Taladine

Ranitidine is both an over-the-counter and a prescription medication used to treat conditions of the stomach, esophagus, and intestines. The over-the-counter form is used to treat heartburn, acid indigestion, and sour or upset stomach. The prescription form is used to treat ulcers, GERD, erosive esophagitis, and other conditions. This medication page refers to the prescription form of ranitidine. 

Ranitidine belongs to a group of drugs called H2 blockers. It works by decreasing the amount of acid produced in the stomach.

This medication comes in regular tablet, effervescent tablet, capsule, and syrup forms. Ranitidine is taken by mouth, up to 4 times a day. This medication is also available in an injectable form to be given directly into a vein (IV) or muscle (IM) by a healthcare professional. 

Common side effects of ranitidine include headache, diarrhea, and constipation.  Ranitidine can cause dizziness and drowsiness.  Do not drive or operate machinery until you know how ranitidine affects you.

Serious side effects have been reported with ranitidine including:

• Ranitidine is cleared from the body by the kidneys and liver. Talk to your doctor if you have kidney or liver disease.
• This medication can cause porphyria attacks in people with acute porphyria, a rare, inherited condition usually affecting the skin or nervous system. Do not take ranitidine if you have a history of acute porphyria (a disease affecting heme in red blood cells). 
• Hypersensitivity reaction:  An allergic reaction to ranitidine is possible.  Call your doctor if you experience one or more of the following symptoms of a hypersensitivity reaction:
  • difficulty swallowing or breathing
  • hoarseness
  • fever
  • rash
  • swelling

Ranitidine can cause dizziness and drowsiness.  Do not drive or operate machinery until you know how ranitidine affects you.

Do not take ranitidine if you:

• are allergic to ranitidine (Zantac)

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Ranitidine falls into category B. Studies in animals have failed to demonstrate a risk to the unborn baby, and there are no well-controlled studies in pregnant women.

Tell your doctor if you are breastfeeding or plan to breastfeed. The active ingredient in ranitidine is excreted in human breast milk. The effect of ranitidine on the nursing infant is not known.

Take this medication exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The dose your doctor recommends may be based on the following:

• the condition being treated
• other medical conditions you have
• other medications you are taking
• how you respond to this medication
• your weight
• your height
• your age
• your gender

Injectable:

• Into the muscle (IM) Injection: 50 mg every 6 to 8 hours
• Into the vein (IV) Itravenous Injection:
  • ​Intermittent Bolus: 50 mg (2 mL) every 6 to 8 hours
  • Intermittent Infusion: 50 mg (2 mL) every 6 to 8 hours
  • Continuous Infusion: Deliver at a rate of 6.25 mg/hour
  • For treatment of Zollinger-Ellison: Start the infusion at a rate of 1 mg/kg per hour. 

​Oral 

• Adult Use
  •  Active Duodenal Ulcer - The current recommended adult oral dosage of ranitidine for duodenal ulcer is 150 mg of ranitidine twice daily. An alternative dosage of 300 mg of syrup once daily after the evening meal or at bedtime.
  • Maintenance of Healing of Duodenal Ulcers - The current recommended adult oral dosage is 150 mg at bedtime.
  • Pathological Hypersecretory Conditions (such as Zollinger-Ellison syndrome) - The current recommended adult oral dosage is 150 mg twice daily. In some patients it may be necessary to administer ranitidine 150-mg doses more frequently. Dosages up to 6 grams/day have been employed in patients with severe disease.
  • Benign Gastric Ulcer - The current recommended adult oral dosage is 150 mg twice daily.
  • Maintenance of Healing of Gastric Ulcers - The current recommended adult oral dosage is 150 mg at bedtime.
  • GERD - The current recommended adult oral dosage is 150 mg twice daily.
  • Erosive Esophagitis - ​​The current recommended adult oral dosage is 150 mg 4 times daily.
  • Maintenance of Healing of Erosive Esophagitis - The current recommended adult oral dosage is 150 mg twice daily.
• Pediatric Use
  • Treatment of Duodenal and Gastric Ulcers - The recommended oral dose for the treatment of active duodenal and gastric ulcers is 2 to 4 mg/kg twice daily to a maximum of 300 mg/day.
  • Maintenance of Healing of Duodenal and Gastric Ulcers - The recommended oral dose for the maintenance of healing of duodenal and gastric ulcers is 2 to 4 mg/kg once daily to a maximum of 150 mg/day.
  • Treatment of GERD and Erosive Esophagitis - Published literature supports a dosage of 5 to 10 mg/kg/day, usually given as 2 divided doses. 

If you take too much this medication, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

If this medication is administered by a healthcare provider in a medical setting, it is unlikely that an overdose will occur. However, if overdose is suspected, seek emergency medical attention.

Heartburn is often confused with the first symptoms of a heart attack. Seek emergency medical attention if you have chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, and a general ill feeling.

Do not use this medication if you are allergic to ranitidine.

Ask a doctor or pharmacist if it is safe for you to take this medicine if you have:

• kidney disease;

• liver disease; or

• porphyria.

FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

Ranitidine passes into breast milk. Do not take ranitidine without telling your doctor if you are breast-feeding a baby.

Using ranitidine may increase your risk of developing pneumonia. Symptoms of pneumonia include chest pain, fever, feeling short of breath, and coughing up green or yellow mucus. Talk with your doctor about your specific risk of developing pneumonia.

The ranitidine effervescent tablet may contain phenylalanine. Talk to your doctor before using this form of ranitidine if you have phenylketonuria (PKU).

Applies to ranitidine: compounding powder, injectable solution, intravenous solution, oral capsule, oral granule effervescent, oral syrup, oral tablet, oral tablet effervescent

General

The most commonly reported side effect for IM administration was injection site pain, and the most commonly reported side effects with IV administration were localized pain and burning.[Ref]

Gastrointestinal

Uncommon (0.1% to 1%): Abdominal discomfort/pain, constipation, nausea, vomiting
Very rare (less than 0.01%): Acute pancreatitis, diarrhea[Ref]

Abdominal pain, constipation, and nausea tended to improve with continued treatment.[Ref]

Cardiovascular

Rare (0.01% to 0.1%): Hypotension, chest pain, arrhythmia, bradycardia, atrioventricular block, tachycardia, premature ventricular beats
Very rare (less than 0.01%): Asystole, vasculitis[Ref]

Bradycardia, atrioventricular block, tachycardia, and asystole have occurred in H2 receptor antagonists.[Ref]

Psychiatric

Rare (0.01% to 0.1%): Insomnia, reversible mental confusion, agitation, depression, hallucinations
Frequency not reported: Loss of libido[Ref]

Nervous system

Headache may be related to administration of treatment.[Ref]

Rare (0.01% to 0.1%): Dizziness, somnolence, vertigo, reversible involuntary movement disorders
Very rare (less than 0.01%): Headache/severe headache[Ref]

Dermatologic

Rare (0.01% to 0.1%): Urticaria, angioneurotic edema, skin rash
Very rare (less than 0.01%): Erythema multiforme, alopecia[Ref]

Musculoskeletal

Very rare (less than 0.01%): Musculoskeletal symptoms, arthralgia, myalgia[Ref]

Hepatic

Rare (0.01% to 0.1%): Transient and reversible changes in liver function tests, increased ALT levels
Very rare (less than 0.01%): Hepatocellular/hepatocanalicular/mixed hepatitis with/without jaundice[Ref]

Hepatitis with/without jaundice were usually reversible.

ALT levels increased to at least 2 times the pretreatment levels in patients receiving high IV doses for at least 5 days.[Ref]

Other

Rare (0.01% to 0.1%): Fever, malaise
Frequency not reported: Death[Ref]

Hypersensitivity

Rare (0.01% to 0.1%): Hypersensitivity reactions
Very rare (less than 0.01%): Anaphylactic shock/anaphylaxis[Ref]

Anaphylactic shock occurred after administration of a single dose.[Ref]

Renal

Rare (0.01% to 0.1%): Elevation in serum creatinine
Very rare (less than 0.01%): Acute interstitial nephritis[Ref]

Elevation in serum creatinine was usually slight, and typically normalized with continued treatment.[Ref]

Respiratory

Rare (0.01% to 0.1%): Bronchospasm
Frequency not reported: Dyspnea, pneumonia[Ref]

Ocular

Rare (0.01% to 0.1%): Reversible blurred vision[Ref]

Hematologic

Very rare (less than 0.01%): Blood count changes, leukopenia, thrombocytopenia, granulocytopenia, agranulocytosis, pancytopenia, marrow hypoplasia/aplasia
Frequency not reported: Aplastic anemia, immune hemolytic anemia/acquired immune hemolytic anemia, eosinophilia[Ref]

Leukopenia, granulocytopenia, and thrombocytopenia were usually reversible.[Ref]

Genitourinary

Very rare (less than 0.01%): Reversible impotence, breast symptoms/conditions, galactorrhea[Ref]

Endocrine

Very rare (less than 0.01%): Gynecomastia[Ref]

Metabolic

Postmarketing reports: Acute porphyria[Ref]

Local

Frequency not reported: Injection site pain, transient localized burning or itching[Ref]

Some side effects of Taladine may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.