ranitidine
ranitidine.JPG

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

    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



    See how to identify renal failure stages according to GFR calculation

    See how to diagnose irreversible renal disease

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