Ranitidine

Provider Level

RN/Paramedic

Class

Histamine H2-receptor antagonist

Mechanism of Action

Competitively inhibits the action of histamine at the H2 receptors of the gastric parietal cells, thereby reducing basal and nocturnal gastric acid secretion.

Indications

Adjunctive treatment of allergic reactions and anaphylaxis. Treatment of upper gastrointestinal bleeding, peptic ulcer disease, and gastroesophageal reflux disease (GERD).

Contraindications

Known hypersensitivity to ranitidine or other H2-receptor antagonists.

Routes

PO, IM, IV

Onset / Duration

Onset: 15 to 60 minutes. Duration: 8 to 12 hours.

Adverse Effects

Headache, dizziness, confusion (especially in the elderly), bradycardia, hypotension (with rapid IV push), nausea, vomiting, diarrhea.

Precautions & Interactions

Use with caution in patients with hepatic or severe renal impairment. Cardiovascular effects such as bradycardia and hypotension may occur if administered too rapidly intravenously.

Special Considerations

Authorized provider levels: RN/Paramedic. Ranitidine was largely withdrawn from the global market (including the FDA in 2020) due to unacceptable levels of NDMA, a probable human carcinogen. When used, IV administration must be performed slowly to avoid adverse cardiovascular reactions.