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Rantak
Last reviewed: 23.04.2024
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Rantak is used in the treatment of GERD and ulcer pathologies. It is an H2 receptor antagonist.
Indications of the rantaka
The medicine is shown in the following cases:
- in the prevention of bleeding due to "stress ulcers";
- as a prophylaxis for the elimination of recurrences of bleeding in people with ulcerative diseases of the duodenum or stomach;
- for the prevention of aspiration of acidic stomach contents (during the administration of general anesthesia to the patient, with acidic aspiration pneumonitis).
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Pharmacodynamics
The active substance of drugs is ranitidine. It blocks the H2 receptors of the lining cells inside the gastric mucosa. The effect of ranitidine occurs by reverse competitive inhibition of histamine activity against H2 receptors in the membranes of the lining cells inside the gastric mucosa.
The substance reduces the amount of hydrochloric acid released (stimulated and unstimulated), the secretion of which is provoked by food loading, irritating effects on baroreceptors, and in addition the influence of hormones with biogenic stimulants (such as gastrin and pentagastrin and histamine).
Ranitidine reduces the volume of gastric juice, as well as the level of hydrochloric acid contained in it. In addition, it increases the pH value of gastric contents, which decreases the activity of pepsin. The drug also slows down the effects of microsomal enzymes. Duration of drug exposure for a single use is no more than 12 hours.
Pharmacokinetics
After administration of the drug in the amount of 2 ml (50 mg) peak of plasma indices (565 nm / ml), it reaches 15-30 minutes later.
The level of binding to the plasma protein is no more than 15%. Metabolism is carried out in the liver (a small part of the substance), resulting in the formation of desmethylranitidine components, as well as ranitidine S-oxides. There is also a "first pass" inside the liver. On the degree, as well as the speed of the elimination process, the liver state is affected little.
The half-life is about 2-3 hours, and at a QC value within 20-30 ml / minute - about 8-9 hours. After iv introduction, the drug is excreted 93% in urine, and the remainder is excreted with feces. About 70% of the drug is excreted unchanged.
Ranitidine weakly penetrates the BBB, but is able to pass through the placenta. The active component of drugs can penetrate into the breast milk (the level of its concentration inside the milk of nursing mothers is higher than the analogous plasma index).
Dosing and administration
In the prevention of bleeding, it is required to perform injections in / m or in / in the method every 6-8 hours (2 ml (50 mg)). The liquid contained in the ampoule (volume 50 mg) should be diluted with a solution of sodium chloride (0.9%) or glucose (5%) until a total volume of 20 ml is obtained. This solution is administered to the patient for 5 minutes.
Infusion of IV is required to be administered by drop method for 2 hours (speed 25 mg / hour). If necessary, the procedure is repeated after 6-8 hours.
When prophylaxis against the occurrence of bleeding in people with peptic ulcers of the duodenum or stomach, it is recommended to use the IV method of injection with an initial dosage of 50 mg and subsequent infusion, the rate of which is 0.125-0.25 mg / kg / h.
To prevent the aspiration of acidic juice inside the stomach during the introduction of general anesthesia (acid-aspirating pneumonitis). The drug is slowly administered IV or IV way in a dosage of 50 mg before the general anesthesia procedure (45-60 minutes).
With kidney failure and KK <50 ml / minute, the recommended single dose of drugs is 25 mg.
Use of the rantaka during pregnancy
The medicine can not be used during pregnancy.
If a solution is required during lactation, breastfeeding should be abolished for the period of drug use.
Contraindications
Among the contraindications of drugs:
- high sensitivity relative to ranitidine or other constituent elements of the drug;
- malignant gastric pathologies;
- presence in the anamnesis of a hepatic cirrhosis (on a background of hepatic encephalopathy);
- severe form of kidney failure.
Side effects of the rantaka
The introduction of a drug solution can trigger the development of the following side effects:
- mental disorders and organs of the National Assembly: the appearance of dizziness or headaches, a feeling of drowsiness or excitement, as well as severe fatigue. Occasionally, there may be noise in the ears, involuntary movements, a feeling of irritability or confusion (reversible). Older people sometimes have vision problems (blurred vision) due to a disorder of accommodation. The elderly, as well as the seriously ill, develop curable mental disorders (a sense of disorientation, anxiety, anxiety and confusion, as well as a state of depression and the appearance of hallucinations);
- CAS organs: development of extrasystole or tachycardia, as well as a decrease in blood pressure; Single arrhythmia, bradycardia, as well as vasculitis, asystole (parenteral drug use) and blockade are observed;
- liver and hepatobiliary system: the occurrence of vomiting, constipation, diarrhea, nausea, bloating, and also dryness in the mouth, loss of appetite, abdominal pain, and curable temporary disorders in the liver. In addition, there is a temporary reversible change in the indications of some laboratory tests (bilirubin, alkaline phosphatase, transaminase and GGT). Hepatitis (cholestatic, hepatocellular or mixed form) with or without jaundice (often curable) and pancreatitis in acute form has developed uniquely;
- organs of the endocrine system: discomfort or swelling in the mammary glands in men, development of gynecomastia, hyperprolactinaemia, and galactorrhea and amenorrhea. In addition, the development of impotence and weakening of libido;
- organs of the hematopoiesis system: curable thrombocytopenia, and in addition neutro- and leukopenia. Pancytopenia, agranulocytosis, bone-marrow aplasia / hypoplasia, as well as immuno-hemolytic form of anemia, develops uniquely;
- urinary system: a disorder of renal function, as well as an acute form of tubulointerstitial nephritis;
- manifestations of allergy: the appearance of itching, rashes, the development of anaphylaxis, edema Quinck, urticaria, MEE, as well as spasms of the bronchi;
- other: the development of myalgia or arthralgia, as well as hyperkreatininemia, and also the state of fever, alopecia, acute form of porphyria and spasm of accommodation.
Overdose
Manifestations of an overdose: the development of bradycardia, arrhythmia of the ventricles, as well as the appearance of seizures.
It is necessary to eliminate the symptoms of violations: in the case of convulsions, enter IV in the diazepam method; In the case of ventricular arrhythmia or bradycardia, use lidocaine or atropine. The hemodialysis procedure will be effective.
Interactions with other drugs
Ranitidine raises plasma level of metoprolol (by 50%), and its half-life increases from 4.4 to 6.5 hours.
Medicinal doses of ranitidine do not affect the work of the enzyme system of hemoprotein P450, nor do they enhance the effect of drugs metabolized by this system (such as lidocaine with propranolol, diazepam with theophylline and phenytoin, etc.).
The drug is able to change the level of gastric pH, while influencing the bioavailability of individual drugs. As a result, their absorption may increase (in midazolam with triazolam and glipizide) or vice versa decrease (in itraconazole with ketoconazole, as well as gefitinib with atazanavir).
Ranitidine is able to slow the hepatic metabolism of such drugs as aminophenazone, phenytoin and phenazone, and in addition propranolol, theophylline with glipizide, hexobarbital with metronidazole and lidocaine, diazepam with buformin, aminophylline, and calcium antagonists and anticoagulants of indirect action.
Medications that inhibit bone marrow function, increase the probability of neutropenia when combined with ranitidine.
The combination of ranitidine with sucralfate and antacid drugs in large doses can disrupt the absorption of ranitidine, which requires a gap of at least 2 hours between use of these drugs.
Rantac in high doses is able to inhibit the excretion of procainamide substances, as well as N-acetylprocainamide, as a result of which the plasma index of these components increases.
Storage conditions
The medicine must be kept in a place that is closed from sunlight and inaccessible to small children. Do not freeze the solution. The temperature for storage is not more than 30 ° C.
Shelf life
Rantak is allowed to use in the period of 3 years from the date of release of the medicinal product.
Attention!
To simplify the perception of information, this instruction for use of the drug "Rantak" translated and presented in a special form on the basis of the official instructions for medical use of the drug. Before use read the annotation that came directly to medicines.
Description provided for informational purposes and is not a guide to self-healing. The need for this drug, the purpose of the treatment regimen, methods and dose of the drug is determined solely by the attending physician. Self-medication is dangerous for your health.