Home Drug Guide Ranitidine Hydrochloride

Drug Guide

Generic Name

Ranitidine Hydrochloride

Brand Names Zantac 25, Zantac 75, Zantac 150, Zantac 300, Zantac

Classification

Therapeutic: H2 histamine receptor antagonist

Pharmacological: H2 receptor antagonist

FDA Approved Indications

Treatment of active gastric ulcers
Prevention of recurrence of gastric ulcers
Treatment of gastroesophageal reflux disease (GERD)
Management of Zollinger-Ellison syndrome

Mechanism of Action

Ranitidine selectively blocks histamine H2 receptors on gastric parietal cells, reducing gastric acid secretion.

Dosage and Administration

Adult: Typical doses range from 150 mg twice daily or 300 mg at bedtime for ulcers. Dosage varies based on condition and severity.

Pediatric: Dosing depends on age and weight; consult specific guidelines.

Geriatric: Adjust dose based on renal function. Be cautious due to increased risk of CNS effects.

Renal Impairment: Dose reduction required; monitor renal function.

Hepatic Impairment: Use with caution; dose adjustments may be necessary.

Pharmacokinetics

Absorption: Rapid, with peak plasma concentrations in 1-3 hours.

Distribution: Widely distributed in body tissues and fluids.

Metabolism: Minimal hepatic metabolism.

Excretion: Primarily renally excreted.

Half Life: 2-3 hours in healthy individuals; may be prolonged in renal impairment.

Contraindications

Hypersensitivity to ranitidine or other H2 antagonists

Precautions

Use with caution in renal or hepatic impairment, pregnancy, lactation, and elderly patients. Monitor for CNS effects in the elderly.

Adverse Reactions - Common

Headache (Occasional)
Dizziness (Uncommon)
Constipation or diarrhea (Uncommon)

Adverse Reactions - Serious

Leukopenia, thrombocytopenia, anemia (Rare)
CNS effects (confusion, agitation, hallucinations) (Rare, especially in elderly or renal impairment)
Arrhythmias (rare) (Rare)

Drug-Drug Interactions

Cimetidine, other antacids may decrease absorption of ranitidine.
Warfarin, phenytoin, theophylline (altered metabolism).

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for relief of symptoms, renal function, and blood counts.

Diagnoses:

Impaired gastric tissue integrity
Risk for electrolyte imbalance

Implementation: Administer before meals or at bedtime as prescribed. Monitor for effectiveness and side effects.

Evaluation: Assess symptom relief and monitor for adverse reactions.

Patient/Family Teaching

Take medication as directed, preferably with or without food as prescribed.
Notify provider if symptoms worsen or side effects occur.
Avoid smoking and foods that worsen reflux.
Report signs of CNS effects or blood abnormalities.

Special Considerations

Black Box Warnings:

Not currently applicable; previous concerns about contaminant NDMA led to recalls and FDA safety communications.

Genetic Factors: No significant genetic considerations.

Lab Test Interference: Ranitidine may interfere with certain drug levels (e.g., cimetidine effects).

Overdose Management

Signs/Symptoms: Nausea, vomiting, dizziness, dry mouth, hallucinations in severe cases.

Treatment: Supportive care, symptom management, no specific antidote.

Storage and Handling

Storage: Store at room temperature, 20-25°C (68-77°F).

Stability: Stable under recommended storage conditions.