Ranitidine

Ranitidine is both an over-the-counter and a prescription medication used to treat conditions of the stomach, esophagus, and intestines. The over-the-counter form is used to treat heartburn, acid indigestion, and sour or upset stomach. The prescription form is used to treat ulcers, GERD, erosive esophagitis, and other conditions.

Ranitidine belongs to a group of drugs called H2 blockers. It works by decreasing the amount of acid produced in the stomach.

This medication comes in regular tablet, effervescent tablet, capsule, and syrup forms. Ranitidine is taken by mouth, up to 4 times a day. This medication is also available in an injectable form to be given directly into a vein (IV) or muscle (IM) by a healthcare professional. 

Ranitidine over-the-counter (OTC) comes in tablet form and can be taken up to twice a day. Do not chew tablets.

Common side effects of ranitidine include headache, diarrhea, and constipation. Ranitidine can cause dizziness and drowsiness.  Do not drive or operate machinery until you know how ranitidine affects you.

Ranitidine is used to treat:

• heartburn, acid indigestion, and sour or upset stomach (over the counter)
• ulcers
• gastroesophageal reflux disease (GERD) and erosive esophagitis.  Both of these conditions result from stomach acid damaging the esophagus.
• conditions in which the stomach makes too much acid, such as Zollinger-Ellison syndrome

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Ranitidine may be found in some form under the following brand names:

• Deprizine

• Rx-Act Heartburn Relief

• Taladine

• Tritec

• Wal-Zan

• Zantac

Serious side effects have been reported with ranitidine. See “Drug Precautions” section.

Common side effects of ranitidine include:

• headache
• constipation
• diarrhea
• nausea
• vomiting
• stomach pain
• dizziness
• fatigue

This is not a complete list of ranitidine side effects. Ask your doctor or pharmacist for more information.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• procainamide
• warfarin (Coumadin)
• triazolam (Halcion)
• midazolam
• glipizide (Glucotrol)
• ketoconazole (Nizoral)
• atazanavir (Reyataz)
• delavirdine (Rescriptor)
• gefitinib (Iressa)

This is not a complete list of ranitidine drug interactions. Ask your doctor or pharmacist for more information.

Serious side effects have been reported with ranitidine including:

• Ranitidine is cleared from the body by the kidneys and liver. Talk to your doctor if you have kidney or liver disease.
• This medication can cause porphyria attacks in people with acute porphyria, a rare, inherited condition usually affecting the skin or nervous system. Do not take ranitidine if you have a history of acute porphyria (a disease affecting heme in red blood cells). 
• Hypersensitivity reaction: An allergic reaction to ranitidine is possible. Call your doctor if you experience one or more of the following symptoms of a hypersensitivity reaction:
  • difficulty swallowing or breathing
  • hoarseness
  • fever
  • rash
  • swelling

Do not take ranitidine if you are allergic to ranitidine.

If you are taking Over-the-counter ranitidine, do not use if:

• if you have trouble or pain swallowing food, vomiting with blood, or bloody or black stools. These may be signs of a serious condition. See your doctor.
• with other acid reducers
• Stop Use and ask a doctor if:
  • your heartburn continues or worsens
  • you need to take this product for more than 14 days

Ranitidine can cause dizziness and drowsiness. Do not drive or operate machinery until you know how ranitidine affects you.

Medicines can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of ranitidine, there are no specific foods that you must exclude from your diet when receiving ranitidine.

Before taking ranitidine, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

• have a history of kidney or liver disease
• have a history of acute porphyria (a disease affecting heme in red blood cells)
• are allergic to ranitidine
• are pregnant or breastfeeding

Before taking Over-the-counter ranitidine, ask your doctor before use if you have:

• had heartburn over 3 months. This may be a sign of a more serious condition.
• heartburn with lightheadedness, sweating or dizziness
• chest pain or shoulder pain with shortness of breath; sweating; pain spreading to arms, neck or shoulders; or lightheadedness
• frequent chest pain
• frequent wheezing, particularly with heartburn
• unexplained weight loss
• nausea or vomiting
• stomach pain

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Ranitidine falls into category B. Studies in animals have failed to demonstrate a risk to the unborn baby, and there are no well-controlled studies in pregnant women.

Tell your doctor if you are breastfeeding or plan to breastfeed. The active ingredient in ranitidine is excreted in human breast milk. The effect of ranitidine on the nursing infant is not known.

Prescription

• Take ranitidine exactly as prescribed.
• The regular tablets, effervescent tablets, capsules, and syrups are usually taken 1 to 4 times a day. 
• The injectable form is administered by a healthcare professional 1 to 4 times a day directly into a vein or muscle.
• Ranitidine is usually taken 30 to 60 minutes before food that may cause heartburn.
• The effervescent tablets should be dissolved in a glass of water before use.
• If you miss a dose, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and take your next dose at the regular time. Do not take two doses of ranitidine at the same time.

Over-the-counter (OTC)

• Ranitidine over-the-counter (OTC) comes in tablet form and can be taken up to twice a day. Do not chew tablets.
• Ranitidine can be taken 30 to 60 minutes before food that may cause heartburn.

Take this medication exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The dose your doctor recommends may be based on the following:

• the condition being treated
• other medical conditions you have
• other medications you are taking
• how you respond to this medication
• your weight
• your height
• your age
• your gender

Injectable:

• Into the muscle (IM) Injection: 50 mg every 6 to 8 hours
• Into the vein (IV) Itravenous Injection:
  • ​Intermittent Bolus: 50 mg (2 mL) every 6 to 8 hours
  • Intermittent Infusion: 50 mg (2 mL) every 6 to 8 hours
  • Continuous Infusion: Deliver at a rate of 6.25 mg/hour
  • For treatment of Zollinger-Ellison: Start the infusion at a rate of 1 mg/kg per hour. 

​Oral-Prescription

• Adult Use
  •  Active Duodenal Ulcer - The current recommended adult oral dosage of ranitidine for duodenal ulcer is 150 mg of ranitidine twice daily. An alternative dosage of 300 mg of syrup once daily after the evening meal or at bedtime.
  • Maintenance of Healing of Duodenal Ulcers - The current recommended adult oral dosage is 150 mg at bedtime.
  • Pathological Hypersecretory Conditions (such as Zollinger-Ellison syndrome) - The current recommended adult oral dosage is 150 mg twice daily. In some patients it may be necessary to administer ranitidine 150-mg doses more frequently. Dosages up to 6 grams/day have been employed in patients with severe disease.
  • Benign Gastric Ulcer - The current recommended adult oral dosage is 150 mg twice daily.
  • Maintenance of Healing of Gastric Ulcers - The current recommended adult oral dosage is 150 mg at bedtime.
  • GERD - The current recommended adult oral dosage is 150 mg twice daily.
  • Erosive Esophagitis - ​​The current recommended adult oral dosage is 150 mg 4 times daily.
  • Maintenance of Healing of Erosive Esophagitis - The current recommended adult oral dosage is 150 mg twice daily.
• Pediatric Use
  • Treatment of Duodenal and Gastric Ulcers - The recommended oral dose for the treatment of active duodenal and gastric ulcers is 2 to 4 mg/kg twice daily to a maximum of 300 mg/day.
  • Maintenance of Healing of Duodenal and Gastric Ulcers - The recommended oral dose for the maintenance of healing of duodenal and gastric ulcers is 2 to 4 mg/kg once daily to a maximum of 150 mg/day.
  • Treatment of GERD and Erosive Esophagitis - Published literature supports a dosage of 5 to 10 mg/kg/day, usually given as 2 divided doses. 

Oral- Over-the-counter (OTC)

• To prevent symptoms- the recommended dose is 1 tablet, with a glass of water, 30 to 60 minutes before eating food or drinking beverages that cause heartburn. Can be used up to twice daily.
• To relieve heartburn associated with acid indigestion and sour stomach- the recommended dose is 1 tablet with a glass of water. Can be used up to twice daily.

If you take too much this medication, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

If this medication is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.