ranitidine hydrochloride Nursing Considerations & Management

Drug Name

Generic Name : ranitidine hydrochloride

Brand Name:  Apo-Ranitidine (CAN), CO Ranitidine (CAN), Gen-Ranitidine (CAN), Novo-Ranitidine, (CAN), Nu-Ranit (CAN), ratio-Ranitidine (CAN), Zantac, Zantac EFFERdose, Zantac GELdose, Zantac 75, Zantac 150

Classification: Histamine2 (H2) antagonist

Pregnancy Category B 

Dosage & Route

Available forms : Tablets—75, 150, 300 mg; effervescent tablets and granules—25, 150 mg; syrup—15 mg/mL; injection—1, 25 mg/mL

ADULTS
  • Active duodenal ulcer: 150 mg bid PO for 4–8 wk. Alternatively, 300 mg PO once daily at bedtime or 50 mg IM or IV q 6–8 hr or by intermittent IV infusion, diluted to 100 mL and infused over 15–20 min. Do not exceed 400 mg/day.
  • Maintenance therapy, duodenal ulcer: 150 mg PO at bedtime.
  • Active gastric ulcer: 150 mg bid PO or 50 mg IM or IV q 6–8 hr.
  • Pathologic hypersecretory syndrome: 150 mg bid PO. Individualize dose with patient’s response. Do not exceed 6 g/day.
  • GERD, esophagitis, benign gastric ulcer: 150 mg bid PO.
  • Treatment of heartburn, acid indigestion: 75 mg PO as needed.
PEDIATRIC PATIENTS
  • Safety and efficacy not established.
GERIATRIC PATIENTS AND PATIENTS WITH IMPAIRED RENAL FUNCTION
  • For creatinine clearance < 50 mL/min, accumulation may occur; use lowest dose possible, 150 mg q 24 hr PO or 50 mg IM or IV q 18–24 hr. Dosing may be increased to q 12 hr if patient tolerates it and blood levels are monitored.
Therapeutic actions
  • Ranitidine blocks histamine H2-receptors in the stomach and prevents histamine-mediated gastric acid secretion. It does not affect pepsin secretion, pentagastrin-stimulated factor secretion or serum gastrin.
Indications
  • Short-term treatment of active duodenal ulcer
  • Maintenance therapy for duodenal ulcer at reduced dosage
  • Short-term treatment of active, benign gastric ulcer
  • Short-term treatment of GERD
  • Pathologic hypersecretory conditions (eg, Zollinger-Ellison syndrome)
  • Treatment of erosive esophagitis
  • Treatment of heartburn, acid indigestion, sour stomach
Adverse effects
  • Headache, dizziness. Rarely hepatitis, thrombocytopaenia, leucopaenia, hypersensitivity, confusion, gynaecomastia, impotence, somnolence, vertigo, hallucinations.
  • Potentially Fatal: Anaphylaxis, hypersensitivity reactions.
Contraindications
  • Porphyria.
Nursing considerations
Assessment
  • History: Allergy to ranitidine, impaired renal or hepatic function, lactation, pregnancy
  • Physical: Skin lesions; orientation, affect; pulse, baseline ECG; liver evaluation, abdominal examination, normal output; CBC, LFTs, renal function tests
Interventions
  • Administer oral drug with meals and at bedtime.
  • Decrease doses in renal and liver failure.
  • Provide concurrent antacid therapy to relieve pain.
  • Administer IM dose undiluted, deep into large muscle group.
  • Arrange for regular follow-up, including blood tests, to evaluate effects.
Teaching points
  • Take drug with meals and at bedtime. Therapy may continue for 4–6 weeks or longer.
  • If you also are using an antacid, take it exactly as prescribed, being careful of the times of administration.
  • Have regular medical follow-up care to evaluate your response.
  • You may experience these side effects: Constipation or diarrhea (request aid from your health care provider); nausea, vomiting (take drug with meals); enlargement of breasts, impotence or decreased libido (reversible); headache (adjust lights and temperature and avoid noise).
  • Report sore throat, fever, unusual bruising or bleeding, tarry stools, confusion, hallucinations, dizziness, severe headache, muscle or joint pain.
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