ranitidine

CLINICAL USE

H2 antagonist:Conditions associated with hyperacidity

DOSE IN NORMAL RENAL FUNCTION

Oral: 150–300 mg once or twice daily Zollinger Ellison: 150 mg 3 times daily up to 6 g/dayIM/Slow IV injection: 50 mg every 6–8 hours

IV infusion

: 25 mg/hour for 2 hours, 6–8 hourly; or for stress ulceration prophylaxis 125–250 mcg/kg/hour

PHARMACOKINETICS

Molecular weight :314.4

%Protein binding :15

%Excreted unchanged in urine : Oral: 30–35; IV: 80

Volume of distribution (L/kg) :1.4

half-life – normal/ESRD (hrs) :2–3/6–9

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : Dose as in normal renal function

<10 : 50–100% of normal dose

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Not dialysed. Dose as in GFR <10 mL/min

HD :Dialysed. Dose as in GFR

<10 : mL/min

HDF/high flux :Dialysed. Dose as in GFR

<10 : mL/min

CAV/VVHD :Probably dialysed. 50 mg every 8–12 hours.1 Oral: dose as in normal renal function

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugsAlpha-blockers: effects of tolazoline antagonised

Antifungals: absorption of itraconazole and ketoconazole reduced

Ciclosporin: may increase or not change ciclosporin levels; nephrotoxicity, additive hepatotoxicity and thrombocytopenia reported

ADMINISTRATION

Reconstition

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Route

Oral, IV peripherally, IM (undiluted)

Rate of Administration

Bolus: 50 mg made up to 20 mL, over at least 2 minutesIntermittent infusion: 50 mg to 100 mL of appropriate intravenous solution run over 2 hours
Continuous infusion: required dose in 250 mL of intravenous fluid over 24 hours

Comments

Compatible with sodium chloride 0.9%, glucose 5% and other fluids. Admixtures stable for 24 hours
Minimum volume: can be used undiluted as a bolus over at least 2 minutes.

OTHER INFORMATION

In CKD 5 usually twice daily for IV preparation and normal dose for oral

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