Zantac, Zantac EFFERdose, Zantac GELdose, Zantac-75
gastrointestinal agent; antisecretory (h2-receptor antagonist)
Prototype: Cimetidine
Pregnancy Category: B


Assessment & Drug Effects

  • Potential toxicity results from decreased clearance (elimination) and therefore prolonged action; greatest in the older adult patients or those with hepatic or renal dysfunction.
  • Lab tests: Periodic liver functions. Monitor creatinine clearance if renal dysfunction is present or suspected. When clearance is <50 mL/min, manufacturer recommends reduction of the dose to 150 mg once q24h with cautious and gradual reduction of the interval to q12h or less, if necessary.
  • Be alert for early signs of hepatotoxicity (though low and thought to be a hypersensitivity reaction): jaundice (dark urine, pruritus, yellow sclera and skin), elevated transaminases (especially ALT) and LDH.
  • Long-term therapy may lead to vitamin B12 deficiency.

Patient & Family Education

  • Note: Long duration of action provides ulcer pain relief that is maintained through the night as well as the day.
  • Be aware that even if symptomatic relief is provided by ranitidine, this should not be interpreted as absence of gastric malignancy. Follow-up examinations will be scheduled after therapy is discontinued.
  • Adhere to scheduled periodic laboratory checkups during ranitidine treatment.
  • Do not supplement therapy with OTC remedies for gastric distress or pain without physician’s advice (e.g., Mylanta II reduces ranitidine absorption).
  • Do not smoke; research shows smoking decreases ranitidine efficacy and adversely affects ulcer healing.
  • Do not breast feed while taking this drug without consulting physician.


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