Ranitidine
Medication that decreases stomach acid / From Wikipedia, the free encyclopedia
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Ranitidine, previously sold under the brand name Zantac[lower-alpha 1] among others, is a medication used to decrease stomach acid production.[12] It was commonly used in treatment of peptic ulcer disease, gastroesophageal reflux disease, and Zollinger–Ellison syndrome.[12] It can be given by mouth, injection into a muscle, or injection into a vein.
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Trade names | Zantac,[1] others |
Other names | Dimethyl [(5-{[(2-{[1-(methylamino)-2-nitroethenyl]amino}ethyl)sulfanyl]methyl}furan-2-yl)methyl]amine, ranitidine hydrochloride (JAN JP) |
AHFS/Drugs.com | Monograph |
MedlinePlus | a601106 |
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Routes of administration | By mouth, intravenous (IV) |
Drug class | Histamine H2 receptor antagonist, aka H2 blocker[1] |
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Bioavailability | 50% (by mouth)[12] |
Protein binding | 15% |
Metabolism | Liver: FMOs, including FMO3; other enzymes |
Onset of action | 55–65 minutes (150 mg dose)[13] 55–115 minutes (75 mg dose)[13] |
Elimination half-life | 2–3 hours |
Excretion | 30–70% kidney |
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ECHA InfoCard | 100.060.283 |
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Formula | C13H22N4O3S |
Molar mass | 314.40 g·mol−1 |
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In September 2019, the probable carcinogen N-nitrosodimethylamine (NDMA) was discovered in ranitidine products from a number of manufacturers, resulting in recalls.[14][15][16][17] In April 2020, ranitidine was withdrawn from the United States market and suspended in the European Union and Australia due to these concerns.[18][19][20][11][21][22]
In 2022, these concerns were confirmed in a Taiwanese nationwide population study finding "significant trends of increased liver cancer risk with an increasing dose of ranitidine" (up to 22% higher than control) and increased gastric, pancreatic, lung[lower-alpha 2] and overall[lower-alpha 3] cancer risk.[23]
Common side effects include headaches, and pain or burning sensation if given by injection.[12] Serious side effects may include cancer,[24] liver problems, a slow heart rate, pneumonia, and the potential of masking stomach cancer.[12] It is also linked to an increased risk of Clostridium difficile colitis.[25] Ranitidine is an H2 histamine receptor antagonist that works by blocking histamine, thus decreasing the amount of acid released by cells of the stomach.[12]
Ranitidine was discovered in England in 1976, and came into commercial use in 1981.[26] It is on the World Health Organization's List of Essential Medicines.[27][28][29] It is still available as a generic medication via the internet.[citation needed] It has been withdrawn at regulator request from most markets, including the United States;[12] according to the UK NHS, it has been discontinued globally.[30]