Ranitidine coated pills 300mg N20
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Description
Anti-ulcer drug, belonging to the group of H₂-histamine receptor blockers, a second-generation drug. The action of ranitidine is based on a decrease in the secretion of gastric juice. Included in the list of essential and essential drugs.
Active ingredients
Ranitidine
Release form
Pills
Composition
Sodium chloride, borate buffer, EDTA, poloxamer, polyhexanide 0.0005%.
Pharmacological effect
Ranitidine is an antagonist of histamine H2-receptors of the parietal cells of the gastric mucosa. Reduces the basal and stimulated secretion of hydrochloric acid, caused by irritation of the baroreceptors, food load, the action of hormones and biogenic stimulants (gastrin, histamine, pentagastrin). Ranitidine reduces the volume of gastric juice and the content of hydrochloric acid in it, increases the pH of the stomach contents, which leads to a decrease in the activity of pepsin. After oral administration in therapeutic doses does not affect the level of prolactin. Inhibits microsomal enzymes. Duration of action after a single dose of up to 12 hours.
Pharmacokinetics
Rapidly absorbed, food intake does not affect the degree of absorption. When ingested, bioavailability of ranitidine is approximately 50%. Maximum plasma concentrations are reached within 2-3 hours after ingestion. Plasma protein binding does not exceed 15%. Slightly metabolized in the liver to form desmethylranitidine and ranitidine S-oxide. Has effect <первого прохождения="прохождения"> through the liver. The rate and degree of elimination depend little on the state of the liver. The half-life after ingestion is 2.5 hours, with creatinine clearance of 20-30 ml / min - 8-9 hours. Mainly excreted in the urine unchanged, a small amount - with the feces. Bad penetrates the blood-brain barrier. Penetrates through the placenta. It is excreted in breast milk (the concentration in breast milk in women during lactation is higher than in plasma).первого>
Indications
Treatment and prevention of acute gastric and duodenal ulcers, gastric and duodenal ulcers associated with nonsteroidal anti-inflammatory drugs (NSAIDs), reflux esophagitis, erosive esophagitis, Zollinger-Ellison syndrome, treatment and prevention of post-operative, <стрессовых> ulcers of the upper gastrointestinal tract, prevention of recurrent bleeding from the upper gastrointestinal tract, prevention of aspiration of gastric juice during operations under general anesthesia (Mendelssohn's syndrome).стрессовых>
Contraindications
Hypersensitivity to ranitidine or other components of the drug. Pregnancy, lactation. Children's age up to 12 years.
Precautionary measures
With care - renal and / or hepatic failure, cirrhosis of the liver with a history of portosystemic encephalopathy, acute porphyria (including history).
Use during pregnancy and lactation
Contraindicated.
Dosage and administration
Ranitidine is taken, regardless of the meal, without chewing, drinking a small amount of liquid. Adults and children over 12 years: Peptic ulcer and 12 duodenal ulcer. For the treatment of exacerbations prescribed at 0.15 g, 2 times a day (morning and evening) or 0.3 g at night. If necessary, 0.3 g 2 times a day. Duration of treatment is 4-8 weeks. For the prevention of exacerbations appoint 0.15 g per night. Ulcers associated with the intake of NSAIDs. Assign 0.15 g 2 times a day or 0.3 g per night for 8-12 weeks. Prevention of ulceration when taking NSAIDs - 0.15 g, 2 times a day. Postoperative and stressful ulcers. Assign 0.15 g 2 times a day for 4-8 weeks. Reflux esophagitis, erosive esophagitis. Assign 0.15 g 2 times a day or 0.3 g per night. If necessary, the dose can be increased to 0.15 g 4 times a day. The course of treatment is 8-12 weeks. Zollinger-Ellison syndrome. The initial dose is 0.15 g 3 times a day, if necessary, the dose can be increased. Prevention of recurrent bleeding. At 0.15 g, 2 times a day. Prevention of the development of Mendelssohn's syndrome. Assign a dose of 0.15 g for 2 hours before anesthesia, and preferably 0.15 g overnight. In the presence of concomitant abnormal liver function, a dose reduction may be required. Patients with renal insufficiency with creatinine clearance less than 50 ml / min, the recommended dose is 0.15 g per day. Patients on hemodialysis, the next dose is prescribed immediately after hemodialysis.
Side effects
On the part of the digestive system: nausea, dry mouth, constipation, vomiting, diarrhea, abdominal pain, rarely - hepatocellular, cholestatic or mixed hepatitis, acute pancreatitis. From the side of blood-forming organs: leukopenia, thrombocytopenia, agranulocytosis, pancytopenia, hypo-and aplasia of the bone marrow, immune hemolytic anemia.Since the cardiovascular system: lower blood pressure, bradycardia, arrhythmia, atrioventricular block. On the part of the nervous system: fatigue, drowsiness, headache, dizziness, rarely - confusion, tinnitus, irritability, hallucinations (mostly in elderly patients and severe patients), involuntary movements. From the senses: blurred visual perception, accommodation paresis. From the musculoskeletal system: arthralgia, myalgia. On the part of the endocrine system: hyperprolactinemia, gynecomastia, amenorrhea, decreased libido, impotence. Allergic reactions: urticaria, skin rash, angioedema, anaphylactic shock, bronchospasm, erythema multiforme. Other: alopecia, hypercreatininemia.
Overdose
Symptoms: convulsions, bradycardia, ventricular arrhythmias. Treatment: symptomatic. With the development of seizures - diazepam in / in, with bradycardia or ventricular arrhythmias - atropine, lidocaine. Hemodialysis is effective.
Interaction with other drugs
Smoking reduces the effectiveness of ranitidine. Increases AUC and serum concentration of metoprolol (by 80% and 50%, respectively), while T1 / 2 of metoprolol increases from 4.4 to 6.5 hours. Due to an increase in the pH of the stomach contents, coadminazole and ketoconazole may decrease. Metabolism in the liver of phenazone, aminophenazone, diazepam, hexobarbital, propranolol, diazepam, lidocaine, phenytoin, theophylline, aminophylline, indirect anticoagulants, glipizide, buformin, metronidazole, calcium antagonists, inhibits. Drugs that inhibit bone marrow, increase the risk of neutropenia. With simultaneous use with antacids, sucralfate in high doses may slow down the absorption of ranitidine, so the interval between taking these drugs should be at least 2 hours.
special instructions
Treatment with ranitidine can mask the symptoms associated with gastric carcinoma, so before starting treatment it is necessary to exclude the presence of cancer-ulcers. Ranitidine, like all H2-histamine blockers, is undesirable to abruptly cancel (syndrome <рикошета>). With long-term treatment of weakened patients under stress, bacterial lesions of the stomach are possible, followed by the spread of infection.The safety and efficacy of ranitidine in children under 12 years of age have not been established. There is evidence that ranitidine can cause acute attacks of porphyria. During the period of treatment, it is necessary to refrain from engaging in potentially hazardous activities that require high concentration of attention and quickness of psychomotor reactions. H2-histamine receptor blockers should be taken 2 hours after taking itraconazole or ketoconazole in order to avoid a significant decrease in their absorption. May increase glutamate transpeptidase activity. It may be the cause of a false positive reaction to the urine protein test. H2-histamine receptor blockers can counteract the effects of pentagistrin and histamine on the acid-forming function of the stomach, so it is not recommended to use H2-histamine receptor blockers during the 24 hours preceding the test. H2-histamine receptor blockers can suppress the skin reaction to histamine, thus leading to false positive results (it is recommended to stop the use of H2-histamine receptor blockers to detect an allergic immediate-type skin reaction). During treatment, avoid eating foods, drinks and other medicines that may irritate the lining of the stomach.рикошета>