Why is this medication prescribed?

Ranitidine is used to treat ulcers; gastroesophageal reflux disease (GERD), a condition in which backward flow of acid from the stomach causes heartburn and injury of the food pipe (esophagus); and conditions where the stomach produces too much acid, such as ZollingerEllison syndrome. Over-the-counter ranitidine is used to prevent and treat symptoms of heartburn associated with acid indigestion and sour stomach. Ranitidine is in a class of medications called H2 blockers. It decreases the amount of acid made in the stomach.

How should this medicine be used?

Ranitidine comes as a tablet, an effervescent tablet, effervescent granules, and a syrup to take by mouth. It is usually taken once a day at bedtime or two to four times a day. Over-the-counter ranitidine comes as a tablet to take by mouth. It is usually taken once or twice a day. To prevent symptoms, it is taken 30 to 60 minutes before eating or drinking foods that cause heartburn. Follow the directions on your prescription or the package label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take ranitidine exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Dissolve ranitidine effervescent tablets and granules in a full glass (6 to 8 ounces [180 to 240 milliliters]) of water before drinking. Do not take over-the-counter ranitidine for longer than 2 weeks unless your doctor tells you to. If symptoms of heartburn, acid indigestion, or sour stomach last longer than 2 weeks, stop taking ranitidine and call your doctor.

Other uses for this medicine

Return to top

Ranitidine is also used sometimes to treat upper gastrointestinal bleeding and to prevent stress ulcers, stomach damage from use of nonsteroidal anti-inflammatory drugs (NSAIDs), and aspiration of stomach acid during anesthesia. Talk to your doctor about the risks of using this medication for your condition. This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow?

Return to top

Before taking ranitidine,

tell your doctor and pharmacist if you are allergic to ranitidine or any other medications. tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention either of the following: anticoagulants ('blood thinners') such as warfarin (Coumadin); and triazolam (Halcion). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.

tell your doctor if you have or have ever had porphyria, phenylketonuria, or kidney or liver disease. tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking ranitidine, call your doctor.

What special dietary instructions should I follow?

Return to top

Unless your doctor tells you otherwise, continue your normal diet.

What should I do if I forget a dose?

Return to top

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What side effects can this medication cause?

Return to top

Ranitidine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

headache constipation diarrhea nausea vomiting stomach pain

Ranitidine may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

What storage conditions are needed for this medicine?

Return to top

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

In case of emergency/overdose
Return to top

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

What other information should I know?

Return to top

Keep all appointments with your doctor. Before having any laboratory test, tell your doctor and the laboratory personnel that you are taking ranitidine. Do not let anyone else take your medicine. Ask your pharmacist any questions you have about refilling your prescription. It is important for you to keep a written list of all of the prescription and nonprescription (overthe-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

Brand names
Return to top

Tritec Zantac Zantac 75 Zantac EFFERdose

Zantac Premixed

ZANTAC 150 (ranitidine hydrochloride) Tablets, USP ZANTAC 300 (ranitidine hydrochloride) Tablets, USP ZANTAC 25 (ranitidine hydrochloride effervescent) EFFERdose Tablets ZANTAC (ranitidine hydrochloride) Syrup, USP DRUG DESCRIPTION The active ingredient in ZANTAC (ranitidine hcl) 150 Tablets, ZANTAC (ranitidine hcl) 300 Tablets, ZANTAC (ranitidine hcl) 25 EFFERdose Tablets, and ZANTAC Syrup is ranitidine hydrochloride (HCl), USP, a histamine H 2-receptor antagonist. Chemically it is N[2-[[[5-[(dimethylamino)methyl]-2furanyl]methyl]thio]ethyl]-N'-methyl-2-nitro-1,1-ethenediamine, HCl. It has the following structure:

The empirical formula is C13H22N4O3SHCl, representing a molecular weight of 350.87. Ranitidine HCl is a white to pale yellow, granular substance that is soluble in water. It has a slightly bitter taste and sulfurlike odor. Each ZANTAC (ranitidine hcl) 150 Tablet for oral administration contains 168 mg of ranitidine HCl equivalent to 150 mg of ranitidine. Each tablet also contains the inactive ingredients FD&C Yellow No. 6 Aluminum Lake, hypromellose, magnesium stearate, microcrystalline cellulose, titanium dioxide, triacetin, and yellow iron oxide. Each ZANTAC (ranitidine hcl) 300 Tablet for oral administration contains 336 mg of ranitidine HCl equivalent to 300 mg of ranitidine. Each tablet also contains the inactive ingredients croscarmellose sodium, D&C Yellow No. 10 Aluminum Lake, hypromellose, magnesium stearate, microcrystalline cellulose, titanium dioxide, and triacetin. ZANTAC (ranitidine hcl) 25 EFFERdose Tablets for oral administration is an effervescent formulation of ranitidine that must be dissolved in water before use. Each individual tablet contains 28 mg of ranitidine HCl equivalent to 25 mg of ranitidine and the following inactive ingredients: aspartame, monosodium citrate anhydrous, povidone, and sodium bicarbonate. Each tablet also contains sodium benzoate. The total sodium content of each tablet is 30.52 mg (1.33 mEq) per 25 mg of ranitidine. Each 1 mL of ZANTAC Syrup contains 16.8 mg of ranitidine HCl equivalent to 15 mg of ranitidine. ZANTAC (ranitidine hcl) Syrup also contains the inactive ingredients alcohol (7.5%), butylparaben, dibasic sodium phosphate, hypromellose, peppermint flavor, monobasic potassium phosphate, propylparaben, purified water, saccharin sodium, sodium chloride, and sorbitol.

WHAT ARE THE POSSIBLE SIDE EFFECTS OF RANITIDINE?

Stop using ranitidine and get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects:

chest pain, fever, feeling short of breath, coughing up green or yellow mucus; easy bruising or bleeding, unusual weakness; fast or slow heart rate; problems with your vision; fever, sore throat, and headache with a severe blistering,...

Read All Potential Side Effects and See Pictures of Zantac

WHAT ARE THE PRECAUTIONS WHEN TAKING RANITIDINE HCL (ZANTAC)?

Before taking ranitidine, tell your doctor or pharmacist if you are allergic to it; or to other H2 histamine blockers (e.g., cimetidine, famotidine); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details. This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: a certain blood disorder (porphyria). Before using this medication, tell your doctor or pharmacist your medical history, especially of: immune system problems, kidney problems, liver problems, lung diseases (e.g., asthma, chronic obstructive pulmonary disease-COPD), other stomach problems (e.g.,... Rea

Generic Name: Ranitidine Brand Name: Zantac, Zantac EFFERdose, Zantac GELdose, Zantac-75 Classifications: gastrointestinal agent; antisecretory (h2-receptor antagonist) Pregnancy Category:B Availability 75 mg, 150 mg, 300 mg tablets; 150 mg effervescent tablets; 150 mg, 300 mg capsules; 15 mg/mL syrup; 0.5 mg/mL, 25 mg/mL injection Actions Potent anti-ulcer drug that competitively and reversibly inhibits histamine action at H2-receptor sites on parietal cells, thus blocking gastric acid secretion. Indirectly reduces pepsin secretion but appears to have minimal effect on fasting and postprandial serum gastrin concentrations or secretion of gastric intrinsic factor or mucus. Therapeutic effects Blocks daytime and nocturnal basal gastric acid secretion stimulated by histamine and reduces gastric acid release in response to food, pentagastrin, and insulin. Shown to inhibit 50% of the stimulated gastric acid secretion. Uses Short-term treatment of active duodenal ulcer; maintenance therapy for duodenal ulcer patient after healing of acute ulcer; treatment of gastroesophageal reflux disease; short-term treatment of active, benign gastric ulcer; treatment of pathologic GI hypersecretory conditions (e.g., Zollinger-Ellison syndrome, systemic mastocytosis, and postoperative hypersecretion); heartburn. Contraindications Safe use during pregnancy (category B) or lactation is not established. Route & Dosage

Duodenal Ulcer,Gastric Ulcer, Gastroesophageal Reflux adult: PO 150 mg b.i.d. or 300 mg h.s. IV 50 mg q68h; 150300 mg/24 h by continuous infusion child: PO 45 mg/kg/d divided q812h (max: 6 mg/kg/d or 300 mg/d) IM/IV 24 mg/kg/d divided q68h; 0.10.125 mg/kg/h by continuous infusion infant: PO < 2 wk, 2 mg/kg/d divided q12h IV 1.5 mg/kg/d divided q12h or 0.04 mg/kg/h by continuous infusion Duodenal Ulcer,Maintenance Therapy adult: PO 150 mg h.s. Pathologic Hypersecretory Conditions adult: PO 150 mg b.i.d. up to 6.3 g/d IV 50 mg q68h Heartburn adult: PO 75 mg b.i.d. Administration Oral

Give with or without food; simultaneous administration does not appear to reduce absorption or serum concentrations.Administer adjunctive antacid treatment 2 h before or after drug. Store tablets in light-resistant, tightly capped container at 1530 C (5986 F) in a dry place. Note: Does not need to be diluted.

Intramuscular Intravenous

Note: Verify correct IV concentration and rate of infusion for infants and children with physician.

PREPARE direct:Dilute 50 mg NS, D5W, RL, or other compatible IV solution to a total volume of 20 mL.intermittent: Dilute 50 mg in 50100 mL of NS, D5W, RL, or other compatible IV solution. continuous: Dilute total daily dose in 250 mL of NS, D5W, RL, or other compatible IV solution. Final concentration should be <=2.5 mg/mL. ADMINISTER direct:Give at a rate of 4 mL/min or 20 mL over not less than 5 min. intermittent: Give over 1530 min. continuous: Give over 24 h. Adverse effects CNS:Headache, malaise, dizziness, somnolence, insomnia, vertigo, mental confusion, agitation, depression, hallucinations in older adults. CV:Bradycardia (with rapid IV push). GI:Constipation, nausea, abdominal pain, diarrhea. Skin:Rash. Hematologic:Reversible decrease in WBC count, thrombocytopenia. BodyWhole:Hypersensitivity reactions, anaphylaxis (rare). Nursing Implications Assessment & Drug Effects

Potential toxicity results from decreased clearance (elimination) and therefore prolonged action; greatest in the older adult patients or those with hepatic or renal dysfunction.

Lab tests: Periodic liver functions. Monitor creatinine clearance if renal dysfunction is present or suspected. When clearance is <50 mL/min, manufacturer recommends reduction of the dose to 150 mg once q24h with cautious and gradual reduction of the interval to q12h or less, if necessary.

Be alert for early signs of hepatotoxicity (though low and thought to be a hypersensitivity reaction): jaundice (dark urine, pruritus, yellow sclera and skin), elevated transaminases (especially ALT) and LDH. Long-term therapy may lead to vitamin B12 deficiency. Note: Long duration of action provides ulcer pain relief that is maintained through the night as well as the day. Be aware that even if symptomatic relief is provided by ranitidine, this should not be interpreted as absence of gastric malignancy. Follow-up examinations will be scheduled after therapy is discontinued.

Patient & Family Education

Adhere to scheduled periodic laboratory checkups during ranitidine treatmentDo not supplement therapy with OTC remedies for gastric distress or pain without physicians advice (e.g., Mylanta II reduces ranitidine absorption). Do not smoke; research shows smoking decreases ranitidine efficacy and adversely affects ulcer healing. Do not breast feed while taking this drug without consulting physician.

GENERIC NAME: ranitidine

BRAND NAME: Zantac

DRUG CLASS AND MECHANISM: Ranitidine is an oral drug that blocks the production of acid by acidproducing cells in the stomach. It belongs to a class of drugs called H2 (histamine-2) blockers that also includes cimetidine(Tagamet), nizatidine (Axid), and famotidine (Pepcid). Histamine is a naturallyoccurring chemical that stimulates cells in the stomach (parietal cells) to produce acid. H2-blockers inhibit the action of histamine on the cells, thus reducing the production of acid by the stomach. Since excessive stomach acid can damage the esophagus, stomach, and duodenum and lead to inflammation and ulceration, reducing stomach acid prevents and heals acid-induced inflammation and ulcers. The FDA approved ranitidine in October 1984. PRESCRIPTION: yes; OTC (Zantac 75 and 150 mg) GENERIC AVAILABLE: yes PREPARATIONS: Tablets or Capsules: 25, 75, 150 and 300 mg; Syrup: 15 mg/ml; Injection: 1 mg/ml or 25 mg/ml. STORAGE: Tablets should be stored at room temperature between 1530 C (59-86 F) in a tightly closed container. Syrup and injection should be stored between 4 and 25 C (39 and 77 F). PRESCRIBED FOR: Ranitidine is useful in promoting the healing of ulcers in the stomach and duodenum, and in reducing ulcer pain. Ranitidine has been effective in preventing ulcer recurrence when given in low doses for prolonged periods of time. It also is used as needed for the treatment of occasional heartburn to reflux of acid into the esophagus. In doses higher than that used for the treatment of ulcers, ranitidine has been helpful in treating heartburn and in healing ulcers and inflammation of the esophagus resulting from acid reflux (erosive esophagitis). It is also used for treating Zollinger Ellison syndrome, a syndrome caused by tumors that stimulate the stomach to produce large amounts of acid. DOSING: Ranitidine may be taken with or without food.

Usual oral doses for treating ulcers and GERD are 150 mg twice daily or 300 mg at bedtime. The maintenance dose is 150 mg daily. Erosive esophagitis is treated with 150 mg 4 times daily. Zollinger Ellison syndrome may be treated with as much as 6 g daily. Heartburn is treated with 75 mg or 150 mg once or twice daily 30-60 minutes before consuming meals or beverages that cause heartburn.

Self-medication should not last longer than 2 weeks unless advised by a physician. DRUG INTERACTIONS: Ranitidine, like other drugs that reduce stomach acid, may interfere with the absorption of drugs that require acid for adequate absorption. Examples include iron salts (for example iron sulphate), itraconazole (Sporanox), and ketoconazole (Nizoral, Extina, Xolegel, Kuric). PREGNANCY: There are no adequate studies of ranitidine in pregnant women. Available evidence suggests that there is little risk when used during pregnancy. NURSING MOTHERS: Ranitidine is secreted into human breast milk and may pose a potential risk to the infant. SIDE EFFECTS: Minor side effects include constipation, diarrhea, fatigue,headache, insomnia, muscle pain, nausea, and vomiting. Major side effects are rare; they include: agitation, anemia, confusion, depression, easy bruising or bleeding, hallucinations, hair loss, irregular heartbeat, rash, visual changes, and yellowing of the skin or eyes. Reference: FDA Prescribing Information

GENERIC NAME: Ranitidine BRAND NAME: Zantac CLASSIFICATION

Therapeutic: Anti-ulcer agents Pharmacologic: Histamine H2 antagonists DOSAGE 20 mg IV q8h MECHANISM OF ACTION Inhibits the action of histamine at the H2 receptor site located primarily in gastric parietal cells, resulting in inhibition of gastric acid secretion. In addition, ranitidine bismuth citrate has some antibacterial action against H. pylori. INDICATION Treatment and prevention of heartburn, acid indigestion, and sour stomach. CONTRA INDICATIONS Contraindicated in: Hypersensitivity, Cross-sensitivity may occur; some oral liquids contain alcohol and should be avoided in patients with known intolerance. Use Cautiously in: Renal impair- ment Geriatric patients (more susceptible to adverse CNS reactions) Pregnancy or Lactation SIDE EFFECTS/ ADVERSE EFFECTS CNS: Confusion, dizziness, drowsiness, hallucinations, headache CV: Arrhythmias GI: Altered taste, black tongue, constipation, dark stools, diarrhea, drug-induced hepatitis, nausea GU: Decreased sperm count, impotence ENDO: Gynecomastia HEMAT: Agranulocytosis, Aplastic Anemia, neutropenia, thrombocytopenia LOCAL: Pain at IM site MISC: Hypersensitivity reactions, vasculitis NURSING IMPLICATIONS/RESPONSIBILITIES Assess patient for epigastric or abdominal pain and frank or occult blood in the stool, emesis, or gastric aspirate. Nurse should know that it may cause false-positive results for urine protein; test with sulfosalicylic acid. Inform patient that it may cause drowsiness or dizziness. Inform patient that increased fluid and fiber intake may minimize constipation.

 Advise patient to report onset of black, tarry stools; fever, sore throat; diarrhea; dizziness; rash; confusion; or hallucinations to health car professional promptly. Inform patient that medication may temporarily cause stools and tongue to appear gray black.