Patients who can not be treated with the oral dosage of the drug in the following indications:healing - peptic ulcer of the stomach and duodenum, reflux oesophagitis, Zollinger-Ellison syndrome;preventively - in the prevention of bleeding from stress ulceration in seriously ill patients, in the prevention of recurrent bleeding in patients with peptic ulceration, prior to general anesthesia in patients at risk of aspiration of acid gastric contents (Mendelson's syndrome), especially in pregnant women during delivery.
Composition:
1 ml of solution contains 25 mg of Ranitidine in the form of hydrochloride.
Action:
Ranitidine is a specific, fast-acting histamine H receptor antagonist2. It inhibits both basic and postprandial secretion of hydrochloric acid and reduces the secretion of pepsin in gastric juice. A single 150 mg dose inhibits gastric acid secretion for 12 hours. After intramuscular administration, ranitidine is rapidly absorbed and reaches its maximum serum concentration within 15 minutes of administration. It is mainly excreted by tubular seepage. T0,5 is 2-3 hours. After intravenous administration, 93% of the dose is excreted in the urine and 5% in the faeces. In the first 24 hours after administering 70% of the dose given intravenously, it is excreted unchanged in the urine. The metabolism of ranitidine given orally and intravenously is similar.
Contraindications:
Hypersensitivity to ranitidine or other ingredients of the preparation.
Precautions:
Treatment with ranitidine may mask the symptoms of cancer of the stomach and therefore delay the diagnosis; before starting treatment, it should be determined if the disease is not cancerous. In rare cases, bradycardia may occur when administered too rapidly, particularly in patients at risk of arrhythmias, so do not exceed the recommended infusion rate. There have been reports of increased liver enzymes in patients receiving intravenous doses higher than the recommended doses of H-receptor antagonists2 for a period longer than 5 days. Caution should be exercised when using the drug in patients with impaired liver or kidney function. Ranitidine should be avoided in patients with a history of porphyria - there are reports of acute porphyria attacks in patients receiving ranitidine. The safety and efficacy of ranitidine in injecting children have not been established.
Pregnancy and lactation:
The drug can be used during pregnancy and while breastfeeding only if clearly necessary. Ranitidine passes through the placenta, however, it was administered in therapeutic doses during delivery or before caesarean section, it did not adversely affect the delivery and development of the newborn. Ranitidine passes into the milk of lactating women.
Side effects:
Rare: hypersensitivity reactions (urticaria, angioneurotic edema, fever, bronchospasm, decrease in blood pressure, chest pain); transient changes in liver enzymes; skin rashes. Very rare: usually transient decreases in the number of leukocytes and platelets, agranulocytosis, aplastic anemia (sometimes with partial or total bone marrow suppression); anaphylactic shock; transient confusional states, depression and hallucinations (mainly in severely ill and elderly patients); headaches, sometimes severe, dizziness, transient involuntary movements; transient blurred vision (probably due to accommodation disorder); slow heart rate and atrioventricular block, asystole; vasculitis; acute pancreatitis, diarrhea; usually transient hepatitis (cellular, tubular or mixed) with jaundice or without jaundice; erythema multiforme, alopecia; joint and muscle pain; acute interstitial nephritis; transient impotence, enlargement of the breast gland in men.
Dosage:
Adults.Healing: in a slow (over 2 min) intravenous injection of 50 mg Ranitidine, after diluting the contents of the ampoule to 20 ml, the injection can be repeated every 6-8 h or 50 mg ranitidine in an intravenous infusion of 2 h administered at a rate of 25 mg / h , the infusion can be repeated every 6-8 h or 50 mg ranitidine by intramuscular injection every 6-8 h (dilution of the contents of the ampoule is not necessary).preventively: in the prevention of bleeding from stress ulceration in severely ill patients and in the prevention of recurrent bleeding in patients with peptic ulceration, it is recommended to administer ranitidine 50 mg in a slow intravenous injection followed by an intravenous infusion administered at a rate of 0.125-0.25 mg / kg ./h; Patients at risk of aspiration of acid gastric contents (Mendelson's syndrome) should be given 50 mg intramuscularly or by slow intravenous injection 45-60 minutes before being injected into general anesthesia. Patients with a creatinine clearance <50 ml / min should be used in doses of 25 mg. The drug can be diluted in: 0.9% NaCl solution, 5% Glucose solution, 0.18% NaCl solution with 4% glucose solution, 4.2% sodium hydrogen carbonate solution with Hartmann solution.
(C)
