varenicline: Histamine H2 Receptor Antagonists may increase the serum concentration of Varenicline. Management: Monitor for increased varenicline adverse effects with concomitant use of cimetidine or other H2-antagonists, particularly in patients with severe renal impairment. International product labeling recommendations vary. Consult appropriate labeling. Monitor therapy

Velpatasvir: Histamine H2 Receptor Antagonists may decrease the serum concentration of Velpatasvir. Monitor therapy

Warfarin: RaNITIdine (Withdrawn from US Market) may increase the serum concentration of Warfarin. Monitor therapy

Test Interactions

False-positive urine protein using Multistix.

Adverse Reactions

Frequency not defined.

Cardiovascular: Asystole, atrioventricular block, bradycardia (with rapid IV administration), tachycardia, vasculitis, ventricular premature contractions

Central nervous system: Agitation, confusion, dizziness, depression, drowsiness, hallucination, headache, insomnia, involuntary motor activity, malaise, vertigo

Dermatologic: Alopecia, erythema multiforme, injection site pruritus (transient), skin rash

Endocrine & metabolic: Acute porphyria, increased serum prolactin

Gastrointestinal: Abdominal distress, abdominal pain, constipation, diarrhea, nausea, necrotizing enterocolitis (very low weight neonates; Guillet 2006), pancreatitis, vomiting

Hematologic & oncologic: Agranulocytosis, aplastic anemia, granulocytopenia, hemolytic anemia (immune; acquired), leukopenia, pancytopenia, thrombocytopenia

Hepatic: Cholestatic hepatitis, hepatic failure, hepatitis, jaundice

Hypersensitivity: Anaphylaxis, angioedema, hypersensitivity reaction (eg, bronchospasm, eosinophilia, fever)

Local: Burning sensation at injection site (transient), pain at injection site (transient)

Neuromuscular & skeletal: Arthralgia, myalgia

Ophthalmic: Blurred vision

Renal: Acute interstitial nephritis, increased serum creatinine

Respiratory: Pneumonia (causal relationship not established)

Warnings/Precautions

Concerns related to adverse effects:

• Confusion: Rare cases of reversible confusion have been associated with ranitidine; usually elderly or severely ill patients, or in patients with renal or hepatic impairment.

• Hepatic effects: Elevation in ALT levels has occurred with higher doses (≥100 mg) or prolonged IV therapy (≥5 days); monitor ALT levels daily for the remainder of treatment.

• Vitamin B12 deficiency: Prolonged treatment (≥2 years) may lead to vitamin B12 malabsorption and subsequent vitamin B12 deficiency. The magnitude of the deficiency is dose-related and the association is stronger in females and those younger in age (<30 years); prevalence is decreased after discontinuation of therapy (Lam 2013).

Disease-related concerns:

• Gastric malignancy: Relief of symptoms does not preclude the presence of a gastric malignancy.

• Hepatic impairment: Use with caution in patients with hepatic impairment (ranitidine undergoes hepatic metabolism).

• Porphyria: Avoid use in patients with a history of acute porphyria; may precipitate attacks.

• Renal impairment: Ranitidine is primarily excreted renally; dosage adjustment is recommended in patients with renal impairment.

Concurrent drug therapy issues:

• Drug-drug interactions: Potentially significant interactions may exist, requiring dose or frequency adjustment, additional monitoring, and/or selection of alternative therapy. Consult drug interactions database for more detailed information.

Special populations:

• Children: Use of gastric acid inhibitors, including proton pump inhibitors and H2 blockers, has been associated with an increased risk for development of acute gastroenteritis and community-acquired pneumonia in pediatric patients (Canani 2006).

Dosage form specific issues:

• Injection: Rapid administration has been associated with bradycardia (rare), usually in patients with predisposing risk factors for cardiac rhythm disorders. Do not exceed the recommended IV administration rate(s).

• Syrup: May contain up to 7.5% alcohol.

Other warnings/precautions:

• OTC labeling: When used for self-medication (OTC), notify health care provider before use if any of the following are present: Frequent chest pain; frequent wheezing particularly with heartburn; nausea/vomiting; unexplained weight loss; stomach pain; heartburn longer than 3 months; heartburn with light-headedness, sweating, or dizziness; chest pain or shoulder pain with shortness of breath; sweating or pain that spreads to arms, neck, or shoulders; light-headedness. Stop use and notify health care provider if heartburn continues, worsens, or lasts longer than 14 days.

Monitoring Parameters

AST, ALT, serum creatinine; occult blood with GI bleeding, signs/symptoms of peptic ulcer disease; when used to prevent stress-related GI bleeding, measure the intragastric pH and try to maintain pH >4; when used for Zollinger-Ellison syndrome, monitor gastric acid secretion (goal: <10 mEq/hour); signs of confusion

Pregnancy Considerations

Ranitidine crosses the placenta (Armentano 1989).

Patient Education

What is this drug used for?

• It is used to treat gastroesophageal reflux disease (GERD; acid reflux).

• It is used to treat or prevent GI (gastrointestinal) ulcers.

• It is used to treat heartburn and sour stomach.

• It is used to treat syndromes caused by lots of stomach acid.

• It may be given to you for other reasons. Talk with the doctor.

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

• Headache

• Nausea

• Vomiting

• Constipation

• Diarrhea

• Abdominal pain

• Injection site irritation

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• Liver problems like dark urine, fatigue, lack of appetite, nausea, abdominal pain, light-colored stools, vomiting, or yellow skin.

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.

Note: This is not a comprehensive list of all side effects. Talk to your doctor if you have questions.

Consumer Information Use and Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a limited summary of general information about the medicine's uses from the patient education leaflet and is not intended to be comprehensive. This limited summary does NOT include all information available about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not intended to provide medical advice, diagnosis or treatment and does not replace information you receive from the healthcare provider. For a more detailed summary of information about the risks and benefits of using this medicine, please speak with your healthcare provider and review the entire patient education leaflet.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.