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)       :1.4half-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/minHDF/high flux   :Dialysed. Dose as in GFR <10           : mL/minCAV/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 reducedCiclosporin: may increase or not change ciclosporin levels; nephrotoxicity, additive hepatotoxicity and thrombocytopenia reported ADMINISTRATION
Reconstition
– 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 hoursComments
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
See how to identify renal failure stages according to GFR calculation
See how to diagnose irreversible renal disease
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