Ranitidine drug

Zantac is an PPI ( antacid ) usually used to control the acidity or ulcers

1. MONOGRAPH ON DRUG RANITIDINE Submitted by : B.RAJU pharm D 2 year 19HF1t0005 Submitted to: Dr. SRIDEVI MAM

2. Brand name : zantac , zantac150 Generic name : Ranitidine Ranitidine has been used to treat and prevent ulcers in stomach and intestines.it is also used to treat conditions in which stomach produces to much acid ,such as zolinger - elision syndrome Also used to treat gastroesophageal reflux disease and other conditions like acid backs causes heart burn

3. Molecular formula : C 13 H 23 ClN 4 O 3 S. HCl IUPAC name : 5- dimethylamino-methyl-2[ furanyl - methylthio -ethyl]-N-methyl-2-nitro -1,1-ethenamide It belongs to the class Histamine H2 Antagonists It is an antiulcer agents gastric antisecretory agents

4. DOSAGE FORMS Injection Syrup Tablet Capsule Effervescent tablets Route of administration : oral & IV or IM route

5. DOSAGE Injection solution 25mg/ml syrup 15mg/ml Tablet 75,150,300mg/ml Capsule 150mg/ml Effervescent tablets 150mg In special cases ; For adult dosage considerations in which certain diseases contain certain dosage, diseases such as gastro oseophageal diseases, renal impairement ,stress ulcer prophylaxis

6. disease Adults pediatric Gastroesophageal reflux Disease 150 mg PO q12hrs or 50mg IM/IV q6-8hrs 5-10mg/kg/day PO 12hrs Gastric ulcer 150 mg PO q12hrs or or 300mg PO at bed time 4-8mg/kg PO q12 hrs Erosive esophagitis 150 mg PO q 6hrs or 50mg IM/IV q6-8hrs 6.25mg/ hr infusion 5-10mg/kg/day PO 12hrs Hypersecretory conditions 150 mg PO q12hrs Parentral : 50mg by IM - Stress ulcer prophylaxis 150mg PO or NG q12hr -

7. Pediatric dosage: Generally childrens under 16 years old should be supervised by a physician Dose 4-8mg/kg (12hrs) NOTE: the dose should not exceed 300mg/day Onset of action : 1-3hrs Duration of action : 15 hours

8. MECHANISM OF ACTION Ranitidine reduces the secretion of gastric acid in the stomach ,by blocking the effect of histamine on histamine H2-receptors located on the parietal cells lining the stomach wall. Histamine is the chemical transmitter that stimulates the parietal cells to release gastric acid. By blocking H2 receptors, ranitidine prevents histamine from having this effect, thereby reducing gastric acid secretion.

9. Side effects Abdominal pain, constipation , nausea Vomiting Hypotension , arrhythmia Insomia , depression Dizziness Jaundice Anaphylaxis Dyspensa , pneumonia

10. Blurred vision, involuntary eye movement and intraocular pressure change • Constipation, stomach pain, dry mouth, decrease in taste sensitivity and swelling of pancreas • Joint or muscle pain, tremor and uncontrolled movement • Weakness ADVERSE EFFECTS

11. • Nervousness, Feeling confused, depressed, or excited, hallucinations. • Swelling of the spaces between renal tubes (in kidney) • Unable to get or maintain an erection (impotence), unusual secretion of breast milk or breast enlargement in men • Allergic reaction, skin itch, dermatitis and hair loss, • Swelling of blood vessels.

12. Rantidine provides fast and effective relief, treatment and prevention, day or night, from the burning, pain and discomfort of the following symptoms caused by too much acid in the stomach. • Heartburn • Acid Indigestion • Upset or Sour stomach • Hyperacidity USES

13. Contraindications Hyper senstivity Gastric cancer Infections Hepatic diseases Tobacco smoking bradycardia

14. Precautions & Warnings If gastroesophageal reflux disease does not respond adequately in 6-8 weeks ,do not increase dosage , prescribe proton pump inhibitor instead Prolonged treatment may leads to malabsorption of vit B12 Use caution in renal impairment adjust dosage If patient taking prescription drug he should ask the pharmacist or doctor whether to take acid reducers simultaneously

15. Drug-drug interactions Anticoagulants (blood thinners), such as warfarin, or other drugs that have blood thinning effects such as aspirin or NSAIDs Antifungals, such as fluconazole, ketoconazole. Cancer treatments, such as bosutinib, dabrafenib, dasatinib , erlotinib, neratinib, or pazopanib Hepatitis medications, such as boceprevir, ledipasvir, sofosbuvir, and telaprevir ,loperamide, metformin, multivitamins, theophylline

16. Drug food interactions raNITIdine ↔ Nicotine The minor drug interaction for ranitidine is alchol however your healthcare provider can determine if adjustments to your medications are needed

17. Precautions May be taken without food . Take with a glass of water and take the exact dosage as directed on the packet (self-medicating) or by your doctor (prescribed). Usually taken twice daily when used to heal ulcers or treat GERD, but may be taken as a single daily dose at night time . Talk to your doctor about the most convenient dosing for you.

18. Do not self-medicate with ranitidine if you are over the age of 40 , use NSAIDs such as aspirin or ibuprofen , have difficulty or pain when swallowing; already take other drugs.

19. Zantac has been banned in india Central drug standard control organization advised patients to avoid using ranitidine drug because it containing human carcinogen ( nitrosodimethylamine ) in the drug this may devolp cancer in human

20. Reference drugs.com ( www.drugs.com/google.com ) Medscape( www.Medscape.com/google.com ) Wikipedia healtthline.com Rxlist.com