Uses
Duodenal Ulcer
Short-term treatment of active duodenal ulcer (endoscopically or radiographically confirmed).
Maintenance of healing and reduction in recurrence of duodenal ulcer.
Pathologic GI Hypersecretory Conditions
Long-term treatment of Zollinger-Ellison syndrome, systemic mastocytosis, postoperative hypersecretion, “short-gut” syndrome.
Gastric Ulcer
Short-term treatment of active benign gastric ulcer.
Maintenance of healing and reduction in recurrence of gastric ulcer.
Gastroesophageal Reflux (GERD)
Treatment of GERD to achieve acid suppression, control symptoms, and prevent complications.
Treatment of erosive esophagitis (endoscopically diagnosed) in patients with GERD.
Maintain healing and decrease recurrence of erosive esophagitis.
Self-medication as initial therapy for less severe symptomatic GERD†.
Short-term self-medication for treatment of heartburn (pyrosis) symptoms associated with acid indigestion and sour stomach in adults and adolescents ≥12 years of age.
Short-term self-medication for prevention of heartburn symptoms associated with acid indigestion and sour stomach brought on by ingestion of certain foods and beverages in adults and children ≥12 years of age.
Increasing Gastric pH in Neonates Undergoing Extracorporeal Membrane Oxygenation (ECMO)
May be useful for increasing gastric pH in neonates (<1 month of age) at risk for GI hemorrhage during ECMO†.
Dosage and Administration
Administration
Administered orally.
Administered by IM or slow IV injection, or by intermittent or continuous IV infusion in hospitalized patients with pathologic GI hypersecretory conditions or intractable duodenal ulcer, or when oral therapy is not feasible.
Administered by slow IV injection or intermittent IV infusion in children 1 month to 16 years of age for the treatment of duodenal ulcer.
Administered by slow IV injection or intermittent or continuous IV infusion to decrease gastric pH in neonates <1 month of age receiving ECMO.
Oral Administration
Administer antacids concomitantly as necessary for relief of pain.
Dissolve each dose to be administered as 150-mg effervescent tablets in 180–240 mL (6–8 ounces) of water as directed prior to ingestion. Effervescent tablets should not be chewed, swallowed whole, or dissolved on the tongue.
Dissolve each 25-mg effervescent tablet in ≥5 mL of water prior to administration. Allow tablet to completely dissolve before administering to the infant or child. May use a calibrated dropper or oral syringe to administer resultant solution in infants.
Administer tablets for self-medication with a glass of water.
IM Injection
May be administered undiluted.
Intermittent Direct IV Injection
Dilution
Dilute 50-mg dose to a concentration no greater than 2.5 mg/mL (i.e., total of 20 mL) with 0.9% sodium chloride injection or other compatible IV solution before direct IV injection.
Rate of Administration
Inject the 20-mL diluted solution (containing 50 mg/20 mL) at rate ≤4 mL/minute (i.e., over at least 5 minutes).
Intermittent IV Infusion
Dilution
Dilute 50-mg dose to a concentration ≤0.5 mg/mL (i.e., 100 mL total) in 5% dextrose injection or other compatible IV solution.
No additional dilution required for commercially available infusion solution (50 mg ranitidine in 50 mL of 0.45% sodium chloride).
Rate of Administration
Infuse 50 mg/100 mL dilution at ≤5–7 mL/minute (i.e., over 15–20 minutes).
Infuse commercially available infusion solution (50 mg in 50 mL of 0.45% sodium chloride) over 15–20 minutes.
Continuous IV Infusion
Dilution
Dilute 150 mg in 250 mL of 5% dextrose injection or other compatible IV solution.
Dilute to concentration ≤2.5 mg/mL in 5% dextrose injection or other compatible IV solution for Zollinger-Ellison syndrome or other pathologic GI hypersecretory conditions.
Rate of Administration
Infuse 150 mg/250 mL dilution at 6.25 mg/hour over 24 hours.
Infuse dilution for Zollinger-Ellison syndrome or other pathologic GI hypersecretory conditions at initial rate of 1 mg/kg per hour; adjust subsequent rate to individual requirements.
Dosage
Available as ranitidine hydrochloride; dosage expressed in terms of ranitidine.
Pediatric Patients
Duodenal Ulcer
Treatment of Active Duodenal Ulcer
Oral
Children 1 month to 16 years of age: 2–4 mg/kg daily given as 2 equally divided doses.
Maximum 300 mg daily.
IV
Children 1 month to 16 years of age: 2–4 mg/kg daily given as divided doses every 6–8 hours.
Maximum 50 mg every 6–8 hours.
Maintenance of Healing of Duodenal Ulcer
Oral
Children 1 month to 16 years of age: 2–4 mg/kg once daily.
Maximum 150 mg daily.
Gastric Ulcer
Treatment
Oral
Children 1 month to 16 years of age: 2–4 mg/kg daily given as 2 equally divided doses.
Maximum 300 mg daily.
Maintenance of Healing of Gastric Ulcer
Oral
Children 1 month to 16 years of age: 2–4 mg/kg once daily.
Maximum 150 mg daily.
Gastroesophageal Reflux
Treatment of GERD
Oral
Children 1 month to 16 years of age: 5–10 mg/kg daily, usually administered as 2 equally divided doses.
Treatment of Erosive Esophagitis
Oral
Children 1 month to 16 years of age: 5–10 mg/kg daily, usually administered as 2 equally divided doses.
Self-medication for Heartburn
Oral
Children ≥12 years of age: 75 or 150 mg once or twice daily for up to 2 weeks.
Maximum 150 mg (as 75-mg tablets) or 300 mg (as 150-mg tablets) in 24 hours continuously for 2 weeks.
Self-medication for Prevention of Heartburn
Oral
Children ≥12 years of age: 75 mg or 150 mg once or twice daily continuously for up to 2 weeks; administer 30–60 minutes before ingestion of causative food or beverage.
Maximum 150 mg (as 75-mg tablets) or 300 mg (as 150-mg tablets) in 24 hours continuously for 2 weeks.
Increase Gastric pH in Neonates Undergoing ECMO
IV
Neonates (<1 month of age) at risk for GI hemorrhage: Consider 2 mg/kg every 12–24 hours (or as continuous infusion).
A dose of 2 mg/kg usually is sufficient to increase gastric pH to >4 for at least 15 hours.
Adults
General parenteral dosage (in hospitalized patients with pathologic hypersecretory conditions or intractable duodenal ulcer, or short-term use when oral therapy is not feasible):
IM
50 mg every 6–8 hours.
Increase dosage when necessary by administering 50 mg more frequently.
Maximum 400 mg daily.
Intermittent Direct IV Injection
50 mg every 6–8 hours.
Increase dosage when necessary by administering 50 mg more frequently.
Maximum 400 mg daily.
Intermittent IV Infusion
50 mg every 6–8 hours.
Increase dosage when necessary by administering 50 mg more frequently.
Maximum 400 mg daily.
Continuous IV Infusion
150 mg/24 hours (6.25 mg/hour). Also see Pathologic GI Hypersecretory Conditions under Dosage.
Duodenal Ulcer
Treatment of Active Duodenal Ulcer
Oral
Usual dosage: 150 mg twice daily.
Alternative: 300 mg daily after evening meal or at bedtime for optimum convenience and compliance.
100 mg twice daily reported to be as effective in healing ulcers as 150 mg twice daily.
Healing usually within 4 weeks; may occur in 2 weeks.
Additional 4 weeks of therapy may be beneficial.
Maintenance of Healing of Duodenal Ulcer
Oral
150 mg daily at bedtime.
Gastric Ulcer
Oral
150 mg twice daily.
Healing usually within 6 weeks.
Maintenance of Gastric Ulcer Healing
Oral
150 mg daily at bedtime.
Gastroesophageal Reflux
Treatment of GERD
Oral
150 mg twice daily.
Treatment of Erosive Esophagitis
Oral
150 mg 4 times daily.
Maintenance of Healing of Erosive Esophagitis
Oral
150 mg twice daily.
Self-medication for Heartburn
Oral
75 mg or 150 mg once or twice daily.
Maximum 150 mg (as 75-mg tablets) or 300 mg (as 150-mg tablets) in 24 hours continuously for 2 weeks.
Self-medication for Prevention of Heartburn
Oral
75 or 150 mg once or twice daily; administer 30–60 minutes before ingestion of causative food or beverage.
Maximum 150 mg (as 75-mg tablets) or 300 mg (as 150-mg tablets) in 24 hours continuously for 2 weeks.
Pathologic GI Hypersecretory Conditions
Oral
150 mg twice daily; may administer more frequently, if needed.
Adjust dosage according to patient response.
Dosages up to 6 g daily have been used for severe disease.
Continue as long as necessary.
Continuous IV Infusion
Initiate at 1 mg/kg per hour.
Titrate upward in 0.5 mg/kg per hour increments and redetermine gastric acid secretion if symptoms occur or gastric acid output is >10 mEq per hour after 4 hours.
Dosages up to 2.5 mg/kg per hour and infusion rates up to 220 mg/hour have been used.
Prescribing Limits
Pediatric Patients
Gastroesophageal Reflux
Self-medication for Heartburn
Oral
Adolescents ≥12 years of age: Maximum 150 mg (as 75-mg tablets) or 300 mg (as 150-mg tablets) in 24 hours continuously for 2 weeks.
Self-medication for Prevention of Heartburn
Oral
Adolescents ≥12 years of age: Maximum 150 mg (as 75-mg tablets) or 300 mg (as 150-mg tablets) in 24 hours continuously for 2 weeks.
Duodenal Ulcer
Treatment of Active Duodenal Ulcer
Oral
Childen 1 month to 16 years of age: Maximum 300 mg daily.
IV
Children 1 month to 16 years of age: Maximum 50 mg every 6–8 hours.
Maintenance of Healing of Duodenal Ulcer:
Oral
Children 1 month to 16 years of age: Maximum 150 mg daily.
Gastric Ulcer
Treatment of Gastric Ulcer
Oral
Children 1 month to 16 years of age: Maximum 300 mg daily.
Maintenance of Healing of Gastric Ulcer
Oral
Children 1 month to 16 years of age: Maximum 150 mg daily.
Adults
General parenteral dosage (hospitalized patients with pathologic hypersecretory conditions or intractable duodenal ulcer, or short-term use when oral therapy is not feasible):
IM
Maximum 400 mg daily.
Maximum 50 mg per dose.
Intermittent Direct IV
Maximum 400 mg daily.
Maximum 50 mg per dose.
Maximum concentration 2.5 mg/mL (50 mg/20 mL).
Maximum injection rate: 4 mL/minute (i.e., over 5 minutes).
Intermittent IV Infusion
Maximum 400 mg daily.
Maximum 50 mg per dose.
Maximum concentration 0.5 mg/mL (50 mg/100 mL).
Maximum infusion rate: 5–7 mL/minute (100 mL over 15–20 minutes).
Commercially available infusion solution (50 mg in 50 mL of 0.45% sodium chloride): over 15–20 minutes.
Gastroesophageal Reflux
Self-Medication for Heartburn
Oral
Maximum 150 mg (as 75-mg tablets) or 300 mg (as 150-mg tablets) in 24 hours continuously for 2 weeks.
Self-medication for Prevention of Heartburn
Oral
Maximum 150 mg (as 75-mg tablets) or 300 mg (as 150-mg tablets) in 24 hours continuously for 2 weeks.
Duodenal Ulcer
Treatment of Active Duodenal Ulcer
Oral
Safety and efficacy for >8 weeks have not been established.
Gastric Ulcer
Treatment of Active Benign Gastric Ulcer
Oral
Safety and efficacy for >6 weeks have not been established.
Pathologic GI Hypersecretory Conditions
Continuous IV Infusion
Zollinger-Ellison Syndrome: Maximum concentration 2.5 mg/mL.
Up to 2.5 mg/kg per hour or 220 mg/hour has been used.
Special Populations
Dosage in Renal Impairment
Clcr <50 mL/minute
Oral
150 mg once every 24 hours. If necessary, may cautiously increase dosage frequency to every 12 hours or more frequently.
IM
50 mg every 18–24 hours. If necessary, may cautiously increase dosage frequency to every 12 hours or more frequently.
Intermittent Direct IV
50 mg every 18–24 hours. If necessary, may cautiously increase dosage frequency to every 12 hours or more frequently.
Intermittent IV Infusion
50 mg every 18–24 hours. If necessary, may cautiously increase dosage frequency to every 12 hours or more frequently.
Continuous IV Infusion
Not evaluated.
Hemodialysis
Decreases blood levels; administer at the end of hemodialysis.
Geriatric Patients
Careful dosage selection recommended because of possible age-related decrease in renal function. (See Geriatric Use under Cautions.)
Print
Email
Save
Media Gallery
Drug Info Tools
Medicare's drug plans are subsidized by the US federal government and offered through insurers.
