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ranitidine, Zantac

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GENERIC NAME: ranitidine

BRAND NAME: Zantac

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.

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


Last Editorial Review: 2/11/2011




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  • Related Diseases & Conditions

    • Gastroesophageal Reflux Disease (GERD)
      • 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
      • 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.
    • Peptic Ulcer
      • 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
      • 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
      • 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
      • 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.
    • Reflux Laryngitis
      • 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.
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ranitidine, Zantac

What is esophageal pH monitoring?

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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