Ranisen: Indications, Pharmacology, Adverse Reactions, Interactions and Warnings

It is a drug that is prescribed to decrease the production of acid in the stomach.

The active substance in ranisen is ranitidine .

Indications

Ranisen is indicated to treat ulcers; gastroesophageal reflux disease (GERD), a condition in which the backward flow of acid from the stomach causes heartburn and damage to the food pipe (esophagus); and conditions in which the stomach produces too much acid, such as Zollinger-Ellison syndrome.

Ranisen is an over-the-counter drug.

Other uses

Ranisen is also sometimes used to treat upper gastrointestinal bleeding and to prevent stress ulcers , stomach damage from the use of non-steroidal anti-inflammatory drugs (NSAIDs), and aspiration of stomach acid during anesthesia.

Pharmacology

Ranitidine is a histamine H2 receptor antagonist similar to cimetidine and famotidine.

An H2 receptor antagonist, often shortened to H2 antagonist, is a drug used to block the action of histamine on parietal cells in the stomach, decreasing acid production by these cells.

These drugs are used in the treatment of dyspepsia, however their use has decreased since the advent of the more effective proton pump inhibitors. Like H1 antihistamines, H2 antagonists are inverse agonists rather than true receptor antagonists.

Ranitidine is a member of the class of histamine H2 receptor antagonists with antacid activity.

Ranitidine is a competitive and reversible inhibitor of the action of histamine, released by enterochromaffin cells (ECL), at histamine H2 receptors in the parietal cells of the stomach, thus inhibiting the normal and meal-stimulated secretion of stomach acid .

Furthermore, other substances that promote acid secretion have a reduced effect on parietal cells when H2 receptors are blocked.

Adverse reactions

The following are possible adverse reactions to ranisen:

  • Cardiovascular AV block.
  • Bradicardia.
  • Cardiac arrhythmia.
  • Premature ventricular beats.
  • CNS agitation.
  • Confusion.
  • Depression.
  • Dizziness.
  • Fatigue.
  • Hallucinations
  • Headache.
  • Insomnia.
  • Discomfort.
  • Motor disorders.
  • Drowsiness.
  • Vertigo.
  • Dermatological alopecia.
  • Erythema multiforme.
  • Eruption.
  • Vasculitis.
  • Blurred vision.
  • Abdominal discomfort
  • Constipation.
  • Diarrhea.
  • Nausea.
  • Pancreatitis.
  • Vomiting
  • Agranulocitosis.
  • Hemolytic or autoimmune aplastic anemia.
  • Granulocitopenia.
  • Leucopenia.
  • Pancytopenia
  • Thrombocytopenia
  • Hepatocellular effects.
  • Musculoskeletal arthralgias.
  • Myalgias.
  • Miscellaneous Anaphylaxis.
  • Angioneurotic edema.
  • Hypersensitive reactions.

The adverse reaction profile in pediatric patients is similar to that observed in the adult population.

Interactions

  • Diazepam, midazolam, triazolam: pharmacological effects may increase or decrease due to decreased GI absorption by ranitidine. Administration times can prevent this reaction.
  • Ethanol: can increase ethanol levels in plasma.
  • Glipizide:  possible increased effect of hypoglycaemia.
  • Ketoconazole –  May decrease the effects of ketoconazole.
  • Lidocaine:  can cause an increase in lidocaine levels.
  • Warfarin:  hypoprothrombinemic effects may increase; may need adjustment.

Warnings

  • Pregnancy category:  B.
  • Lactation: ranisen is distributed in breast milk.
  • The safety and efficacy of ranise have been established in children 1 to 16 years of age for the treatment of duodenal and gastric ulcers, GERD and erosive esophagitis, and for the maintenance of healed duodenal and gastric ulcer.
  • Safety and efficacy have not been established for the treatment of pathological hypersecretory conditions or for the maintenance of healing of erosive esophagitis in children or neonates less than 1 month of age.
  • The elderly may have reduced kidney function; therefore, the decrease in drug Cl may be more common.
  • Hypersensitivity: Rare cases of anaphylaxis and rare episodes of hypersensitivity have occurred.
  • Kidney function : decreased Cl may occur; a dose reduction may be necessary. Hemodialysis lowers the ranitidine dosage level; the time should be adjusted so that the scheduled dose coincides with the end of hemodialysis.
  • Liver function : use the drug with caution; Cl lowering can occur. It can be a hepatocellular lesion, manifesting as reversible, hepatocellular or hepatocanalicular or mixed hepatitis, with or without jaundice.
  • Rapid intravenous administration can rarely cause bradycardia, tachycardia, or premature ventricular beats, usually in patients predisposed to cardiac rhythm disturbances.

Route of elimination

The main route of excretion is the urine (active tubular excretion, renal clearance 410 ml / min), with approximately 30% of the orally administered dose collected in the urine as unchanged drug within 24 hours.