DATE ORDERED: August 15, 2009

ORDERED DOSE: 50 ig IVTT q 8 hours

GENERIC NAME: Ranitidine

BRAND NAME/S:
 Zeptag
 Zantac
- Injection 1 mg (as base)/mL
- Injection 25 mg (as base)/mL
- Syrup 15 mg (as base)/mL
- Tablets 150 mg (as base)
- Tablets 300 mg (as base)
 Zantac 75
- Tablets 75 mg (as base)
 Zantac 150
- Tablets 150 mg (as base)

 Zantac EFFERdose
- Tablets, effervescent 25 mg (as base)
- Tablets, effervescent 150 mg (as base)

 Apo-Ranitidine (Canada)

 CO Ranitidine (Canada)

 Gen-Ranitidine (Canada)

 Novo-Ranidine (Canada)

 Nu-Ranit (Canada)

 PMS-Ranitidine (Canada)

 Ratio-Ranitidine (Canada)

 Sandoz Ranitidine (Canada)

 Zantac Maximum Strength Non-Prescription (Canada)

CLASSIFICATION: Histamine H 2 antagonist

SUGGESTED DOSE:
Duodenal Ulcer (Active)
Adults
PO 150 mg twice daily or 300 mg at bedtime. Maintenance dose is 150 mg at
bedtime. IM/IV/Intermittent IV 50 mg every 6 to 8 h.

Treatment of Duodenal and Gastric Ulcers

Children 1 mo to 16 yr of age \
PO 2 to 4 mg/kg twice daily (max, 300 mg/day).

Maintenance of Healing of Duodenal and Gastric Ulcers

Children 1 mo to 16 yr of age
PO 2 to 4 mg/kg daily (max, 150 mg/day).

Acute Benign Gastric Ulcer and GERD

Adults
PO 150 mg twice daily. IM/IV/Intermittent IV 50 mg every 6 to 8 h.

Treatment of GERD and Erosive Esophagitis

Children 1 mo to 16 yr of age
PO 5 to 10 mg/kg daily usually given in 2 divided doses.

Pathologic Hypersecretory Conditions

Adults
PO 150 mg twice daily. Individualize.

Erosive Esophagitis
Adults
PO 150 mg 4 times daily. IM/IV/Intermittent IV 50 mg every 6 to 8 h. Continuous
IV 6.25 mg/h. For patients with Zollinger-Ellison, start infusion at rate of 1 mg/kg/h and
adjust upward in 0.5 mg/kg/h increments according to gastric acid output (max, 2.5
mg/kg/h; infusion rate 220 mg/h).

Maintenance of Healing of Erosive Esophagitis

Adults
PO 150 mg at bedtime.

Heartburn (OTC)
Adults
PO Treatment: 75 to 150 mg with a glass of water. Prevention: 75 to 150 mg with
a glass of water 30 to 60 min before eating food or drinking beverages that cause
heartburn. Maintenance: Up to 150 mg twice daily.

Renal Insufficiency (Ccr less than 50 mL/min)

Adults
PO 150 mg every 24 h. IM/IV 50 mg every 18 to 24 h.
MODE OF ACTION: Competitively inhibits the action of histamine at the H2 receptors of
the parietal cells of the stomach, inhibiting basal gastric acid secretions and gastric acid
secretion that is stimulated by food, insulin, histamine, cholinergic agonists, gastrin, and
pentagastrin.

INDICATION:
 Short-term treatment of active duodenal ulcer
 Maintenance therapy for duodenal ulcer at reduced dosage
 Short-term treatment of active, benign gastric ulcer
 Short-term treatment of GERD
 Pathologic hypersecretory conditions
 Treatment of erosive esophagitis
 Treatment of heartburn, acid indigestion, sour stomach

CONTRAINDICATION:
 Contraindicated with allergy to ranitidine, lactation.
 Use cautiously with impaired renal or hepatic function, pregnancy.

DRUG INTERACTION:
Drug-drug - Increase effects of warfarin, TCAs; monitor patient closely and adjust
dosage as needed.

SIDE EFFECTS:
 Confusion, agitation, or hallucinations
 Depression
 Heart problems, including fast heart rate (tachycardia), slow heart rate
(bradycardia), and abnormal heart rhythms (arrhythmias)
 Symptoms of liver problems or hepatitis, including yellowing of the eyes or skin,
pain in the upper right side of the abdomen, and dark urine
 Angioedema (life-threatening swelling of the throat and mouth)
 Signs of an allergic reaction, including an unusual rash, hives, itching, wheezing,
trouble breathing, and swelling of the mouth or throat.

ADVERSE EFFECTS:
 CNS: headache, malaise, dizziness, somnolence, insomnia, vertigo
 CV: tachycardia, bradycardia, PVCs (rapid IV administration)
 Dermatologic: Rash, alopecia
 GI: constipation, diarrhea, nausea, vomiting, abdominal pain, hepatitis, increased
ALT levels
 GU: gynecomastia, impotence or decreased libido
 Hematologic: leukopenia, granulocytopenia, thrombocytopenia, pancytopenia
 Local: pain at IM site, local burning or itching at IV site
 Other: arthralgia
NURSING RESPONSIBILITY:
1. Administer oral drug with meals and at bedtime.
2. Decrease doses in renal and liver failure.
3. Provide concurrent antacid therapy to relieve pain.
4. Administer IM dose undiluted, deep into large muscle group.
5. Arrange for regular follow-up, including blood test, to evaluate effects.
6. Assess patient for epigastric or abdominal pain and frank or occult blood in the
stool, emesis, or gastric aspirate.
7. Nurse should know that it may cause false-positive results for urine protein; test
with sulfosalicylic acid.
8. Inform patient that it may cause drowsiness or dizziness.
9. Inform patient that increased fluid and fiber intake may minimize constipation.
10. Advise patient to report onset of black, tarry stools; fever, sore throat; diarrhea;
dizziness; rash; confusion; or hallucinations to health car professional promptly.
11. Inform patient that medication may temporarily cause stools and tongue to
appear gray black.