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Ranitidine

Medical and Pharmacy Editor:

Brand Name: Zantac, Zantac 150 Maximum Strength, Zantac 75

Generic Name: ranitidine

Drug Class: Histamine H2 Antagonists

What Is Ranitidine and How Does It Work?

Ranitidine is a prescription drug used to treat ulcers of the stomach and intestines and to prevent intestinal ulcers from coming back after they have healed. Ranitidine is also used to treat certain stomach and throat problems such as erosive esophagitis, gastroesophageal reflux disease or GERD, and Zollinger-Ellison syndrome. It works by decreasing the amount of acid your stomach makes. It relieves symptoms such as cough that doesn't go away, stomach pain, heartburn, and difficulty swallowing. Ranitidine belongs to a class of drugs known as H2 blockers.

Ranitidine is available under the following different brand names: Zantac, Zantac 150 Maximum Strength, and Zantac 75.

Dosages of Ranitidine

Adult and pediatric dosages:

Injection solution

  • 25 mg/mL

Syrup

  • 15 mg/mL

Tablet

  • 75 mg
  • 150 mg
  • 300 mg

Dosage Considerations -- Should Be Given As Follows:

Adult Dosage Considerations

Gastroesophageal Reflux Disease

  • 150 mg orally every 12 hours or 50 mg intramuscular/intravenously every 6-8 hours

Gastric Ulcer, Benign

  • Treatment: 150 mg orally every 6 hours or 50 mg intermuscular/intravenously every 6-8 hours intermittent bolus or infusion; alternatively, 6.25 mg/hours intravenously by continuous infusion
  • Maintenance of healing: 150 mg orally every 12 hours

Hypersecretory Conditions

  • 150 mg orally every 12 hours, up to 6 g/day used
  • Parenteral: 50 mg (2 mL) intramuscularly or intermittent intravenous bolus or infusion every 6-8 hours, not to exceed 400 mg/day; alternatively, 6.25 mg/hour continuous infusion

Dosing Considerations

More frequent doses may be necessary, individualize dosage, and continue as long as indicated; dosages up to 6 g/day have been used for severe disease.

Zollinger-Ellison syndrome: Start intravenous infusion at 1 mg/kg/hour, then adjust upward in 0.5 mg/kg/hour increments according to gastric acid output (not to exceed 2.5 mg/kg/hour or 220 mg/hour.

Stress Ulcer Prophylaxis (Off-label)

  • 150 mg orally or nasogastric every 12 hours
  • 50 mg (2 mL) intramuscular or intermittent intravenous bolus or infusion every 6-8 hours, not to exceed 400 mg/day; alternatively, 6.25 mg/hour continuous infusion

Dosing Modifications

  • Renal impairment (Creatinine clearance less than 50 mL/min): 50 mg intravenously/intramuscular every 18 to 24 hours or 150 mg orally once daily
  • Hepatic impairment: Dosage adjustment not necessary

Pediatric Dosage Considerations

Active Duodenal/Gastric Ulcer

  • Treatment: 4-8 mg/kg orally every 12 hours; not to exceed 300 mg/day
  • Maintenance: 2-4 mg/kg orally once daily; not to exceed 150 mg/day
  • Parenteral: 2-4 mg/kg/day intravenously divided every 6-8 hours; not to exceed 50 mg/dose or 200 mg/day

Gastroesophageal Reflux Disease (GERD)

Children: 1 month - 16 years

  • 5-10 mg/kg/day orally divided every 12 hours; not to exceed 300 mg/day
  • Parenteral (Off-label): 2-4 mg/kg/day intravenously divided every 6-8 hours; not to exceed 50 mg/dose or 200 mg/day; alternatively, infusion at 1mg/kg/dose once followed by continuous infusion of 0.08-0.17 mg/kg/hour or 2-4 mg/kg/day

Erosive Esophagitis

Children: 1 month - 16 years

  • 5-10 mg/kg/day orally divided every 12 hours; not to exceed 300 mg/day
  • Parenteral (Off-label): 2-4 mg/kg/day intravenously divided every 6-8 hours; not to exceed 200 mg/day; alternatively, 1mg/kg/dose once followed by continuous infusion of 0.08-0.17 mg/kg/hour or 2-4 mg/kg/day

Neonates (Off-label)

Term Neonates (less than 29 days)

  • 2-4 mg/kg/day orally divided every 8-12 hours or 2 mg/kg/day intravenously divided every 8 hours

Prophylaxis against dexamethasone associated ulceration: 0.031-1.25 mg/kg/hour during dexamethasone therapy to maintain gastric pH greater than 4

Prophylaxis against stress ulceration: 2 mg/kg every 12 hours or 1.5 mg/kg intravenously every 8 hours; alternatively, 2 mg/kg over 10 min, followed by continuous infusion of 0.083 mg/kg/hour

Medically Reviewed by a Doctor on 4/6/2017



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