The active medical ingredient ranitidine is used to protect the stomach. It belongs to the H2 antagonists.
What is ranitidine?
Ranitidine is used to treat reflux disease, prevent stomach ulcers, and control stomach acid in heartburn. Ranitidine is a drug that belongs to the class of H2 antihistamines. It is used to treat reflux disease, to prevent peptic ulcers, and to control stomach acid in heartburn. In addition to human medicine, veterinary medicine also makes use of ranitidine. Ranitidine is related to active ingredients such as nizatidine, cimetidine, roxatidine and famotidine. Here, the drug attaches to H2 receptors in the stomach and leads to their blockade. In low doses, ranitidine can be purchased from pharmacies without a prescription. In higher doses, however, the drug is subject to prescription. Although ranitidine is considered to be well tolerated, it is only a second-choice therapeutic agent. The effect of the drug is lower than that of proton pump inhibitors (PPI). In addition, the stomach produces more acid again after stopping ranitidine. This poses a risk of renewed inflammation. The drug should not be used for more than seven days without medical supervision.
Pharmacologic action
Gastric acid is produced in the gastric vestibular cells. Ranitidine, as an H2 antagonist, has the property of inhibiting the production of gastric acid. In doing so, the active ingredient competes with the tissue hormone histamine at histamine-2 receptors. The histamine causes the release of digestive enzymes and activation of acid production. H2 antagonists, on the other hand, inhibit the formation of gastric acid, which in turn has a protective effect on the stomach. In this respect, ranitidine has an antagonistic (opposite) effect to histamine. The gastric juice can therefore be neutralized by the use of ranitidine, making it less aggressive to the stomach and other organs such as the small intestine and esophagus. This procedure can effectively treat heartburn and inflammation. Even at a low dosage, ranitidine causes the activity of gastric occupancy cells to decrease. This leads to a lower release of hydrochloric acid within the stomach, which reduces the discomfort. However, the effect of proton pump inhibitors is much stronger. For example, these can inhibit up to 90 percent of stomach acid formation, while ranitidine only achieves a maximum of 50 percent.
Medical use and application
For use, ranitidine is used for gastritis and stomach ulcers. The same applies to ulcers and inflammation of the duodenum. Other indications include esophagitis (inflammation of the esophagus), gastritis (inflammation of the gastric mucosa), and reflux disease manifested by heartburn. In veterinary medicine, ranitidine is also used to treat gastrinoma such as Zollinger-Ellison syndrome, mast cell tumors and mastocytosis. In the context of cortisone treatment, ranitidine can be administered to protect the stomach. It also makes sense to use the active ingredient in pain treatments with NSAIDs (non-steroidal anti-inflammatory drugs). These often cause heartburn, stomach pain or stomach bleeding when used for a long time. Another area of application for ranitidine is allergy prophylaxis prior to surgery. In this case, the drug is administered together with an H1 blocker. For heartburn and pain caused by acidity, the recommended dose of ranitidine is 75 milligrams, which can be administered up to four times a day. The duration of treatment takes four weeks. This dosage is also suitable for self-treatment. If, on the other hand, a gastric or duodenal ulcer is present, the daily dose is between 300 and 600 milligrams, taken once or twice a day. To prevent ulcer reoccurrence, the patient should receive 150 milligrams of ranitidine per day.
Risks and side effects
Ranitidine is considered to be well tolerated. Thus, patients rarely suffer from adverse side effects such as nausea, vomiting, diarrhea, gastrointestinal distress, cardiac arrhythmias, joint pain, headache, or dizziness. In some cases, skin rash, constipation, fatigue, hypersensitive reactions and changes in the blood count, such as thrombocytopenia or leukocytopenia, may also occur.Rare adverse effects include gynecomastia, erythema multiforme, and confusion. Ranitidine should not be used at all if the patient is hypersensitive to the drug. Acute porphyria (liver disease) is also a possible contraindication. During pregnancy or breastfeeding, it is recommended that ranitidine be taken only if the benefits and risks have been carefully weighed. Temporary adverse effects on the baby cannot be completely ruled out. The administration of ranitidine is not suitable in children under ten years of age. There is a risk of interactions when taking ranitidine. Thus, the absorption of other drugs is negatively affected by the drug. This includes, for example, the antifungal drug ketoconazole, whose positive effect suffers under ranitidine. Furthermore, the H2 antagonist increases the effect of the anesthetic midazolam, the asthma drug theophylline, the blood sugar-lowering agent glipizide, and the psychopharmaceutical triazolam. In addition, the effects of alcohol are also enhanced by ranitidine.
