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Rantak
Last reviewed: 03.07.2025
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Rantak is used in the treatment of GERD and ulcer pathologies. It is an H2 receptor antagonist.
Indications Rantaka
The medicine is indicated in the following cases:
- in the prevention of bleeding due to “stress ulcers”;
- as a preventive measure to eliminate recurrent bleeding in people with ulcerative diseases of the duodenum or stomach;
- to prevent aspiration of acidic gastric contents (during general anesthesia; in acid-aspiration pneumonitis).
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Pharmacodynamics
The active substance of the drug is ranitidine. It blocks the H2 receptors of parietal cells inside the gastric mucosa. The effect of ranitidine occurs through the reverse competitive inhibition of histamine activity relative to the H2 receptors in the membranes of parietal cells inside the gastric mucosa.
The substance reduces the amount of secreted hydrochloric acid (stimulated and unstimulated), the secretion process of which is provoked by food load, irritating effect on baroreceptors, and in addition, the influence of hormones with biogenic stimulants (such as gastrin with pentagastrin and histamine).
Ranitidine reduces the volume of gastric juice secreted, as well as the level of hydrochloric acid contained in it. In addition, it increases the pH of the gastric contents, which reduces the activity of pepsin. The drug also slows down the action of microsomal enzymes. The duration of the drug's effect with a single use is no more than 12 hours.
Pharmacokinetics
After administration of the drug in a dose of 2 ml (50 mg), the peak plasma levels (565 nm/ml) are reached after 15-30 minutes.
The plasma protein binding level is no more than 15%. Metabolism occurs in the liver (a small part of the substance), resulting in the formation of desmethylranitidine components, as well as ranitidine S-oxides. The "first pass" inside the liver is also observed. The state of the liver has little effect on the degree and speed of the elimination process.
The half-life is about 2-3 hours, and with a CC rate of 20-30 ml/minute - about 8-9 hours. After intravenous administration, 93% of the drug is excreted in the urine, and the remainder - in the feces. At the same time, 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 the drug can also penetrate into breast milk (and its concentration level in the milk of nursing mothers is higher than the similar plasma indicator).
Dosing and administration
To prevent bleeding, it is necessary to perform intramuscular or intravenous injections every 6-8 hours (2 ml (50 mg)). The liquid contained in the ampoule (volume 50 mg) must 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 over 5 minutes.
Intravenous infusions should be administered by drip over 2 hours (rate 25 mg/hour). If necessary, the procedure is repeated after 6-8 hours.
For the prevention of bleeding in people with ulcerative pathologies of the duodenum or stomach, it is recommended to use the intravenous injection method with an initial dosage of 50 mg and subsequent infusion at a rate of 0.125-0.25 mg/kg/hour.
To prevent the process of aspiration of acidic juice inside the stomach during the introduction of general anesthesia (acid-aspiration pneumonitis). The drug is slowly administered intravenously or intramuscularly in a dosage of 50 mg before the general anesthesia procedure (45-60 minutes).
In case of renal failure and CC <50 ml/minute, the recommended single dose of the drug is 25 mg.
Use Rantaka during pregnancy
The medicine should not be used during pregnancy.
If the use of the solution during lactation is required, breastfeeding should be discontinued for the period of use of the drug.
Contraindications
Among the contraindications of the drug:
- hypersensitivity to ranitidine or other components of the drug;
- malignant gastric pathologies;
- history of liver cirrhosis (against the background of hepatic encephalopathy);
- severe form of kidney failure.
Side effects Rantaka
The introduction of the medicinal solution may provoke the development of the following side effects:
- Mental disorders and nervous system organs: dizziness or headaches, drowsiness or agitation, and severe fatigue. Occasionally, tinnitus, involuntary movements, irritability, or confusion (reversible) may occur. Elderly people sometimes experience problems with vision (blurred vision) due to accommodation disorders. Elderly and seriously ill people develop treatable mental disorders (a feeling of disorientation, restlessness, anxiety, and confusion, as well as depression and hallucinations);
- cardiovascular system organs: development of extrasystole or tachycardia, as well as a decrease in blood pressure; arrhythmia, bradycardia, as well as vasculitis, asystole (parenteral use of drugs) and blockades are observed sporadically;
- liver and hepatobiliary system: vomiting, constipation, diarrhea, nausea, bloating, as well as dry mouth, loss of appetite, abdominal pain, and treatable temporary liver dysfunction. In addition, temporary reversible changes in the readings of some laboratory tests (bilirubin, alkaline phosphatase, transaminase, and GGT levels) are observed. Hepatitis (cholestatic, hepatocellular, or mixed) with or without jaundice (often treatable) and acute pancreatitis have developed sporadically;
- endocrine system organs: discomfort or swelling in the mammary glands in men, development of gynecomastia, hyperprolactinemia, as well as galactorrhea and amenorrhea. In addition, development of impotence and weakening of libido;
- organs of the hematopoietic system: curable thrombocytopenia, as well as neutro- and leukopenia. Pancytopenia, agranulocytosis, bone marrow aplasia/hypoplasia, and also the immunohemolytic form of anemia develop occasionally;
- urinary system: renal dysfunction, as well as acute tubulointerstitial nephritis;
- manifestations of allergies: the appearance of itching, rashes, development of anaphylaxis, Quincke's edema, urticaria, MEE, as well as bronchial spasms;
- Others: development of myalgia or arthralgia, as well as hypercreatininemia, as well as a state of fever, alopecia, acute porphyria and spasm of accommodation.
Overdose
Manifestations of overdose: development of bradycardia, ventricular arrhythmia, and the appearance of convulsions.
It is necessary to eliminate the symptoms of the disorders: in case of convulsions, administer diazepam intravenously; in case of ventricular arrhythmia or bradycardia, use lidocaine or atropine. Hemodialysis will also be effective.
Interactions with other drugs
Ranitidine increases the 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 functioning of the hemoprotein P450 enzyme system, and do not enhance the effect of drugs that are metabolized by this system (such as lidocaine with propranolol, diazepam with theophylline and phenytoin, etc.).
The drug is capable of changing the gastric pH level, thereby affecting the bioavailability of individual drugs. As a result, their absorption may increase (midazolam with triazolam and glipizide) or, conversely, decrease (itraconazole with ketoconazole, as well as gefitinib with atazanavir).
Ranitidine is able to slow down the hepatic metabolism of such drugs as aminophenazone, phenytoin and phenazone, as well as propranolol, theophylline with glipizide, hexobarbital with metronidazole and lidocaine, diazepam with buformin, aminophylline, as well as calcium antagonists and indirect anticoagulants.
Drugs that suppress bone marrow function increase the likelihood of neutropenia when combined with ranitidine.
The combination of ranitidine with sucralfate and antacid drugs in high doses may interfere with the absorption of ranitidine, which is why it is necessary to maintain an interval of at least 2 hours between the use of these drugs.
Rantac in high doses is capable of inhibiting the excretion of procainamide and N-acetylprocainamide, resulting in an increase in the plasma levels of these components.
Storage conditions
The medicine must be kept in a place protected from sunlight and inaccessible to small children. It is prohibited to freeze the solution. The storage temperature is no more than 30°C.
Shelf life
Rantak is permitted to be used for a period of 3 years from the date of release of the drug.
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.