Ranitidine

What is Ranitidine?

Ranitidine is a treatment for acid reflux, gastroesophageal reflux disease (GORD) and stomach ulcers. It can be taken to relieve symptoms as they occur, or taken continuously to treat recurrent acid reflux or GORD, and is available as both a prescription and an over-the-counter medication.

How does Ranitidine work?

Ranitidine is a H2 receptor agonist which works by reducing acid production in the stomach and preventing acid from moving up into the esophagus, reducing heartburn and allowing any esophageal damage to heal.

How long does it take for Ranitidine to work?

Ranitidine can begin to relieve symptoms of acid reflux in 30 minutes.

Active ingredients

The active ingredient in Ranitidine is ranitidine hydrochloride.

Inactive ingredients

The inactive ingredients in Ranitidine are croscarmellose sodium, magnesium stearate, colloidal anhydrous silica, microcrystalline cellulose 112 (Flocel 112), purified talc, titanium dioxide (E171), hypromellose E15, castor oil and ferric oxide yellow.

Please Note: Different manufacturers of generic Ranitidine may use different inactive ingredients in their drugs that those listed above.

How to take Ranitidine

Always take Ranitidine as instructed by a doctor or pharmacist. Tablets should be swallowed whole with a glass of water. If you miss a dose, take it as soon as you remember unless it is time for your next dose, in what case you should skip it. Never take a double dose to make up for a missed one.

Ranitidine dosage

The recommended dosage for Ranitidine is 150 mg taken in the morning and 150 mg in the evening, or 300 mg taken once daily at bedtime. 

Can Ranitidine tablets be crushed or split?

Ranitidine tablets should be swallowed whole and should not be crushed or split.

What is the best time to take Ranitidine?

For best results, take Ranitidine 30 to 60 minutes before eating.

Ranitidine side effects

Like all medications, Ranitidine can cause side effects in some patients. If you experience any of the following rare but serious side effects, stop taking Ranitidine and seek urgent medical attention:

• Allergic reactions with symptoms of rash, itching or hives, swelling of the face, lips or tongue, chest pain, shortness of breath, wheezing or trouble breathing, unexplained fever and feeling faint when standing up
• Kidney problems which may cause changes in the amount and colour of urine you pass, leading to back pain, fever, pain when urinating, blood in the urine and blood tests
• Pancreatitis with severe stomach pain
• A slow or irregular heartbeat

The following uncommon side effects may affect up to 1 in 10 patients:

• Stomach pain
• Constipation
• Nausea

Rare side effects (1 in 1 000 people) include:

• Skin rash
• Increase in serum creatine in the blood
• Changes to liver function

Very rarely (1in 10 000 cases), the following side effects may occur:

• Changes in the level of certain substances in your blood, causing you to feel unusually tired and short of breath, more likely to bruise or get an infection
• Feeling depressed, confused, or hallucinations
• Headache
• Diarrhea
• Feeling dizzy or blurred vision
• Joint or muscle pain or inflammation
• Slow or irregular heartbeat
• Vasculitis with symptoms such as rash, swollen joints or kidney problems
• Swollen liver, with symptoms such as nausea, vomiting, loss of appetite, generally feeling unwell, itching, fever, yellowing of the skin and eyes or dark coloured urine
• Flushing or target-like marks on the skin
• Unexplained hair loss
• Impotence
• Breast tenderness and/or breast enlargement
• Breast discharge
• Inflammation of the pancreas

Contraindications

Do NOT take Ranitidine if you are allergic to any of the ingredients in this medication. Before taking Ranitidine, speak to your doctor if:

• You have stomach cancer
• You have kidney problems
• You have had stomach ulcers before
• You have a rare condition called acute porphyria
• You are over 65 years old
• You have lung disease
• You are diabetic
• You have any problems with your immune system

Drug interactions

Tell your doctor or pharmacist if you are taking any other medications, including those purchased over the counter without a prescription. In particular, tell your doctor and take particular care if you are taking any of the following:

• Non-steroidal anti-inflammatory (NSAID) medicines such as aspirin, naproxen, and ibuprofen
• Lidocaine
• Propranolol, procainamide or n-acetylprocainamide
• Diazepam
• Phenytoin
• Theophylline
• Warfarin
• Glipizide
• Atazanavir or delavirdine for HIV
• Triazolam for insomnia
• Gefitinib
• Ketoconazole, itraconazole
• Sucralfate

How to cope with Ranitidine side effects

Like all medications, Ranitidine can have some side effects. There are usually mild and can be managed easily. If you experience stomach pains, try eating smaller portions of food more often. Rest up with a hot water bottle against your abdomen, and speak to a doctor if the pain does not let up. Any constipation can usually be relieved by eating more high-fibre foods, such as fruits, vegetables and cereals, and by exercising regularly. Avoid eating particularly rich or spicy food and don’t drink too much alcohol while taking Ranitidine, as this can cause you to feel nauseous. 

Ranitidine and alcohol

You can drink alcohol with Ranitidine, but be aware that Ranitidine itself contains a small amount of alcohol. Alcohol can irritate your stomach lining and exacerbate acid reflux, so it best to avoid it to get the full results of Ranitidine. 

Ranitidine and pregnancy

Ranitidine is usually safe for use during pregnancy and breastfeeding, but speak to a doctor first.

Alternatives to Ranitidine

In many cases, Acid reflux can be treated with lifestyle changes and over-the-counter treatments. Ranitidine is available as an over-the-counter version, as is Omeprazole and foaming agents such as Gaviscon, which work by coating your stomach to prevent reflux. Proton pump inhibitors Omeprazole (Losec) and Lansoprazole are other prescription-treatments. Omeprazole is available in a dispersible and orodispersible form for those who struggle to swallow tablets and capsules.

Are Ranitidine and Omeprazole the same?

While Ranitidine (Zantac) and Omeprazole (Losec) both reduce stomach acid, they do so in different ways. While Ranitidine is an H2 receptor agonist which works by blocking the role of histamine on stomach acid production, Omeprazole prevents the production of acid in the stomach by inhibiting the proton pump. Both are available on prescription and over the counter, and have similar side effects, although Ranitidine carries a higher chance of the side effects constipation and fatigue.

Other ways to avoid acid reflux

In most cases, Acid reflux can be avoided by making a few lifestyle changes. Try eating smaller meals more frequently throughout the day and avoid foods that seem to be triggers. Citrus fruits, tomato, mint, garlic, onions, spicy food, alcohol and fizzy drinks are the foods most commonly linked to acid reflux. Avoid lying down or sleeping for at least 2 hours after eating, and sleep in a chair for daytime naps. If you are overweight, losing weight is the best way to reduce heartburn, and quit smoking if you a have not already done so.

Can I take Ranitidine with other acid reflux medications?

You can take other acid reflux medications with Ranitidine, but you should stagger your doses so that you never take them within 2 hours of each other.

What does Ranitidine look like?

Ranitidine is produced by a few different manufacturers, and so its appearance can differ accordingly. If you prefer your Ranitidine to be supplied by a particular manufacturer, let us know and we will do our best to make it available for you.

Should I take Ranitidine before surgery?

Ranitidine can be taken before surgery, but you should speak to your doctor first. They may advise you against Ranitidine if the local anaesthetic lidocaine or the medicine midazolam are going to be used.

Sources

• Patient Information Leaflet
• NHS > Ranitidine
• NHS > Drugs on the day of surgery