Ranitidine

Ranitidine – the antiulcerous drug blocking _H2-histamine receptors.

Form of release and structure

Dosage form – tablets, film coated: a round form, biconvex, light orange color (in blisters on 10 таб., 2 blisters in a box cardboard).

Active ingredient: ranitidine (in the form of a hydrochloride) – 150 or 300 mg in 1 tablet.

Auxiliary components: коллидон VA-64, corn starch, silicon dioxide colloid, propylene glycol, polyethyleneglycol 6000, sodium lauryl sulfate, gipromelloz, magnesium stearate, ethyl cellulose, microcrystallic cellulose, titanium dioxide, dye sunset yellow.

Indications to use

• Aggravation of a peptic ulcer of a stomach and 12-perstny gut (treatment and prevention);
• Zollingera-Ellison's syndrome;
• Erosive esophagitis and reflux esophagitis;
• Stomach ulcer and a 12-perstny gut, developed owing to reception of non-steroidal anti-inflammatory drugs (NPVP);
• Postoperative and stressful ulcers of upper parts of digestive tract (treatment and prevention);
• Prevention of a syndrome of Mendelssohn (aspiration of a gastric juice) at operations using the general anesthesia;
• Prevention of a recurrence of bleedings from upper parts of digestive tract.

Contraindications

Absolute:

• Children's age up to 12 years;
• Period of pregnancy and lactation;
• Individual hypersensitivity to Ranitidine components.

Relative:

• Cirrhosis with portosistemny encephalopathy in the anamnesis;
• Liver and/or renal failure;
• Acute porphyria, in the anamnesis including.

Route of administration and dosage

Ranitidine should be accepted inside: to swallow of tablets entirely and to wash down with enough liquid. Meal does not influence efficiency of drug.

The recommended dosages for adults and children are more senior than 12 years depending on indications:

• Peptic ulcer of a stomach and 12-perstny gut: treatment of aggravations – on 150 mg in the morning and in the evening or on 300 mg for the night, is in some cases possible increase in a dose up to 300 mg 2 times a day, a course of treatment – from 4 to 8 weeks; prevention of aggravations – on 150 mg of 1 times a day for the night, to the smoking patients – on 300 mg for the night;
• Peptic ulcer owing to reception of NPVP: treatment – on 150 mg in the morning and in the evening or on 300 mg for the night a course of 8-12 weeks; prevention – on 150 mg in the morning and in the evening;
• Postoperative and stressful ulcers: on 150 mg 2 times a day for 4-8 weeks;
• Zollingera-Ellison's syndrome: on 150 mg 3 times a day, if necessary a dose raise;
• Erosive reflux esophagitis: on 150 mg in the morning and in the evening or on 300 mg for the night, in some cases the doctor can increase a dose to 150 mg 4 times a day, therapy duration – 8-12 weeks. In need of performing long preventive therapy appoint 150 mg 2 times a day;
• Prevention of recurrent bleedings from upper parts of digestive tract: on 150 mg 2 times a day;
• Prevention of a syndrome of Mendelssohn: 150 mg on the eve of operation, then – 150 mg in 2 hours prior to an anesthesia.

At a renal failure (clearance of creatinine less than 50 ml/minute) the daily dose should not exceed 150 mg.

Decrease in a daily dose can be also required by patients with the accompanying abnormal liver functions.

Side effects

• Allergic reactions: bronchospasm, skin rash, small tortoiseshell, acute anaphylaxis, Quincke's edema, multiformny erythema;
• From cardiovascular system: atrioventricular block, bradycardia, lowering of arterial pressure, arrhythmia;
• From a musculoskeletal system: mialgiya, arthralgia;
• From a nervous system: headache, drowsiness, dizziness, increased fatigue; seldom – a sonitus, the involuntary movements, irritability, confusion of consciousness, a hallucination (is more often at elderly people and heavy patients);
• From bodies of a hemopoiesis: hypo - and a marrow aplasia, an agranulocytosis, immune hemolitic anemia, thrombocytopenia, a leukopenia, a pancytopenia;
• From the alimentary system: dryness in a mouth, abdominal pains, a diarrhea/lock, nausea and/or vomiting; seldom – acute pancreatitis, the cholestatic, hepatocellular or mixed hepatitis;
• From endocrine system: amenorrhea, gynecomastia, decrease in a libido, giperprolaktinemiya, impotence;
• From sense bodys: accommodation paresis, illegibility of visual perception;
• Others: giperkreatininemiya, alopecia.

Special instructions

Because Ranitidine can mask the symptoms characteristic of a stomach carcinoma, before its appointment it is necessary to exclude existence of oncology.

During therapy it is recommended to refrain from the use of drinks, food stuffs and medicines which can irritate a mucous membrane of a stomach, and also from driving of the car and performance of potentially dangerous works demanding the speed of psychophysical reactions and special attention.

At the weakened patients at prolonged use of drug in the conditions of a stress bacterial gastric damages with the subsequent spread of an infection are possible.

As well as all _{H2-gistaminoblokatory}, Ranitidine it is not necessary to cancel sharply (there is a risk of development of a syndrome of "ricochet").

In need of simultaneous use blockers histamine _{H2 receptors} need to be accepted in 2 hours after reception of a ketokonazola/itrakonazol, differently perhaps considerable reduction of their absorption.

Ranitidine can increase activity of a glutamattranspeptidaza.

There are separate data that drug can cause bad attacks of a porphyria.

Blockers histamine _{H2 receptors} can counteract influence of a histamine and Pentagastrinum on acid-forming function of a stomach therefore within 24 hours before test they are not recommended to be applied.

During treatment by Ranitidine receiving false positive reaction when conducting test to availability of protein in urine is possible.

As blockers _{of H2-histamine} receptors can suppress skin reaction to a histamine, they should be cancelled before conducting diagnostic skin tests for identification of allergic skin reaction of immediate type.

Medicinal interaction

It is necessary to consider that ranitidine:

• Metabolism in a liver of indirect anticoagulants, antagonists of calcium, Aminophenazonum, glipizid, diazepam, lidocaine, metronidazole, propranolol, phenazone, theophylline, hexobarbital, Buforminum, Aminophyllinum, Phenytoinum oppresses;
• Increases concentration in blood serum and an elimination half-life of a metoprolol;
• Reduces absorption of a ketokonazol and itrakonazol.

Smoking reduces efficiency of ranitidine.

At simultaneous use of drugs which have the oppressing effect on marrow the risk of development of a neutropenia increases.

Antiacid means and сукральфат in high doses can slow down ranitidine absorption therefore between receptions it is necessary to observe at least 2-hour intervals.

Terms and storage conditions

To store in the place, dry, unavailable to children, with observance of temperature condition of 15-30 °C.

Period of validity – 3 years.