- treatment of duodenal, gastric or "stress" ulcers and upper GI bleeding
- antagonist of histamine at gastric H2 receptors
- inhibits both basal gastric acid secretion and gastric acid secretion induced by histamine, pentagastrin, food, insulin and amino acids
- use with caution in infants with liver or kidney disease. Approximately 70% of an IV dose in excreted in urine as unchanged drug. Orally administered ranitidine undergoes extensive metabolism on first pass through the liver.
- rare and usually mild
- most frequent are GI (diarrhea, constipation, abdominal discomfort and pain)
- agitation or drowsiness can occur
- rash; urticaria at site of injection
- tachycardia and bradycardia have been reported, but are rare
- increases in liver enzymes have also been seen
- IV: 0.5 to 1 mg/kg q12h
- may increase to 1.5 mg/kg q6h
- give by slow infusion
- must be diluted to 1mg/mL for IV administration
- PO: 1 to 2 mg/kg q12h
- may increase to 2 mg/kg q8h
an oral dose of 5 mg/kg, twice daily, has been used for the treatment of gastroesophageal reflux in young infants (6 weeks to 6 months of age). The authors suggested that the dose be administered 2 hours after feeding. (1)
- a continuous IV infusion (0.2 mg/kg/h for 37 hours) was used successfully in a 30 week old infant who had an acute gastrointestinal bleed secondary to tolazoline and indomethacin. Ranitidine accumulated in the serum after 24 hours; the authors felt that this dose, although effective, was excessive.
- 1 mg/mL syringe, prepared by Pharmacy
- 15 mg/mL oral solution
- 25 mg/mL, 2mL ampoule (must be diluted to 1 mg/mL)
- to DILUTE the 25 mg/mL solution to 1 mg/mL:
- withdraw 0.5 mL of 25 mg/mL solution (this volume contains 12.5mg)
- add volume from i) to 12 mL with sterile water for injection
- final concentration = 12.5 mg/12.5 mL
= 1 mg/mL
- Mallet E, Mouterde O, Dubois F, Flipo LJ, Moore N : Use of ranitidine in young infants with gastro-oesophageal reflux. Eur J Clin Pharmacol 1989;36:641-2.
- McEvoy G K (ed): AHFS Drug Information, American Society of Hospital Pharmacists, 1991.
- Gomella TL (Ed): Neonatology - Management, Procedures, On-Call Problems, Diseases, Drugs, 1992, Appleton and Lange, Norwalk, Connecticut.
- Milan EM and McFeely EJ: Memory Bank for Neonatal Drugs, 1990, Williams and Wilkins, Baltimore.
- Rosenthal M and Miller PW: Ranitidine in the newborn, Archives of Disease in Childhood 1988; 63: 88-89.
- Hyman PE, Garvey TQ and Abrams CE: Tolerance to intravenous ranitidine, The Journal of Pediatrics 1987; 110: 794-796.
- Blumer JL, Rothstein FC, Kaplan BS et al: Pharmacokinetic determination of ranitidine pharmacodynamics in pediatric ulcer disease, The Journal of Pediatrics 1985; 107: 301-306.
- Hyman PE, Garvey TQ and Harada T: Effect of ranitidine on gastric acid hypersecretion in an infant with short bowel syndrome, Journal of Pediatric Gastroenterology and Nutition 1985; 4: 316-319.
- Young TE and Mangum OB: Neofax - A Manual of Drugs Used in Neonatal Care, Columbus, Ohio: Ross Laboratories, 1992.