Pharmacological effect of Ranitidine 150:
Ranitidine Blocker H2-histamine receptor II generation. The mechanism of action related to the blockade of H2-histamine receptor membrane of parietal cells of gastric mucosa. Inhibits secretion of the day and night HCl, as well as basal and stimulated, reduces the volume of gastric juice, gastric distension caused by the food load, the action of hormones and biogenic stimulants (gastrin, histamine, acetylcholine, pentagastrin, caffeine). Reduces the amount of HCl in gastric juice, almost stifling, “liver” enzymes associated with cytochrome P450, does not affect the concentration of gastrin in plasma, mucus production. Reduces the activity of pepsin. Does not affect the concentration of Ca2 + in serum. Following oral administration in therapeutic doses has no effect on prolactin (possibly passing a slight increase in prolactin concentrations in serum after i / v administration of ranitidine 100 mg or more). No effect on pituitary hormone: gonadotropin, TSH and GH. Does not affect the concentration of cortisol, aldosterone, androgens or estrogens on sperm motility, sperm quantity and composition, but also does not have antiandrogenic action. May reduce the release of vasopressin. Strengthens the defense mechanisms of the gastric mucosa and promotes healing of injuries related to exposure to HCl (including cessation of gastrointestinal bleeding and scarring of stress ulcers), by increasing the formation of gastric mucus glycoprotein content in it, stimulating the secretion of gastric mucosal bicarbonate , endogenous synthesis of Pg and its rate of regeneration. At a dose of 150 mg inhibits the secretion of gastric juice for 8-12 hours inhibits microsomal enzymes (cimetidine weaker).
Indications Ranitidine 150:
Treatment and prevention – a stomach ulcer and 12 duodenal ulcer, NSAID-gastropathy, heartburn (due to giperhlorgidriey), hypersecretion of gastric juice, symptomatic ulcers, gastrointestinal stress ulcers, erosive esophagitis, reflux esophagitis, Zollinger-Ellison syndrome, systemic mastocytosis, multiple endocrine adenomatosis, dyspepsia, characterized by epigastric or retrosternal pain associated with eating or sleep disturbances, but not due to the above conditions, treatment of bleeding from upper gastrointestinal bleeding, prevention of recurrence of gastric postoperative, prevention of aspiration of gastric juice in patients who performed the operation under general anesthesia (Mendelson’s syndrome), aspiration pneumonia (prevention), rheumatoid arthritis (as adjuvant therapy).
Contraindications Ranitidine 150:
Hypersensitivity, lactation. Renal and / or liver failure, liver cirrhosis with portosystemic encephalopathy (in history), acute porphyria (including history), children (12 years), and pregnancy.
Side effects of Ranitidine 150:
Part of the digestive system: nausea, dry mouth, constipation, vomiting, diarrhea, abdominal pain, increased activity of “liver” enzymes, rare – hepatocellular, cholestatic or mixed hepatitis, acute pancreatitis. On the part of hematopoiesis: leukopenia, thrombocytopenia, agranulocytosis, pancytopenia, hypo-and aplasia of the bone marrow, immune hemolytic anemia. From the CCC: lowering blood pressure, bradycardia, arrhythmia, AV block, asystole (parenteral administration). Nervous system disorders: headache, dizziness, fatigue, drowsiness, rarely – confusion, tinnitus, irritability, hallucinations (mainly in elderly patients and seriously ill), involuntary movements. From the senses: blurred vision, paresis of accommodation. On the part of the musculoskeletal system: arthralgia, myalgia. From the Endocrine: hyperprolactinemia, gynecomastia, amenorrhea, reduced potency and / or libido. Allergic reactions: hives, skin rash, angioedema, anaphylactic shock, bronchospasm, erythema multiforme. Other: alopecia, hypercreatininemia, increased activity glutamattranspeptidazy, acute porfiriya.Peredozirovka. Symptoms: seizures, bradycardia, ventricular arrhythmias. Treatment: symptomatic. With the development of convulsions – diazepam in / in, at a bradycardia – atropine, ventricular arrhythmias – lidocaine. Hemodialysis is effective.
Dosage and administration Ranitidine 150:
Parenteral (a / c, w / o), inside. In the / slow (within 5 min) 50 mg, at a dilution of 0.9% NaCl or 5% dextrose and 20 ml, if necessary, to repeat injection every 6-8 h. / drip at 25 mg / h for 2 hours, if necessary – re-introduction of 6-8 hours / m – 50 mg 3-4 times a day. To prevent bleeding from the upper gastrointestinal patients with stress ulcers, preferably in / slow introduction to the initial dose of 50 mg followed by continuous in / infusion 0.125-0.25 mg / kg / h. Introduction to spend as long as the patient not be able to eat. Patients with persistent risk of bleeding in the future appointed interior, 150 mg 2 times a day (as soon as patients begin feeding by mouth). For the prevention of Mendelson’s syndrome risk – a / m or / slow, 50 mg 45-60 minutes before general anesthesia or oral, 150 mg 2 hours before general anesthesia and the night before. Women in labor during childbirth – 150 mg every 6 hours for children – a / c, infusion (over 15-20 min), pre-diluted to the required volume of compatible solution for i / v administration in gastric ulcer – 2-4 mg / kg / day, with gastroesophageal reflux – 2-8 mg / kg 3 times a day. Inside. Peptic ulcer and 12 duodenal ulcer (exacerbation), postoperative ulceration – 150 mg 2 times daily or 300 mg at bedtime for 4-8 weeks. In patients with unhealed ulcers during this period – the continuation of treatment over the next 4 weeks. Relapse prevention – 150 mg at night; for smokers – 300 mg at night. NSAID-gastropathy – 150 mg 2 times daily or 300 mg at night for 8-12 weeks, prevention – 150 mg 2 times a day. Erosive reflux esophagitis – 150 mg 2 times daily or 300 mg at bedtime for 8 weeks, if necessary, extend treatment to 12 weeks. In the II-III century. severity of reflux esophagitis dose increased to 600 mg / day in 4 divided doses for 12 weeks. Long-term preventive therapy – 150 mg 2 times a day. Zollinger-Ellison syndrome – an initial dose of 150 mg 3 times a day if necessary – to 6 g / day. In chronic episodes of dyspepsia – 150 mg 2 times a day for 6 weeks. Children for the treatment of peptic ulcer disease – oral, 2-4 mg / kg 2 times a day for reflux esophagitis – 2-8 mg / kg 3 times per day, maximum daily dose – 300 mg. Patients with impaired renal function requires correction dosing regimen. When CC less than 50 ml / min for parenteral administration – 50 mg every 18-24 hours, if necessary, increase the frequency of administration up to 2 times a day every 12 hours or more frequently, with intake – 150 mg / day. In the presence of concomitant liver dysfunction may require further dose reduction. Patients on hemodialysis, another dose administered immediately after hemodialysis.
Cautions Ranitidine 150:
Treatment ranitidine may mask symptoms associated with carcinoma of the stomach, so prior to treatment to exclude the presence of malignant neoplasms. Ranitidine, as well as all H2-blockers of histamine receptors, cancel undesirable rapidly syndrome (“bounce”). With long-term treatment of debilitated patients under stress may damage the stomach bacteria, followed by the spread of infection. Instant tablets contain Na + (to consider the appointment of patients who showed his limitations) and aspartame (important to consider the appointment of patients with concomitant PKU). H2-blockers of histamine receptors should be taken 2 hours after taking itraconazole or ketoconazole to prevent a significant decrease in their intake. May cause false positive reactions during the tests for protein in the urine. Blockers H2-histamine receptors may counteract the influence of pentagastrin and histamine on the acid-forming function of the stomach, so for 24 hours preceding the test, use H2-blockers of histamine receptors are not recommended. H2-blockers of histamine receptors can inhibit skin reactions to histamine, thus resulting in to false-negative results (prior to diagnostic skin tests for detection of allergic skin reactions of immediate type blocker use H2-histamine receptors should stop). During treatment you should avoid eating food, beverages and other drugs that can cause irritation of the gastric mucosa. During the period of treatment must be careful when driving and occupation of other potentially hazardous activities that require your full attention and psychomotor speed of reaction.
Interaction of Ranitidine 150:
Increases the AUC and the concentration of metoprolol in serum (by 80 and 50%), with T1 / 2 of metoprolol increased from 4.4 to 6.5 pm reduces the absorption of itraconazole and ketoconazole. Inhibits metabolism in the liver phenazone, aminofenazona, diazepam, geksobarbitala, propranolol, diazepam, lidocaine, phenytoin, theophylline, aminophylline, indirect anticoagulants, glipizide, buformina, metronidazole, BCCI. Compatible with 0.9% solution of NaCl, 5% dextrose, 4% dextrose, 4.2% sodium bicarbonate. Antacids, sucralfate slow the absorption of ranitidine (while applying a break between the intake of antacids and ranitidine should be at least 1-2 hours). Drugs that suppress the bone marrow to increase the risk of neutropenia. Smoking reduces the effectiveness of ranitidine.
