Ranitidine

Ranitidine can be taken by adults. It can also be given to children under 16 years of age on prescription.

Ranitidine isn’t suitable for some people. To make sure that it is safe for you, tells your doctor if you:

• have had an allergic reaction to ranitidine or any other medicines in the past
• have kidney problems
• have an intolerance to, or cannot absorb, some sugars such as fructose
• have been advised to eat a low calcium or low salt diet
• cannot have alcohol – ranitidine liquid contains a small amount of alcohol
• have phenylketonuria a rare inherited illness

If you’re due to have an endoscopy to find out what’s causing your symptoms, stop taking ranitidine at least 2 weeks before your procedure. This is because ranitidine may hide some of the problems that would usually be spotted during an endoscopy.

Pregnancy and breastfeeding

Usually, ranitidine is safe to take during pregnancy and while breastfeeding.

If you’re pregnant, it’s always better to try to treat indigestion without taking a medicine.

Your doctor or midwife will first advise you to try to ease your symptoms by eating smaller meals more often, and not eating fatty and spicy foods. They may also suggest raising the head of your bed by 10 to 20cm, so your head and chest are higher than your waist. This will help stop stomach acid travelling up towards your throat.

If these lifestyle changes don’t work, you may be recommended a medicine like ranitidine.

Ranitidine and breastfeeding

Ranitidine is safe to take while you’re breastfeeding. It passes into breast milk, but only in small amounts which aren’t harmful to the baby.

However, if your baby is premature or has health problems check with your doctor first.

For safety purposes, tell your pharmacist or doctor if you’re trying to get pregnant, are already pregnant or if you’re breastfeeding.

It’s usual to take ranitidine twice a day – 1 dose in the morning and 1 dose in the evening. Some people only need to take ranitidine once a day, at bedtime.

Very young babies, and people with Zollinger-Ellison syndrome, usually take ranitidine 3 times a day. People with severe inflammation of the food pipe (oesophagitis) may need to take it 4 times a day.

How do I take it?

You can take ranitidine with or without food. However, if you get symptoms whenever you eat or drink, take your medicine 30 minutes to 60 minutes before having a drink, snack or meal.

Tablets – swallow tablets whole with a glass of water, milk or juice.

Soluble tablets – dissolve tablets in half a glass of water. Do not use milk, fizzy water or other fizzy drinks. Wait until the medicine has completely dissolved and then drink it straight away.

Liquid – this comes with a syringe or spoon to help you measure it. If you don’t have a syringe or spoon, ask your pharmacist for one. Do not use a kitchen teaspoon as it won’t give you the right amount.

Liquid ranitidine is suitable for children and people who find it difficult to swallow tablets.

How much will I take?

Each tablet contains 75mg, 150mg or 300mg of ranitidine. You can buy 75mg tablets in pharmacies and supermarkets. Soluble tablets, and 150mg and 300mg tablets are only available on prescription.

The usual dose to treat:

• indigestion or heartburn is 75mg to 300mg a day
• stomach ulcers and inflammation of the food pipe is 300mg to 600mg a day
• Zollinger-Ellison syndrome is 450mg to 6 grams a day

Ranitidine liquid comes in 2 different strengths – your daily dose will depend on what your doctor prescribes. Follow your doctor’s advice about how much ranitidine to take and when.

Doses are usually lower for children and people with kidney problems.

If a doctor prescribes ranitidine for your child, they will use your child’s weight or age to work out the right dose.

Will my dose go up or down?

Sometimes your doctor will increase your dose of ranitidine if it isn’t working well enough.

Depending on the reason you take ranitidine, you may take a higher dose to start with – usually for at least 1 month. After this, your doctor may recommend a lower dose.

How long will I take it for?

If you’re taking lower strength ranitidine (75mg) that you bought from a pharmacy or supermarket, speak to a pharmacist or doctor before starting on a second packet. They may recommend tests to find out what’s causing your symptoms, if taking ranitidine hasn’t cleared them up.

If your doctor prescribes ranitidine for you, you may only need to take it for a few weeks or months, depending on your health problem. Sometimes you might need to take it for longer.

Your doctor may suggest taking ranitidine only when you have symptoms. This means you won’t have to take it every day. Once you feel better, you can stop taking it – often after a few days or weeks.

Taking ranitidine this way isn’t suitable for everyone. Speak to your doctor about what’s best for you.

What if I forget to take it?

If you usually take it:

• once a day, take the missed dose as soon as you remember, unless it’s less than 12 hours until your next dose – in which case skip the missed dose
• twice a day, take the missed dose as soon as you remember, unless it’s nearly time for your next dose – in which case skip the missed dose
• 3 or 4 times a day, skip the missed dose and take your next dose as normal

Do not take a double dose to make up for a forgotten dose.

If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to remember your medicine.

What if I take too much?

Ranitidine is generally very safe. Taking too much is unlikely to harm you or your child.

If you take an extra dose by mistake, you might get some side effects, such as feeling sick. Call your doctor if you’re worried, or you’re bothered by side effects.

Most people who take ranitidine do not have any side effects. If you do get a side effect, it is usually mild and will go away when you stop taking ranitidine.

The following side effects aren’t common and may happen in more than 1 in 1,000 people. Talk to your doctor or pharmacist if these side effects bother you or don’t go away:

• stomach pains
• constipation
• feeling sick

Serious side effects

Serious side effects are very rare and happen in less than 1 in 10,000 people. Call a doctor straight away if you have:

• stomach pain that seems to be getting worse – this can be a sign of an inflamed liver or pancreas
• back pain, fever, pain when peeing or blood in your pee – these can be signs of kidney problems
• a rash, swollen joints or kidney problems – these can be signs that your small blood vessels are swollen (vasculitis).
• a slow or irregular heartbeat

Serious allergic reaction

In rare cases, it’s possible to have a serious allergic reaction (anaphylaxis) to ranitidine.

• You get a skin rash that may include itchy, red, swollen, blistered or peeling skin
• You’re wheezing
• You get tightness in the chest or throat
• You have trouble breathing or talking
• Your mouth, face, lips, tongue or throat start swelling.

You could be having a serious allergic reaction and may need immediate treatment in hospital.

These are not all the side effects of ranitidine. For a full list see the leaflet inside your medicines packet.

How to cope with side effects

What to do about:

• Stomach pains – try to rest and relax. It can help to eat and drink slowly and have smaller and more frequent meals. Putting a heat pad or covered hot water bottle on your stomach may also help. If you are in a lot of pain, speak to your pharmacist or doctor.
• Constipation – eat more high fibre foods such as fresh fruit and vegetables and cereals, and drink plenty of water. Try to exercise, for example, by going for a daily walk or run. If this doesn’t help, talk to your pharmacist or doctor.
• Feeling sick – it may help if you don’t eat rich or spicy food while you’re taking ranitidine.

Usually, ranitidine is safe to take during pregnancy and while breastfeeding.

If you’re pregnant, it’s always better to try to treat indigestion without taking a medicine.

Your doctor or midwife will first advise you to try to ease your symptoms by eating smaller meals more often, and not eating fatty and spicy foods. They may also suggest raising the head of your bed by 10 to 20cm, so your head and chest are higher than your waist. This will help stop stomach acid travelling up towards your throat.

If these lifestyle changes don’t work, you may be recommended a medicine like ranitidine.

Cautions with other medicines

Some medicines can interfere with ranitidine and make you more likely to have side effects.

Tell your doctor if you’re taking these medicines before you start taking ranitidine:

• anti-fungal medicines such as itraconazole, ketoconazole or posaconazole
• any medicine used to treat cancer
• HIV medicines

These are not all the medicines that may not mix well with ranitidine. For a full list see the leaflet inside your medicines packet.

Mixing ranitidine with herbal remedies and supplements- There isn’t enough research to know if complementary medicines and herbal remedies are safe to take with ranitidine.

Important- For safety, tell your pharmacist or doctor if you’re taking other medicines including herbal remedies, vitamins or supplements.

How does ranitidine work?

Ranitidine is a type of medicine called a histamine antagonist, also known as an H2 blocker.

Histamine is a chemical that occurs naturally in the body. It encourages your stomach to produce acid which it needs to digest your food. By blocking the histamine, ranitidine reduces the amount of acid your stomach produces.

Having less acid in your stomach allows ulcers and inflammation to heal. If your food pipe has been damaged by stomach acid, this will also have a chance to heal.

When will I feel better?

Your indigestion and heartburn should start to feel better within 1 or 2 hours. The effects will usually last for around 12 hours.

It may take a few weeks for ranitidine to work properly. Depending on your problems, you may still have some acid symptoms during this time.

If you’re taking ranitidine to prevent stomach ulcers, however, you may not feel any different. Carry on taking your medicine. It will still be working.

Is it safe to take ranitidine for a long time?

It’s usually best to take ranitidine for a short time. You might take it for a month or two, for example, until your stomach heals. Some people may take it every now and again when they have symptoms. You may find that ranitidine stops working and your symptoms come back if you take it for longer than this.

If you’re taking ranitidine to treat Zollinger Ellison syndrome or another long term problem, however, you may need to take it for longer. In this case, follow your doctor’s instructions about the best way to take it.

Are there similar medicines?

There are 3 other medicines that are similar to ranitidine. They are cimetidine, famotidine and nizatidine.

Like ranitidine, these medicines are H2 blockers. They work in the same way as ranitidine to reduce the amount of acid in your stomach.

Famotidine and nizatidine generally work as well as ranitidine and have similar side effects. However they may suit some people better.

Cimetidine can interfere with lots of medicines and has more side effects than other H2 blockers.

Are there other indigestion medicines?

There are other pharmacy and prescription medicines for indigestion and heartburn.

Antacids, like calcium carbonate (Tums), sodium bicarbonate, Maalox and Milk of Magnesia, relieve indigestion and heartburn by neutralising the acid in your stomach. They give quick relief that lasts for a few hours. They’re ideal for occasional stomach acid symptoms.

Some antacids, such as Gaviscon, have an extra ingredient called alginic acid. They work by lining your stomach so that juices from it don’t splash up into your food pipe. They’re especially good for relieving acid reflux.

Antacids are available from pharmacies and supermarkets.

Proton pump inhibitors (PPIs) reduce the amount of acid made in your stomach, but they do this in a different way to H2 blockers.

They include esomeprazole (Nexium), lansoprazole Zoton FasTabs), omeprazole (Losec), pantoprazole (Pantoloc Control) and rabeprazole (Pariet).

In general, PPIs are used first because they are better than H2 blockers at reducing stomach acid. Your doctor may prescribe an H2 blocker if you don’t get on with a PPI – for example because of the side effects.

Lansoprazole and rabeprazole are only available on prescription but you can buy omeprazole, esomeprazole and pantoprazole directly from pharmacies. You can also buy esomeprazole from supermarkets.

Can I take ranitidine with other indigestion medicines?

Some antacids are OK to take at the same time as ranitidine. Other antacids, such as Gaviscon, need to be taken a certain amount of time before or after you take the ranitidine. Check the instructions on the packet to see how long you need to wait between medicines.

Sometimes, depending on your symptoms, your doctor may prescribe an H2 blocker as well as a proton pump inhibitor. This will often be for a short time and you’ll usually take the H2 blocker at night.

If you’re prescribed sucralfate (a medicine to treat ulcers), take it at least 2 hours after ranitidine. This is because sucralfate can stop your body from properly absorbing the ranitidine.

Will it affect my fertility?

There’s no firm evidence to suggest that taking ranitidine will reduce fertility in either men or women. However, speak to a pharmacist or your doctor if you’re trying to get pregnant. They may want to review your treatment.

Will it affect my contraception?

Ranitidine doesn’t affect any type of regular contraception including the contraceptive pill.

It may reduce the effectiveness of one type of emergency contraception called Ella one (ulipristal), so a different form of emergency contraceptive may be recommended instead.

Can I drive or ride a bike?

Occasionally, ranitidine can make you feel dizzy or sleepy, or give you blurred vision. If this happens to you, do not drive, cycle or use machinery or tools until you feel better.

The amount of alcohol contained in a large dose of ranitidine liquid may affect your ability to drive or operate machines. In this case, do not attempt to drive or use any machinery.

Can I drink alcohol with it?

Yes, you can drink alcohol with ranitidine but be aware that ranitidine liquid also contains a small amount of alcohol.

Also, drinking alcohol makes your stomach produce more acid than normal. This can irritate your stomach lining and make your symptoms worse.

Is there any food or drink I need to avoid?

You can eat and drink normally while taking ranitidine.

However, it’s best to avoid foods that seem to make your indigestion worse, such as rich, spicy and fatty foods. You may also want to cut down on caffeinated drinks, such as tea, coffee and cola, as well as alcohol.

Can lifestyle changes help?

It may be possible to ease symptoms caused by too much stomach acid by making a few changes to your diet and lifestyle:

• lose excess weight
• do not eat foods that can make your symptoms worse, such as rich, spicy and fatty foods, and acidic foods like tomatoes, citrus fruits, salad dressings and fizzy drinks
• cut down on caffeinated drinks, such as tea, coffee and cola, as well as alcohol and smoking
• if you have symptoms at night, try not to eat for at least 3 hours before you go to bed
• raise the head of your bed by 10 to 20cm, so your head and chest are higher than your waist