Anti-R Tablet

Introduction

Ranitidine hydrochloride is an anti-ulcer agent commonly used to treat the symptoms of gastroesophageal reflux disease (GERD), peptic ulcers, and other acid reflux conditions. It is the hydrochloride salt of ranitidine, a histamine H2 receptor antagonist. Ranitidine HCl has a wide range of clinical applications in human medicine and veterinary medicine.

Uses

Ranitidine hydrochloride is used to treat ulcers and acid reflux conditions, by blocking the production of acid in the stomach. It is also used to treat erosive esophagitis, abdominal pain, indigestion, and dyspepsia, as well as to prevent the formation of gastric ulcers and reduce the acidity in the stomach. It is also sometimes used for the prevention of gastrointestinal bleeding.

Brand Name	Anti-R
Type	Tablet
Weight	150 mg
Generic	Ranitidine Hydrochloride
Manufacturer	United Pharmaceuticals Ltd.
Available in	English বাংলা

Mechanism of Action

Ranitidine hydrochloride works by blocking the action of an enzyme in the stomach (called the histamine H2 receptor) that causes acid production. In blocking the action of this enzyme, the production of acid is reduced, reducing the symptoms of acid reflux and other acid-related conditions.

How long does it take to work?

Ranitidine hydrochloride typically begins to work within 30 minutes of oral administration. However, it can take up to 4 hours for full effect.

Absorption

Ranitidine hydrochloride is quickly and well absorbed from the gastrointestinal tract and reaches peak concentrations in the bloodstream after approximately 2 hours. It is then distributed throughout the body.

Route of Elimination

Ranitidine hydrochloride is eliminated mainly by hepatic metabolism and renal excretion. Approximately 85% of a dose of the drug is eliminated in the urine and 5-15% in the feces.

Dosage

Ranitidine Tablet & Syrup:

Duodenal and gastric ulcer: The usual dosage is 150 mg twice daily taken in the morning and evening or 300 mg as a single daily dose at night for 4 to 8 weeks.

Reflux oesophagitis: 150 mg twice daily or 300 mg at bed time for up to 8 weeks.

Zollinger Ellison syndrome: 150 mg 3 times daily and increased if necessary up to 6 g daily in divided doses. Dosage should be continued as long as clinically indicated.

Episodic dyspepsia: 150 mg twice daily or 300 mg at bed time for up to 6 weeks.

Maintenance: 150 mg at night for preventing recurrences.

Child (peptic ulcer): 2-4 mg/kg twice daily, maximum 300 mg daily.

Ranitidine IV injection & IV Infusion:

Ranitidine injection may be given either as a slow (over a period of at least two minutes) intravenous injection of 50 mg, after dilution to a volume of 20 ml per 50 mg dose, which may be repeated every six to eight hours; or as an intermittent intravenous infusion at a rate of 25 mg per hour for two hours; the infusion may be repeated at six to eight hour intervals; or as an intramuscular injection of 50 mg (2 ml) every six to eight hours. In the prophylaxis of haemorrhage from stress ulceration in seriously ill patients or the prophylaxis of recurrent haemorrhage in patients bleeding from peptic ulceration, parenteral administration may be continued until oral feeding commences.

In the prophylaxis of upper gastrointestinal haemorrhage from stress ulceration in seriously ill patient sapriming dose of 50 mg as low as intravenous injection followed by a continuous intravenous infusion of 0.125-0.250 mg/kg/hour may be preferred. In patients considered to be at risk of developing aspiration syndrome Ranitidine injection 50 mg may be given intramuscularly or by slow intravenous injection 45 to 60 minutes before induction of general anaesthesia.

Children: The recommended oral dose for the treatment of peptic ulcer in children is 2 mg/kg to 4 mg/kg twice daily to a maximum of 300 mg ranitidine per day. Safety and effectiveness of Ranitidine injection have not been established in case of children.

The recommended adult dosage for treating peptic ulcer disease is 150-300mg twice daily. For GERD, it is 300mg twice daily. The dosage of ranitidine hydrochloride for children and adolescents is 25 to 50 mg/kg per day administered in divided doses. The maximum daily dose should not exceed 6 g/day.

Administration

Ranitidine hydrochloride is available in tablet, capsule, syrup, and injection form. It should be orally administered with water or meals, depending on the doctor’s prescription. For injection form, it should be administered intravenously. It is also available as an oral solution.

Side-Effects

Common side effects of ranitidine hydrochloride include: headaches, abdominal pain, diarrhea, nausea, vomiting, constipation, rash, and rarely, allergic reactions. Rare but serious side effects can include liver damage, reduction in white blood cells, and allergic reactions.

Toxicity

In case of an overdose, the symptoms may include abdominal pain, restlessness, confusion, nausea, vomiting, or diarrhea. An overdose of ranitidine hydrochloride may lead to an increase in acid levels in the blood and can be fatal without medical intervention.

Precaution

Ranitidine hydrochloride should be used with caution in patients with renal or hepatic disease, and in the elderly. It should also be avoided in patients who have known hypersensitivity to ranitidine or any other component of the product.

Interaction

Ranitidine hydrochloride may interact with other medications including anticoagulants, immunosuppressants, antifungals, and antibiotics. It is important to tell your doctor about any other medications you are taking before starting ranitidine hydrochloride, to avoid potential drug-drug interactions.

Disease Interaction

Ranitidine hydrochloride should be used cautiously in patients with pre-existing renal or hepatic disease. Patients with a history of cardiovascular disease or diabetes should consult a physician before taking ranitidine hydrochloride, as it may affect their condition.

Drug Interaction

Food Interactions

Ranitidine hydrochloride should be taken with food or immediately after a meal to ensure proper absorption. In some cases, a high fat or high protein meal may decrease the absorption of ranitidine hydrochloride, and so it should be taken at least 45 minutes after a meal.

Pregnancy Use

Ranitidine hydrochloride should be used only if prescribed by a doctor during pregnancy. It is generally recommended to avoid the use of ranitidine in pregnant women, unless the benefit outweighs the risk.

Lactation Use

Ranitidine hydrochloride should be avoided during breastfeeding, unless the benefit outweighs the risk. If it is prescribed, it should be taken after consulting a doctor.

Acute Overdose

In cases of an acute overdose, the symptoms may include abdominal pain, restlessness, confusion, nausea, vomiting, or diarrhea. An overdose of ranitidine hydrochloride may lead to an increase in acid levels in the blood and can be fatal without medical intervention.

Contraindication

Ranitidine hydrochloride is contraindicated in patients with known hypersensitivity to ranitidine or any other component of the product. It should also be used with caution in patients with renal or hepatic disease, and in the elderly.

Use Direction

Ranitidine hydrochloride should be taken exactly as prescribed by the doctor. It should be orally administered with water or meals, depending on the doctor’s prescription. For injection form, it should be administered intravenously. It is also available as an oral solution.

Storage Condition

Ranitidine hydrochloride should be stored at room temperature, in a well-sealed container, away from excessive heat and moisture. Injection should be stored in the original package and should not be stored above 25°C (77°F).

Volume of Distribution

Ranitidine hydrochloride has a volume of distribution of 0.5-1.3 L/kg.

Half Life

The half-life of ranitidine hydrochloride is 1-2 hours.

Clearance

The clearance rate of ranitidine hydrochloride is approximately 10-20 mL/min/kg.

See in details version Anti-R Tablet 150 mg also Anti-R Tablet 150 mg in bangla

Some Frequently Asked Questions About Anti-R Tablet 150 mg

1. What is Anti-R Tablet 150 mg?

Anti-R Tablet 150 mg is a medication classified as an H2 receptor antagonist (H2 blocker). It reduces stomach acid production and was widely used to treat conditions like heartburn, gastroesophageal reflux disease (GERD), and peptic ulcers. Sold under brand names like Zantac, it was available as tablets, syrup, or injections until its withdrawal from many markets in 2020 due to NDMA contamination concerns.

2. What class of drug is Ranitidine?

Ranitidine belongs to the H2 receptor blocker class. These drugs block histamine from binding to H2 receptors on parietal cells in the stomach, reducing acid secretion. It was a popular alternative to antacids and proton pump inhibitors (PPIs) for acid-related disorders.

3. How does Anti-R Tablet 150 mg work?

Ranitidine works by competitively inhibiting histamine at the H2 receptors on gastric parietal cells. This reduces:

Basal acid secretion: Acid produced at rest.
Stimulated acid secretion: From food, caffeine, or stress.

By lowering acid levels, it relieves symptoms and promotes healing of acid-damaged tissues.

4. What conditions does Ranitidine treat?

It was used for:

Heartburn: Acid reflux relief.
GERD: Managing chronic acid reflux.
Peptic ulcers: Healing stomach/duodenal ulcers.
Zollinger-Ellison syndrome: Treating excessive acid production.

It also prevented acid-related damage in certain cases.

5. Is Ranitidine used for anything other than acid reduction?

Off-label, it was sometimes used to prevent stress ulcers in critically ill patients or to reduce allergic reactions (due to histamine-blocking effects), though these uses were less common. Its primary role was acid suppression.

6. How is Ranitidine taken?

Ranitidine was taken orally as tablets (75 mg, 150 mg, 300 mg), syrup, or, in hospitals, via IV injection. It was typically taken once or twice daily, with or without food, depending on the condition and severity.

7. What is the typical dosage for adults?

For adults:

Heartburn/GERD: 75–150 mg twice daily or 300 mg at bedtime.
Ulcers: 150 mg twice daily or 300 mg once daily, for 4–8 weeks.
Zollinger-Ellison: Up to 600 mg daily, divided doses.

OTC doses were lower (e.g., 75 mg) for occasional use.

8. What is the dosage for children?

For children (1 month and older):

Ulcers/GERD: 2–4 mg/kg twice daily (max 300 mg/day).

Dosing was weight-based and supervised by a doctor.

9. Can Ranitidine be taken with food?

Yes, it can be taken with or without food. Food doesn’t significantly affect absorption, though taking it before meals may enhance its effect on meal-induced acid production.

10. What should I do if I miss a dose?

If you miss a dose, take it as soon as you remember unless it’s nearly time for the next dose. Skip it if it’s close, and don’t double up, as this could increase side effects like dizziness.

11. How quickly does Ranitidine work?

It reduces acid within 30–60 minutes, with peak effects in 2–3 hours. Relief from heartburn or indigestion is often felt within an hour, lasting up to 12 hours per dose.

12. What are the common side effects?

Common side effects include:

Headache: Mild and transient.
Dizziness: Occasional lightheadedness.
Constipation or diarrhea: Minor bowel changes.
Nausea: Rare stomach upset.

These were generally mild.

13. What are the serious side effects?

Rare but serious side effects include:

Liver issues: Yellowing skin or dark urine.
Blood disorders: Bruising or infections.
Heart rhythm changes: Palpitations (very rare).
Allergic reactions: Rash or swelling.

Seek medical help if these occurred.

14. Why was Ranitidine withdrawn from the market?

In 2020, Ranitidine was recalled in many countries (e.g., U.S., EU) due to contamination with N-nitrosodimethylamine (NDMA), a probable carcinogen. NDMA levels increased over time, especially with heat exposure, prompting the FDA and other agencies to halt its sale.

15. Can Ranitidine cause allergic reactions?

Yes, though rare, it could cause rash, itching, or anaphylaxis in sensitive individuals. Those with histamine-related drug allergies were at higher risk.

16. Who should not take Ranitidine?

It was contraindicated for:

Allergy to Ranitidine: Or other H2 blockers.
Severe kidney disease: Without dose adjustment.

Caution was needed in liver disease or pregnancy.

17. Is Ranitidine safe during pregnancy?

It was Category B—generally safe based on animal studies, with limited human data. It was often used for pregnancy-related heartburn, but alternatives (e.g., antacids) are now preferred post-recall.

18. Can I take Ranitidine while breastfeeding?

It passes into breast milk in small amounts but was considered safe. Post-recall, consult a doctor for safer options like famotidine.

19. Does Ranitidine interact with other medications?

Yes, it could affect:

Warfarin: Slight bleeding risk increase.
Antacids: May reduce Ranitidine absorption if taken together.
Drugs needing acid: E.g., ketoconazole absorption may decrease.

Spacing doses minimized issues.

20. Can I drink alcohol while taking Ranitidine?

Alcohol doesn’t interact directly, but it increases stomach acid and worsens GERD, countering Ranitidine’s benefits. Limit intake for best results.

21. Does Ranitidine cause weight gain?

No, it doesn’t affect metabolism or cause weight gain. Any perceived change might be from reduced bloating or diet.

22. Can Ranitidine be taken at night?

Yes, a common dose (e.g., 300 mg) was taken at bedtime to control nighttime acid reflux and promote ulcer healing.

23. How long do I need to take Ranitidine?

Duration varied:

Heartburn: As needed (OTC).
Ulcers: 4–8 weeks.
GERD: Long-term if chronic.

Post-recall, alternatives are used.

24. Can Ranitidine be stopped suddenly?

Yes, stopping poses no withdrawal risk, but acid rebound might worsen symptoms if the underlying issue persists.

25. Does Ranitidine affect blood sugar?

No, it doesn’t directly impact blood sugar. Diabetics could use it safely for acid issues.

26. Can Ranitidine cause cancer?

The NDMA contamination raised cancer concerns (e.g., stomach, liver cancer) with long-term use. While no definitive link was proven in humans, this led to its withdrawal. Alternatives lack this risk.

27. What should I avoid while taking Ranitidine?

Avoid:

Smoking: Increases acid production.
Acidic foods: E.g., citrus, if treating GERD.
NSAIDs: May worsen ulcers.

28. Can Ranitidine cause fatigue?

Fatigue was rare but reported, possibly from dizziness or underlying conditions, not a primary effect.

29. Is Ranitidine safe for elderly patients?

Yes, but dose adjustments were needed for reduced kidney function in the elderly to avoid accumulation.

30. Does Ranitidine affect the liver?

Rarely, it could cause reversible liver enzyme elevations. Significant damage was uncommon unless liver disease pre-existed.

31. Can Ranitidine be used in children?

Yes, for infants (1 month+) and children, with doses of 2–4 mg/kg twice daily for ulcers or GERD, under medical supervision.

32. What’s the maximum dose of Ranitidine?

Maximum was 600 mg daily (e.g., for Zollinger-Ellison), typically divided into doses, though 300 mg daily was common for most uses.

33. Can Ranitidine cause dizziness?

Yes, dizziness was a mild side effect, especially in higher doses or the elderly, likely from systemic effects.

34. How is Ranitidine different from PPIs?

Ranitidine (H2 blocker) reduces acid by blocking histamine, acting faster but less potently than PPIs (e.g., omeprazole), which inhibit the proton pump directly and last longer.