Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Ranitidine is an oral drug that blocks the
production of acid by acid-producing 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
naturally-occurring 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 15–30 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.
GERD (gastroesophageal reflux disease) is a condition in which the acidified liquid
contents of the stomach backs up into the esophagus. The symptoms of uncomplicated GERD are heartburn,
regurgitation, and nausea. Effective treatment is available for most patients with GERD.
Hives, also called urticaria, is a raised, itchy area of skin that is usually a sign of an
allergic reaction. The allergy may be to food or medications, but usually the
cause of the allergy (the allergen) is unknown.
A peptic ulcer is an ulcer in the lining of the stomach, duodenum, or esophagus. Ulcer formation is related to Helicobacter pylori bacteria in the stomach, use of anti-inflammatory medications, and cigarette smoking.
Esophagitis is caused by an infection or irritation of the esophagus. Infections that cause esophagitis include candida yeast infection of the esophagus as well as herpes.
Barrett's esophagus occurs as a complication of chronic gastroesophageal reflux disease (GERD), primarily in white males. GERD refers to the reflux of acidic fluid from the stomach into the esophagus (the swallowing tube), and is classically associated with heartburn.
Heartburn is a burning sensation experienced from acid reflux (GERD). Symptoms of heartburn include chest pain, burning in the throat, difficulty swallowing, the feeling of food sticking in the throat, and a burning feeling in the chest. Causes of heartburn include dietary habits, lifestyle habits, and medical causes. Treatments for heartburn include lifestyle changes, OTC medication, prescription medication, and surgery.
Acid backing up into the larynx (voice box), it causes reflux laryngitis. Irritation of the lining of the esophagus, larynx, and throat can lead to esophagitis, sinusitis, strictures, hoarseness, throat clearing, swallowing problems, asthma, chronic cough, and more. Typical symptoms of reflux laryngitis include heartburn, hoarseness, or a sensation of a foreign body in the throat. Reflux laryngitis can be treated with OTC medication, prescription medication, and lifestyle changes.
Esophageal pH (pH is a measure of the acidity or alkalinity of a solution) monitoring is a procedure for measuring the reflux (regurgitation or backwash) of acid from the stomach into the esophagus that occurs in gastroesophageal reflux disease (GERD).
When is esophageal pH monitoring used?
Esophageal pH monitoring is used to diagnose GERD effects, to determine the effectiveness of medications that are given to prevent acid reflux, and to determine if episodes of acidic reflux are causing episodes of chest pain. Monitoring esophageal pH also can be used to determine if acid is reaching the pharynx (lower throat) and is possibly responsible for such symptoms as
cough, hoarseness, and sore throat.
How is esophageal pH monitoring performed?
Esophageal pH monitoring is performed by passing a thin plastic catheter a sixteenth of an
inch in diameter through one nostril, down th...
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