Ranitidine

Ranitidine

[injection $1.75; tablets 4 cents]

ADMINISTRATION ROUTES:

• PO, IV

ALTERNATIVE NAMES:

• Apo-Ranitidine, Zantac, Peptisoothe

ICU INDICATIONS:

1. Ulcerprophylaxis

PRESENTATION AND ADMINISTRATION:

• IV:
  Dilute 50mg dose to 20ml with compatible IV fluid and administer into side arm over at least 2 minutes.
  Compatible with the following IV fluids: 0.9% sodium chloride, 5% and 10% dextrose, Glucose and Sodium Chloride, Hartmann’s
• Store at room temperature

• PO Tablets:
  Apo-Ranitidine 150mg tablets (white), Arrow Ranitidine 150mg tablets (white), Zantac relief tablets (150mg)
• Oral solution:
  Peptisoothe 150mg/10ml, Zantac Syrup 150mg/10ml

DOSAGE:

• PO:
  150mg 8-12 hourly or 300mg at night
• IV:
  50mg 8 hourly

DOSAGE IN RENAL FAILURE AND RENAL REPLACEMENT THERAPY:

• Dose in renal impairment [GFR (ml/min)]:
  <10: 50-100% of normal dose
  10-20: dose as in normal renal function
  >20-50: dose as in normal renal function
• Dose in renal replacement therapy:
  CAPD: 50-100% of normal dose
  HD: 50-100% of normal dose
  CVVHDF: dose as in normal renal function

DOSAGE IN PAEDIATRICS:

• IV:
  1mg/kg 8 hourly

• PO:
  2-4mg/kg 8-12 hourly

CLINICAL PHARMACOLOGY:

• Ranitidine is a selective, competitive antagonist of histamine at H2-receptor sites

CONTRAINDICATIONS:

1. hypersensitivity to ranitidine

WARNINGS

• Nil

PRECAUTIONS

• General: Nil
• Laboratory Tests: No tests in addition to routine ICU tests are required.
• Drug/Laboratory Test Interactions: None known.

IMPORTANT DRUG INTERACTIONS FOR THE ICU

• None of note

ADVERSE REACTIONS:

• Body as a Whole: Hypersensitivity reactions (e.g. fever, bronchospasm, anaphylactic shock, rash, eosinophilia)
• Central nervous system: Malaise, dizziness, somnolence, insomnia, vertigo, mental confusion, depression and hallucinations.
• Cardiovascular system: Tachycardia, bradycardia, premature ventricular beats, A-V block and asystole.
• Gastrointestinal system: Constipation, diarrhoea, nausea/ vomiting, abdominal discomfort/ pain, hepatitis, pancreatitis. Musculoskeletal system: Rare reports of arthralgias and myalgia.
• Haematological system: Agranulocytosis or pancytopenia, sometimes with marrow hypoplasia or aplasia, have been reported.
• Dermatological system: Rash including rare cases of mild erythema multiforme. Rare cases of vasculitis have been reported.