Ranitidine: Uses, Dosage, and Side Effects Explained

Summary of Key Points

Ranitidine is a medication used to reduce stomach acid and treat conditions such as heartburn, ulcers, and gastroesophageal reflux disease (GERD). It belongs to a class of drugs known as H2 blockers, which work by decreasing the amount of acid produced by the stomach. Ranitidine is available in various forms and strengths, but it is crucial to consult a healthcare provider before starting or adjusting the dose.

Names of Medication

US Brand Name: Zantac

Generic Name: Ranitidine

The generic name refers to the active ingredient, while the brand name is assigned by the manufacturer. In this article, the generic name will appear in parentheses.

Pharmacologic Category

H2 receptor antagonists (H2 blockers)

Other medications in this category include:

1. Famotidine (Pepcid)
2. Cimetidine (Tagamet)
3. Nizatidine (Axid)

Ranitidine Dosage

Ranitidine is used to treat several conditions related to excess stomach acid. The dosage varies depending on the specific condition being treated. Always consult your healthcare provider before making any changes to your dose. You can also schedule a telemedicine appointment with one of our providers to discuss your treatment plan.

Gastroesophageal Reflux Disease (GERD)

Adult dose: 150 mg twice daily or 300 mg once daily at bedtime. Treatment typically lasts 4 to 8 weeks.

Peptic Ulcer Disease

Adult dose: 150 mg twice daily or 300 mg once daily at bedtime. Treatment usually lasts 4 to 8 weeks.

Zollinger-Ellison Syndrome

Adult dose: Initial dose of 150 mg three times daily, which may be increased as needed. Treatment is long-term and should be closely monitored by a healthcare provider.

Erosive Esophagitis

Adult dose: 150 mg twice daily or 300 mg once daily at bedtime. Treatment typically lasts 8 to 12 weeks.

Duodenal Ulcer

Adult dose: 150 mg twice daily or 300 mg once daily at bedtime. Treatment usually lasts 4 to 8 weeks.

Gastric Ulcer

Adult dose: 150 mg twice daily or 300 mg once daily at bedtime. Treatment typically lasts 4 to 8 weeks.

Heartburn and Acid Indigestion

Adult dose: 75 mg to 150 mg as needed, up to twice daily. Do not exceed 300 mg in 24 hours. Treatment is taken as needed for symptom relief.

Stomach Ulcers

Adult dose: 150 mg twice daily or 300 mg once daily at bedtime. Treatment usually lasts 4 to 8 weeks.

Esophagitis

Adult dose: 150 mg twice daily or 300 mg once daily at bedtime. Treatment typically lasts 8 to 12 weeks.

Dosage Forms and Strengths

Ranitidine is available in the following forms and strengths:

1. Tablets: 75 mg, 150 mg, 300 mg
2. Oral Syrup: 15 mg/mL
3. Injection: 25 mg/mL (for hospital use)

Administration Instructions

Ranitidine can be taken with or without food. If using the tablet form, swallow it whole with a glass of water. For the liquid form, use a proper measuring device to ensure the correct dose. If you miss a dose, take it as soon as you remember. However, if it’s close to your next scheduled dose, skip the missed dose and continue with your regular dosing schedule. Do not double up on doses.

Ranitidine Side Effects and Adverse Reactions

Like all medications, Ranitidine can cause side effects. Most are mild, but some may be more serious. If you experience any severe reactions, contact your healthcare provider immediately or schedule a telemedicine visit with one of our providers.

Common Side Effects (1-10% of patients)

1. Headache: Mild to moderate headaches may occur.
2. Dizziness: Some patients report feeling lightheaded or dizzy.
3. Constipation or Diarrhea: Digestive issues such as constipation or diarrhea can occur but are usually mild.

Less Common Side Effects (Less than 1% of patients)

1. Fatigue: Some patients may feel unusually tired.
2. Rash: Skin reactions, including rashes or itching, may occur.
3. Nausea or Vomiting: Some patients may experience nausea or vomiting.

Contraindications for Ranitidine

A contraindication is a specific condition where a medication should not be used because it may cause harm. If you have any of the following conditions, you should not take Ranitidine. Always consult your healthcare provider before starting or stopping any medication. You can also speak to one of our providers through telemedicine for personalized advice.

1. Allergy to Ranitidine: If you have a known allergy to Ranitidine or any of its ingredients, taking the medication could cause a severe allergic reaction, including rash, swelling, or difficulty breathing.
2. Porphyria: Ranitidine is contraindicated in patients with acute porphyria, a rare genetic disorder affecting the nervous system. Ranitidine can trigger an attack, leading to severe symptoms such as abdominal pain and neurological issues.
3. Severe Kidney Disease: Ranitidine is processed by the kidneys, and in individuals with severe kidney disease, the medication may accumulate in the body, increasing the risk of side effects.
4. Pregnancy (with caution): While Ranitidine is sometimes used during pregnancy, it should only be taken if clearly necessary and under the guidance of a healthcare provider. More details are provided below.

Drug to Drug Interactions with Ranitidine

Ranitidine can interact with other medications, potentially altering its effectiveness or increasing the likelihood of side effects. It’s important to inform your healthcare provider about all the medications you are taking, including over-the-counter drugs and supplements. Below are some common medications that may interact with Ranitidine:

1. Warfarin (Coumadin): Ranitidine may enhance the effects of Warfarin, a blood thinner, which could increase the risk of bleeding.
2. Ketoconazole (Nizoral): Ranitidine can reduce the absorption of Ketoconazole, an antifungal medication, potentially making it less effective.
3. Atazanavir (Reyataz): Ranitidine may decrease the absorption of Atazanavir, an antiretroviral drug used to treat HIV, reducing its effectiveness.
4. Midazolam (Versed): Ranitidine may intensify the sedative effects of Midazolam, which is used for anesthesia or sedation, potentially leading to excessive drowsiness or breathing difficulties.

Is Ranitidine Safe During Pregnancy?

Is it safe to take Ranitidine during pregnancy? The safety of Ranitidine during pregnancy has not been fully established. While some studies suggest it may be safe when used under a healthcare provider’s supervision, it is generally recommended only if clearly necessary. If you are pregnant and experiencing heartburn or acid reflux, consult one of our telemedicine providers to determine whether Ranitidine is appropriate for you or if safer alternatives are available.

Ranitidine and Breastfeeding: What You Need to Know

Is it safe to take Ranitidine while breastfeeding? Ranitidine does pass into breast milk, but its effects on a nursing infant are not well understood. If you are breastfeeding, it’s important to consult your healthcare provider before taking Ranitidine. They can help you weigh the potential risks and benefits. You can also connect with one of our telemedicine providers to discuss your options.

Estimated Cost of Ranitidine Medication

The estimated cost of a 30-day supply of Ranitidine without insurance, using a GoodRX coupon, ranges from $10 to $25, depending on the pharmacy and dosage. Prices may vary, so it’s a good idea to check with your local pharmacy or use a coupon service like GoodRX to find the best price.

Ranitidine Alternatives for Acid Reflux and Other Conditions

If you are considering alternatives to Ranitidine, there are other medications and lifestyle changes that may help. Always consult your healthcare provider before making any changes to your treatment plan. You can also speak to one of our telemedicine providers for personalized guidance.

1. Gastroesophageal reflux disease (GERD): Alternatives include proton pump inhibitors (PPIs) like Omeprazole (Prilosec) or lifestyle changes such as avoiding trigger foods, eating smaller meals, and elevating the head of your bed.
2. Peptic ulcer disease: Treatment may involve PPIs or antibiotics if the ulcer is caused by H. pylori bacteria. Avoiding NSAIDs and managing stress can also be beneficial.
3. Zollinger-Ellison syndrome: PPIs like Lansoprazole (Prevacid) are often used to reduce stomach acid production. In some cases, surgery may be considered.
4. Erosive esophagitis: PPIs or H2 blockers like Famotidine (Pepcid) may be prescribed. Avoiding acidic foods and quitting smoking can also help alleviate symptoms.
5. Duodenal ulcer: PPIs or H2 blockers, along with antibiotics if H. pylori is present, are common treatments. Reducing alcohol consumption and avoiding spicy foods may also help.
6. Gastric ulcer: PPIs, H2 blockers, and antibiotics (if H. pylori is involved) are often used. Reducing stress and avoiding NSAIDs can also help prevent ulcers.
7. Heartburn and Acid indigestion: Over-the-counter antacids like Tums, along with lifestyle changes such as avoiding spicy foods, caffeine, and alcohol, may help relieve symptoms.
8. Stomach ulcers: Similar to peptic ulcers, treatment may involve PPIs, H2 blockers, and antibiotics. Avoiding NSAIDs and managing stress can also help.
9. Esophagitis: Treatment may include PPIs, H2 blockers, or corticosteroids, depending on the cause. Lifestyle changes like avoiding acidic foods and quitting smoking can also help manage symptoms.

Recent Updates on Ranitidine Research and Recall

In recent years, Ranitidine has been the subject of significant research due to concerns about a contaminant called N-nitrosodimethylamine (NDMA), a potential carcinogen. In 2020, the U.S. Food and Drug Administration (FDA) requested the removal of all Ranitidine products from the market due to the risk of NDMA contamination. Since then, research has focused on understanding the long-term risks of NDMA exposure and identifying safer alternatives for patients who need acid-reducing medications.

As of now, Ranitidine is no longer available in the U.S. market. Patients are encouraged to discuss alternative treatments with their healthcare providers. If you are currently taking Ranitidine or have concerns about your treatment, please reach out to one of our telemedicine providers for guidance on safer alternatives.

James Kingsley

Learn More