Ranitidine is an active pharmacological tool designed to prevent and treat ulcerative processes in the digestive organs. And also it is successfully used as an additional medicine for allergic diseases. Included in the group of histamine H2 receptor blockers.
Material Content:
The composition (active substance) of the drug
The underlying medication is ranitidine hydrochloride.
Available in two dosage forms:
- Soluble coating tablets, which may contain 150 or 300 mg of the treatment component. It is supplemented with silicon dioxide, magnesium stearate, ethyl cellulose. Tablets are packaged in cell aluminum or plastic blisters of 10 units. In a paper bundle, place 2 or 3 blisters with attached medical instructions.
- Ampoules with 2 ml of a medicinal solution for injection into a muscle and vein (25 ml of a treating substance in 1 ml, and phenol, potassium phosphate and water for injection are also present), 10 units per pack.
The medicine is produced in Belarus, Russia, Bulgaria, Ukraine, India, Serbia and Switzerland.
What helps ranitidine
Experts have established the quality of the active component, which provide the therapeutic effect of anti-ulcer medication. And also revealed additional indications for the use of Ranitidine not only in the field of gastroenterology, but also in other areas of medicine.
Therapeutic properties and excretion
The healing properties of the drug are based on the suppression of the functions of histamine H2 receptors - a biogenic substance that activates the secretion of digestive juice, the development of allergic reactions, bronchospasm and inflammation, stagnation and thickening of the blood.
The antiulcer effect of the pharmaceutical is due to the fact that the active component:
- blocks the activity of H2-histamine receptors of gastric cells;
- inhibits the excretory function of the gastric glands, inhibiting the secretion of hydrochloric acid and the enzyme pepsin;
- reduces the total volume of digestive juice, eliminating the stretching of the organ cavity;
- improves the protective properties of the mucosa, creating conditions for the cessation of bleeding, healing of ulcerated foci in the digestive tract by increasing the production of enveloping substances, improving blood circulation, accelerating regeneration processes.
In this case, the medication does not affect:
- on the serum concentration of calcium ions, gastrin;
- on the level of sex hormones, aldosterone, cortisol;
- the production of pituitary hormones;
- on the activity and properties of sperm.
The active ingredient of the pharmaceutical product is rapidly absorbed and shows the maximum blood content 20-30 minutes after the injection and 2-3 hours after swallowing the tablet.
It is almost completely excreted in the urine, and only a small volume (7-12%) - through the intestines. Due to the fact that the enzymatic treatment of the treating substance in the liver is insignificant, the weak functioning of the organ has little effect on the intensity of its removal from the body.
The removal time of half the received dose of the drug is 2–2.5 hours. In patients with renal pathologies, the elimination of the drug from the blood slows down (CC 20-30 ml / min - up to 9 hours), which can lead to its accumulation and the occurrence of undesirable side reactions. Therefore, the dose for kidney disease should be adjusted downward.
Ranitidine hardly penetrates the blood-brain barrier, therefore, does not cause adverse neurological disorders. It enters the bloodstream of the fetus and breast milk.
Indications
Ranitidine helps with such abnormal conditions of the digestive system as:
- digestive ulcers associated with deep stress, Helicobacter pylori infection, non-hormonal anti-inflammation therapy (Aspirin, Ibuprofen, Diclofenac), chondroprotective medications (Arthra, Teraflex);
- ulceration of the gastrointestinal mucosa after surgery;
- pain with erosive esophagitis (ulceration of the esophagus, accompanied by acute pain behind the sternum, heartburn, and violation of swallowing);
- heartburn with gastritis with high acidity, gastroesophageal reflux (reverse reflux of gastric acidic food gruel into the esophagus tube);
- peptic ulcers on the mucous membrane of the lower esophagus or upper stomach;
- Zollinger-Ellison syndrome - multiple difficultly healing gastrointestinal ulcers caused by a tumor that produces excess gastrin, which causes an abnormally high acid formation;
- chronic episodic pain behind the sternum or in the epigastric region associated with gastric disorders.
Ranitidine shows a significant effect when it is prescribed to prevent:
- severe damage and chemical burns of the bronchi and lungs when acid contents of the stomach get into the lower respiratory tract during operations with venous anesthesia (Mendelssohn syndrome);
- peptic ulcer, the development of stress ulcerative lesions on the background of strong experiences in seriously ill people, postoperative ulcerations;
- bleeding from open ulcers of the upper stomach and lower esophagus.
An antiulcer drug is indicated not only to eliminate heartburn, treatment or prevention of ulcerative processes.
It was found that part of the skin receptors are of type H2 histamine, therefore, the medication is often included in the composition of therapy:
- cholinergic urticaria;
- mastocidosis of the systemic type.
Due to its therapeutic qualities, the pharmaceutical product is included in the list of vital medicines.
Instructions for use for children and adults
Ranitidine is allowed to be taken from the age of 12.
Doses and regimen are set in accordance with the type of disease and the severity of pathological manifestations.
Before starting therapy, you need to check the patient for malignant tumors in the digestive organs, since the medication can weaken the signs of the cancer process.
Tablets are taken entirely, regardless of food intake, washed down with the volume of liquid necessary for the patient.
The duration of therapy is determined by the doctor according to the indications.
Long-term treatment should not be stopped abruptly in order to avoid exacerbation of pathological manifestations.
| Pathology | Ranitidine tablets | Injections |
|---|---|---|
| exacerbation of peptic ulcer | 0.15 g twice a day (optimally in the morning and evening) or 0.3 g before bedtime. If necessary, a single dose is increased to 300 mg, and the frequency of administration is up to 3 times. The duration of the course is from 4 to 8 weeks. To prevent exacerbations - 0.15 g before bedtime | |
| reflux disease, esophagitis, ulcers after surgery, stress, medication | 2-3 months, 150 mg twice daily or 300 mg at night. It is possible to increase the frequency of administration and achieve a daily dose of 600 mg. Preventively 1-2 months 2 doses per day, 150 mg each | In the muscle - 50 mg (2 ml) 3-4 times a day. In a vein with a syringe - very slowly (at least 5 minutes to avoid bradycardia) 50 mg (2 ml), to which dextrose (5%) or NaCl (0.9%) was added to obtain a total volume of 20 ml. Intravenously through a dropper - for 2 hours at a speed of 25 mg / hour. Repeated administration of the drug solution is allowed after 6-8 hours. |
| Zollinger-Ellison syndrome. | Begin with a minimum dose of 0.15 g after 6-8 hours. If necessary, the amount of Ranitidine per day is adjusted to 600 mg according to a 2-3-time regimen | |
| heartburn | 150-300 mg once or several days. Burning in the epigastrium disappears after 60–90 minutes, the effect lasts a long time - up to 24 hours, unlike antacids | Injection is not practical |
| cholinergic urticaria | 150 mg twice daily with anti-allergic drugs that block H1-histamine receptors | |
| prevention of the development of Mendelssohn syndrome | 0.15 g in the evening before the day of surgery, and 0.15 g 2 hours before general anesthesia | Slowly 1 ampoule to a muscle or vein 45-60 minutes before anesthesia |
| recurrent gastrointestinal bleeding | 0.15 g 2 times a day | First, slow intravenous administration of 2 ml, then drip infusion at a rate of 0.125-0.25 mg per 1 kg of patient’s body weight per hour. The dropper is not removed until the patient is able to eat on their own |
Features of the reception:
- In case of kidney failure, a dose reduction of approximately 50% is necessary: in tablets - up to 150 mg per day (with creatine clearance ≥ 50 ml / min), in injections - up to 50 mg in 20-24 hours. With an improvement in the condition of the kidneys, injections are allowed every 12 hours or more often.
- Patients undergoing hemodialysis, the next dose of 150 mg is received immediately after the procedure.
- Manifestations of peptic ulcer are weakened and may disappear after 7-14 days of therapy, but treatment is not allowed to be interrupted until healing is confirmed by endoscopy or radiography.
- Long-term therapy of debilitated patients against the background of the psychoemotional overstrain they endure can create conditions for the aggressive spread of harmful bacteria in the stomach.
- With a weakening of liver function, cirrhosis, a dosage reduction is required.
Taking a medication sometimes causes:
- false positive analysis for the presence of protein in the urine;
- false negative skin test for an immediate allergy (Ranitidine must be canceled before testing);
- increased creatinine levels, GGT activity, and hepatic transaminases;
- changes in the test for acid-excreting function of the stomach (the day before the test, cancel the reception).
These features should be considered when evaluating laboratory test data.
During pregnancy and lactation
Full-fledged and long-term studies confirming the safety of Ranitidine for the embryo and its effect on the course of pregnancy have not been conducted. This prevents gastroenterologists from prescribing the medicine to women who are expecting or nursing a child.
However, a single or short-term administration of a medication in an amount of 150 mg is allowed during pregnancy from 12 weeks, with the permission of a specialist who evaluated the possible risks.
It is recommended that a nursing mother receiving the drug not once, to relieve heartburn, but for a long time, transfer the infant to infant formula.
Drug interaction
With concomitant use with other medicines, Ranitidine shows the following effects described in the table.
| Medication | Effects |
|---|---|
| medications that depress bone marrow | increases the likelihood of neutropenia |
| Metronidazole, Hexobarbital, Propranolol (Anaprilin), Lidocaine, Phenytoin, Theophylline, Diazepam, Indirect Anticoagulants (Warfarin), Calcium Antagonists (Verapamil, Amlodipine, Diltiazem, Cinnarizine), Aminofillin | enhances the effect of these pharmaceuticals, inhibiting their processing in the liver and increasing the concentration in the blood (increases the risk of toxic damage) |
| Warfarin, other anticoagulants | risk of bleeding |
| Glibenclamide | likelihood of hypoglycemia |
| Itraconazole (Irunin, Orungal, Canditral), Ketoconazole (Mycozoral) | reduces their absorption (an interval of 2 hours is required) |
| Procainamide, cyclosporin | increased blood concentration |
| Metoprolol, Betalok, Egilok | by 50% increases their concentration in serum, inhibits excretion (elimination half-life increases to 6.5 hours) |
| furosemide | increased bioavailability |
| anticholinergics — Atropine, Pirenzepine, Antrovent, Platifillin | possibly a disturbance in memory and attention in the elderly |
| Nicotine | reduces the effectiveness of ranitidine, so smokers should increase the dosage |
| Antacids (Maalox, Almagel, Rennie) | make Ranitidine absorption difficult (an interval of 2 hours must be maintained) |
| Cisapride | risk of cardiotoxic damage |
To avoid unpredictable and harmful interaction reactions for the body, a thorough study of the instructions of both medications is required.
Contraindications and side effects
Ranitidine is not prescribed:
- acute porphyria patients;
- people with intolerance to the components of a medical device;
- pregnant patients, nursing mothers, children under 12 years of age (due to the lack of accurate safety data);
Adverse Reactions:
- fatigue, low blood pressure;
- dizziness, dry mouth, headaches;
- irritability;
- constipation, loose stools;
- blurred vision;
- bronchospasm (more often in people with asthma and pulmonary diseases);
- muscle and joint pain;
- rash, urticaria;
- rapid or slow heartbeat, heart rhythm failure.
With prolonged therapy:
- low platelet count, white blood cells, neutrophils;
- anemia due to B12 deficiency;
- increased levels of prolactin, creatinine;
- cardiotoxic effects, atrioventricular block (with rapid intravenous administration - especially with heart disease);
- hepatitis, confusion (isolated cases);
- failure of the monthly cycle, weakening of erection and sexual desire, an increase in the mammary glands in men;
- recurrent mumps;
- hair loss;
- anaphylactic shock, allergic edema (in violation of contraindications in people allergic to ranitidine).
Overdose, as a rule, can occur if they significantly exceed the recommended amount of the drug, especially with injection. The main signs: skin rashes, drowsiness, impaired perception, convulsive muscle twitching, a sharp decrease in heart rate (below 55), arrhythmia.
First aid - intake of adsorbents (Polysorb, Smecta). In severe cases, emergency hospitalization is required. In a hospital, Relanium, Diazepam are used to suppress seizures, with a marked decrease in the heart rate, Atropine is used, and with ventricular arrhythmias, Lidocaine is used. With severe overdose, hemodialysis helps.
Ranitidine analogs
Structural analogues of Ranitidine with an identical active substance: Atzilok, Ranigast, Ranisan, Zantak.
Analogs with a similar therapeutic effect and other therapeutic substance: Kvamatel, Famotidine, Famosan.
Omez (Omeprazole) refers to drugs that, like Ranitidine, are aimed at suppressing the secretion of hydrochloric acid. Both pharmaceuticals have similar indications, but various side effects and contraindications. Therefore, the answer to the question which of them is more effective and safer for a particular patient can only be given by a specialist.
