Ranitidine

General characteristics. Structure:

Active agent: ranitidine of 150 mg.

Pharmacological properties:

Blocker histamine H2 receptors. Suppresses basal and stimulated a histamine, gastrin and acetylcholine (to a lesser extent) secretion of hydrochloric acid. Promotes increase рН gastric contents and reduces activity of pepsin. Duration of effect of ranitidine at a single dose - 12 h.

Pharmacokinetics. After intake ranitidine is quickly absorbed from a GIT. Meal and antacids slightly influences extent of absorption. Is exposed to effect of "the first passing" through a liver. Cmax in plasma is reached in 2 h after a single dose inside. After introduction in oil it is quickly and almost completely soaked up from the place of an injection. Cmax is reached in 15 min.
Linkng with proteins - 15%. Vd - 1.4 l/kg. Ranitidine is emitted with breast milk.
T1/2 makes 2-3 h. About 30% of the accepted dose are removed with urine in not changed look. Speed of removal decreases at an abnormal liver function or kidneys.

Indications to use:

Peptic ulcer of a stomach and duodenum in an aggravation phase; prevention of aggravations of a peptic ulcer; symptomatic ulcers; erosive and reflux esophagitis; Zollingera-Ellison's syndrome; prevention of "stressful" ulcers of a GIT, postoperative ulcers, a recurrence of bleedings from upper parts of a GIT; prevention of aspiration of a gastric juice at operations under anesthetic.

Route of administration and doses:

Establish individually. Inside for treatment by the adult and to children 14 years are more senior apply 300-450 mg in a daily dose, if necessary increase a daily dose to 600-900 mg; frequency rate of reception - 2-3 apply 150 mg To prevention of exacerbations of diseases / before going to bed. Duration of treatment is defined by indications to use. The patient with a renal failure at creatinine level more than 3.3 mg / 100 ml - on 75 mg 2

In/in or in oil - on 50-100 mg each 6-8 h.

Features of use:

With care apply at patients with disturbance of secretory function of kidneys.
Before an initiation of treatment it is necessary to exclude a possibility of existence of a malignant disease of a gullet, stomach or duodenum.
At prolonged treatment at the weakened patients in the conditions of a stress bacterial damages of a stomach with the subsequent spread of an infection are possible.
The sharp termination of reception of ranitidine because of danger of a recurrence of a peptic ulcer is undesirable. Efficiency of preventive treatment of a peptic ulcer is higher at ranitidine reception by courses for 45 days during the spring and autumn period, than at constant reception. Bystry in/in administration of ranitidine in rare instances causes bradycardia, usually in the patients predisposed to disturbance of a cordial rhythm.
There are separate messages that ranitidine can promote development of a bad attack of a porphyria in this connection it is necessary to avoid its use for patients with an acute porphyria in the anamnesis.
Against the background of use of ranitidine distortions of these laboratory researches are possible: increase in level of creatinine, activity gamma глутамилтранспептидазы and transaminases of a liver in a blood plasma.
When ranitidine is applied in a combination with antacids, the break between reception of antacids and ranitidine has to be not less than 1-2 h (antacids can cause ranitidine absorption disturbance).
Clinical data on safety of use of ranitidine in pediatrics are limited.

Side effects:

- From cardiovascular system: in isolated cases (at in introduction) - AV blockade.
- From the alimentary system: seldom - diarrhea, a lock; in isolated cases - hepatitises.
- From TsNS: seldom - a headache, dizziness, feeling of fatigue, a sight illegibility; in isolated cases (at seriously ill patients) - confusion of consciousness, a hallucination.
- From system of a hemopoiesis: seldom - thrombocytopenia; at prolonged use in high doses - a leukopenia.
- From a metabolism: seldom - slight increase of creatinine in blood serum in an initiation of treatment.
- From endocrine system: at prolonged use in high doses increase in content of prolactin, a gynecomastia, an amenorrhea, impotence, decrease in a libido are possible.
- From a musculoskeletal system: very seldom - an arthralgia, a mialgiya.
- Allergic reactions: seldom - skin rash, a small tortoiseshell, a Quincke's disease, an acute anaphylaxis, a bronchospasm, arterial hypotension.
- Other: seldom - recurrent parotitis; in isolated cases - a hair loss.

Interaction with other medicines:

At simultaneous use with antacids ranitidine absorption reduction is possible.

At simultaneous use with anticholinergics disturbance of memory and attention at patients of advanced age is possible.

Believe that blockers histamine H2 receptors reduce ulcerogenic action of NPVS by a mucous membrane of a stomach.

At simultaneous use with warfarin reduction of clearance of warfarin is possible. The case of development of a prothrombinopenia and bleeding at the patient receiving warfarin is described.

At simultaneous use from bismuth, a trikaliya dicitrate perhaps undesirable increase in absorption of bismuth; with Glibenclamidum - cases of development of a hypoglycemia are described; with ketokonazoly, itrakonazoly - absorption of a ketokonazol, itrakonazol decreases.

At simultaneous use with metoprololy increase in concentration in a blood plasma and increase in AUC and T1/2 of a metoprolol is possible.

At simultaneous use with sukralfaty in high doses (2 g) ranitidine absorption disturbance is possible.

At simultaneous use with procaineamide decrease in removal of procaineamide kidneys is possible that leads to increase in its concentration in a blood plasma.

There are data on increase in absorption of a triazolam at its simultaneous use, apparently, in connection with change of pH of contents of a stomach under the influence of ranitidine.

Believe that at simultaneous use with Phenytoinum increase in concentration of Phenytoinum in a blood plasma and increase in risk of development of toxicity is possible.

At simultaneous use with furosemide increase in bioavailability of furosemide is moderately expressed.

The case of development of ventricular arrhythmia (bigeminal pulse) at simultaneous use with quinidine is described; with tsizapridy - the cardiotoxicity development case is described.

It is impossible to exclude some increase in concentration of cyclosporine in a blood plasma at its simultaneous use with ranitidine.

Contraindications:

Pregnancy, lactation (breastfeeding), hypersensitivity to ranitidine.

Use at pregnancy and feeding by a breast
Adequate and well controlled researches of safety of use of ranitidine at pregnancy were not conducted in this connection use at pregnancy is contraindicated.
In need of use of ranitidine in the period of a lactation it is necessary to stop breastfeeding.

Use at renal failures
With care apply at patients with disturbance of secretory function of kidneys.

Use for children
Clinical data on safety of use of ranitidine in pediatrics are limited.

Overdose:

There are no data.

Storage conditions:

List B. In the dry, protected from light place, at a temperature not above 30 °C.

Issue conditions:

Without recipe

Packaging:

Tab. of the item of the lake of 150 mg, unitary enterprise. контурн. cell. 10, pack. cardboard. 2.