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Ranitidine blocks the histamine H2 receptors of the parietal cells of the gastric mucosa, reduces the basal and stimulated secretion of hydrochloric acid caused by irritation of the baroreceptors, food load, the action of hormones and biogenic stimulants (gastrin, histamine, pentagastrin). Ranitidine reduces the volume of gastric juice and the content of hydrochloric acid in it, increases the pH of the stomach contents, which leads to a decrease in the activity of pepsin. After oral administration in therapeutic doses does not affect the level of prolactin. Inhibits microsomal enzymes.
Duration of action after a single dose of up to 12 hours.
Rapidly absorbed, food intake does not affect the degree of absorption. When ingested, bioavailability of ranitidine is approximately 50%. Cmax in plasma is reached 2-3 hours after administration.
Plasma protein binding does not exceed 15%. Slightly metabolized in the liver to form desmethylranitidine and ranitidine S-oxide.
It has the effect of first passing through the liver. The rate and degree of elimination depend little on the state of the liver.
T1 / 2 after ingestion - 2.5 hours, with KK 20-30 ml / min - 8-9 hours. It is mainly eliminated with urine (60-70%, unchanged - 35%), a small amount - with feces. It penetrates the blood-brain barrier poorly. Penetrates through the placenta. It is excreted in breast milk (the concentration in breast milk in women during lactation is higher than in plasma).
- treatment and prevention of exacerbations of gastric ulcer and duodenal ulcer;
- gastric and duodenal ulcers associated with the intake of NSAIDs;
- reflux esophagitis, erosive esophagitis;
- Zollinger-Ellllson syndrome;
- treatment and prevention of postoperative, "stressful" ulcers of the upper GI tract;
- prevention of recurrent bleeding from the upper GI tract;
- prevention of gastric juice aspiration during operations under general anesthesia (Mendelssohn's syndrome).
1 tablet contains:
Active ingredient: ranitidine (as hydrochloride) 150 mg;
Auxiliary substances: MCC; corn starch; Collidon VA-64; colloidal silicon dioxide; magnesium stearate; hypromellose; ethyl cellulose; polyethylene glycol 6000; propylene glycol; sodium lauryl sulfate; titanium dioxide; Dye "Sunsets" yellow.
Ranitidine is marketed under different brands and generic names, and comes in different dosage forms:
|Brand name||Manufacturer||Country||Dosage form|
|Ranisan||PRO.MED.CS Praha a.s||Czech||pills|
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Dosage and Administration
Orally, regardless of the meal, not chewing, squeezed with a small amount of liquid Peptic ulcer and 12 duodenal ulcer. For the treatment of exacerbations prescribed 150 mg 2 times a day (morning and evening) or 300 mg per night. If necessary, 300 mg 2 times a day. Duration of treatment is 4–8 weeks. For the prevention of exacerbations appoint 150 mg at night. Ulcers associated with the intake of NSAIDs. Assign 150 mg 2 times a day or 300 mg at night for 8-12 weeks. Prevention of ulceration when taking NSAIDs - 150 mg 2 times a day. Postoperative and stressful ulcers. Assign 150 mg 2 times a day for 4-8 weeks. Gastroesophageal reflux disease. Assign 150 mg 2 times a day or 300 mg at night. If necessary, the dose can be increased to 150 mg 4 times a day. The course of treatment is 8-12 weeks. Zollinger-Ellison syndrome. The initial dose is 150 mg 3 times a day, if necessary, the dose can be increased to 6 g / day. Prevention of recurrent bleeding. At 150 mg 2 times a day. Prevention of the development of Mendelssohn's syndrome. Ranitidine is prescribed in a dose of 150 mg 2 hours before anesthesia, and preferably 150 mg the night before. Patients with renal insufficiency with creatinine clearance less than 50 ml / min, the recommended dose is 150 mg per day.
On the part of the digestive system: nausea, dry mouth, constipation, vomiting, diarrhea, abdominal pain; rarely - hepatitis (hepatocellular, cholestatic, mixed), acute pancreatitis. On the part of the blood-forming organs: leukopenia, thrombocytopenia, agranulocytosis, pancytopenia, bone marrow hypo- and aplasia, immune hemolytic anemia. Since the cardiovascular system: lower blood pressure, bradycardia, vasculitis, arrhythmia, atrioventricular block. On the part of the nervous system: increased fatigue, headache, dizziness, drowsiness, insomnia, emotional lability, anxiety, anxiety, depression, hyperthermia; rarely - confusion, tinnitus, irritability, hallucinations (mainly in elderly patients and severely ill patients), involuntary movements. From the senses: blurred visual perception, accommodation paresis. From the musculoskeletal system: arthralgia, myalgia. On the part of the endocrine system: hyperprolactinemia, gynecomastia, amenorrhea, reduced potency and / or libido. Allergic reactions: urticaria, skin rash, pruritus, angioedema, anaphylactic shock, bronchospasm, erythema multiforme exudative (including Stevens-Johnson syndrome). Others: alopecia, hypercreatininemia, increased glutamate transpeptidase activity, acute porphyria.
Hypersensitivity to ranitidine or other components of the drug. Pregnancy, lactation. Children's age up to 14 years. With care. Renal and / or liver failure, liver cirrhosis with a history of portosystemic encephalopathy; acute porphyria (including in history).
Smoking reduces the effectiveness of ranitidine.
Increases the concentration of metoprolol in serum (by 80% and 50% respectively), while the half-life of metoprolol increases from 4.4 to 6.5 hours.
Due to an increase in the pH of the stomach contents while taking it, absorption of itraconazole and ketoconazole may decrease.
Metabolism in the liver of phenazone, aminophenazone, diazepam, hexobarbital, propracolol, diazepam, lidocaic, phenytoin, theophylline, aminophylline, indirect anticoagulants, glipizide, buformin, metronidazole, calcium antagonists, inhibits calcium.
Drugs that inhibit bone marrow, increase the risk of neutropenia.
With simultaneous use with antacids, sucralfate in high doses may slow down the absorption of ranitidine, so the interval between taking these drugs should be at least 2 hours.
Pregnancy and Lactation
Contraindicated in pregnancy and lactation.
Treatment with ranitidine may mask the symptoms associated with gastric carcinoma, so before starting treatment it is necessary to exclude the presence of a malignant neoplasm. Ranitidine, like all blockers of H2-histamine receptors, is undesirable to cancel abruptly (in order to avoid ricochet syndrome). With long-term treatment of weakened patients under stress, bacterial lesions of the stomach are possible. with the subsequent spread of infection. There is evidence that ranitidine can cause acute attacks of porphyria. During the period of treatment, it is necessary to refrain from engaging in potentially hazardous activities that require an increased concentration of attention and quickness of psychomotor reactions. May increase glutamate transpeptidase activity. May be the cause of a false-positive reaction when conducting a sample for protein in the urine. H2-histamine receptor blockers may counteract the effects of pentagastrin and histamine on the acid-forming function of the stomach, therefore, within 24 hours prior to the test, their use is not recommended. It can suppress the skin reaction to histamine, thus leading to false-positive results (it is recommended to stop taking ranitidine before conducting diagnostic skin tests to detect an allergic skin reaction of the immediate type). During treatment, avoid eating foods, beverages. and other drugs that may irritate the gastric mucosa.
Symptoms: convulsions, bradycardia, ventricular arrhythmias.
Treatment: symptomatic. With the development of seizures - diazepam IV, with bradycardia or ventricular arrhythmias - atropine, lidocaine. Hemodialysis is effective.
- Brand name: Ranitidine
- Active ingredient: Ranitidine
- Dosage form: Coated pills
- Manufacturer: Ozone
- Country of Origin: Russia
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