Ranitidine (Ranitidine Hydrochloride)
Also sold as: Zantac, Rani, Ranidil
Pregnancy
Cat B
Lactation
Safe
Schedule
OTC
Forms
Tablet 75mg, 150mg, 300mg +3
Indications
- Peptic ulcer disease (gastric/duodenal)
- GERD / reflux esophagitis
- Zollinger-Ellison syndrome
- Stress ulcer prophylaxis (hospital)
- Pathological hypersecretion
Adult Dosing
Peptic ulcer / GERD
150 mg PO BD or 300 mg at bedtime
6-12 weeks for ulcer; long-term for GERD
Active ulcer (short-term)
300 mg at bedtime or 150 mg BD
4-6 weeks
Zollinger-Ellison (high-dose)
300 mg-1.2 g daily divided doses
Long-term
IV (hospital)
50 mg IV Q6-8H
Acute setting
Pediatric Dosing
Adjust for renal function; IV preferred in critical care
Renal Dose Adjustment
| CrCl / eGFR | Dose Adjustment |
|---|---|
| CrCl > 50 mL/min | No adjustment |
| CrCl 30-50 mL/min | 150 mg once daily or every 24 hours |
| CrCl < 30 mL/min | 150 mg every 24 hours |
Hepatic Adjustment
Mild-moderate: no adjustment. Severe: use with caution.
Pregnancy & Lactation
Pregnancy: Category B
Safe in pregnancy; commonly used for GERD symptoms.
Lactation: Safe
Minimal excretion in breast milk; compatible.
Top Drug Interactions
| Interacting Drug | Effect | Severity |
|---|---|---|
| Warfarin | Possibly increased INR (monitor) | Moderate |
| Cimetidine | Competitive H2 antagonism; avoid combining | Moderate |
| Azole antifungals (ketoconazole, itraconazole) | Reduced antifungal absorption | Moderate |
| Iron supplements | Reduced iron absorption | Minor |
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Side Effects
Common
- Headache
- Diarrhea
- Constipation
- Nausea
- Abdominal pain
Serious / Discontinue If
- Hepatitis (rare)
- Confusion / delirium (especially elderly, high-dose)
- Agranulocytosis (very rare)
- Interstitial nephritis (rare)
Contraindications
- Hypersensitivity to ranitidine
- Severe renal impairment (eGFR <10 mL/min)
Available Indian Brands
| Brand | Manufacturer | Price (approx) |
|---|---|---|
| Zantac 150 mg | GSK | 10 tab ₹75-90 |
| Rani 150 mg | Cipla | 10 tab ₹50-60 |
| Ranidil 150 mg | Intas | 10 tab ₹45-55 |
Monitoring Required
- Ulcer healing: endoscopy if not responding in 6-8 weeks
- Renal function at baseline (elderly or CKD)
- LFT if prolonged use (>3 months)
- CBC if on long-term high-dose
Patient Counseling Points
- Take with food or at bedtime for better effect
- Antacids: take 1 hour apart from ranitidine
- Iron/antifungals: take 2+ hours apart
- Report confusion, severe GI pain, or dark urine
- Usually 4-6 weeks for ulcer healing; continue full course
- GERD: may need long-term treatment; monitor symptoms
- Usually replaced by PPIs (omeprazole) in modern practice due to superior efficacy
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Clinically reviewed by: Dr. Vikram Patel, MD (Gastroenterology), Ulcer Disease Specialist
Last reviewed: 2026-04-11
References
- BNF — Ranitidine
- ACG GERD Guidelines 2023
- H2 Antagonist Review Cochrane