What are the functions and uses of ranitidine?
Ranitidine is a selective H2 receptor antagonist, which can competitively antagonize the binding of histamine to H2 receptor on gastric parietal cells, effectively inhibit basal gastric acid secretion and gastric acid secretion caused by histamine, pentapeptide gastrin and food stimulation, reduce gastric enzyme activity, and inhibit the secretion of gastric protease, but has no effect on the secretion of gastrin and sex hormone.
Ranitidine’s acid inhibitory effect is 5-12 times that of cimetidine. It has the characteristics of quick effect and long-term effect. It has less inhibitory effect on liver drug enzymes than cimetidine. It is suitable for active duodenal ulcer, preventing duodenal ulcer recurrence, gastric ulcer, reflux esophagitis and Zhuo AI syndrome, and alleviating stomach pain, heartburn and acid reflux caused by excessive gastric acid.
What are the adverse reactions of ranitidine?
1,Compared with cimetidine, ranitidine has less adverse effects on renal function, gonadal function and central nervous system.
2,Cardiovascular system: sudden arrhythmia, bradycardia, cardiogenic shock and mild atrioventricular block may occur.
3,Nervous and mental system: headache, dizziness and fatigue may occur, and there are reports of severe headache. Reversible unconsciousness, mental disorder, abnormal behavior, hallucination, excitement, insomnia, etc. can also occur. Patients with liver and kidney dysfunction and elderly patients occasionally have mental symptoms such as disorientation, sleepiness and anxiety.
4,Digestive system: constipation, diarrhea, nausea, vomiting and abdominal pain may occur. A few patients can cause mild liver function injury after taking medicine. After stopping the medicine, the symptoms can disappear and the liver function can return to normal. It was suspected that it might be a drug allergic reaction, which had nothing to do with the drug dosage.
Long term use can continuously reduce the acidity in the stomach, which is conducive to the reproduction of bacteria in the stomach, so as to reduce the nitrate in the food to nitrite, form N-nitroso compounds, and infection may occur in the case of gastric reflux. Hepatitis with or without jaundice has been reported, usually reversible, and pancreatitis has been occasionally reported.
5,Blood system: leukopenia, thrombocytopenia and eosinophilia are occasionally seen, which can be recovered after drug withdrawal. Rare reports of agranulocytosis or pancytopenia are sometimes complicated with bone marrow hypoplasia or poor formation.
6,Metabolism and endocrine system: long term use can lead to vitamin B12 deficiency. Feminization of male breast is rare, and its incidence increases with age, which can be recovered after drug withdrawal. There are few reports suggesting that it may lead to the onset of acute porphyria, so patients with a history of acute porphyrin should avoid taking ranitidine.
7,Allergic reactions: rare allergic reactions, such as rubella, angioneuroedema, fever, bronchospasm, hypotension, anaphylactic shock, chest pain, etc. Reduce the dosage or stop the drug, and the symptoms can improve or disappear.
8,Eye: there are a few reports of blurred vision, which may be related to the change of eye regulation function.
9,Skin: rash and skin pruritus may occur, but most of them are not serious. They can disappear after drug withdrawal, and there are very few reports of pleomorphic erythema.
10,Musculoskeletal: rare reports of joint pain and myalgia.
11,Others: it can cause renal function injury, reduce dosage or stop medication, and the symptoms can improve or disappear.
1,Duodenal ulcer and benign gastric ulcer: in the acute stage, the standard dose is 150mg once, twice a day, taken in the morning and evening with meals; Or 300mg once before going to bed. The course of treatment is 4-8 weeks, and can be treated for 12 weeks if necessary. Most patients were cured within 4 weeks and a few within 8 weeks. It was reported that taking 300mg once a night was better than taking 150mg twice a day.
For patients with duodenal ulcer, the cure rate of 300mg once and twice a day for 4 weeks is higher than that of 150mg once and 300mg twice a day or at night, and the increase of dose does not increase the incidence of adverse reactions. Long term treatment: usually taken at night, 150mg a day. Patients with acute duodenal ulcer should be treated for more than one year to avoid ulcer recurrence.
2,Gastric mucosal injury caused by non steroidal anti-inflammatory drugs: in the acute stage, 150mg once, twice a day or 300mg at night. The course of treatment is 8-12 weeks. Prevention: take 150mg once, twice a day or 300mg at night at the same time as the treatment of non steroidal anti-inflammatory drugs.
3,Gastroesophageal reflux disease: acute reflux esophagitis, 150mg once, twice a day or 300mg at night. The course of treatment is 8-12 weeks. Moderate to severe esophagitis, 150mg once, 4 times a day for 12 weeks. Long term treatment of reflux esophagitis, 150mg once, twice a day.
4,Zhuo AI syndrome: it is advisable to use a large amount, 600-1200mg a day.
5,Intermittent paroxysmal dyspepsia: the standard dose is 150mg once, twice a day for 6 weeks.
6,Prevention of stress ulcer bleeding or repeated bleeding caused by peptic ulcer in severe patients: once the patient can resume eating, oral administration of 150mg once, twice a day can be used instead of injection.
What should I pay attention to when I often eat ranitidine?
1,Use with caution in patients with liver and kidney dysfunction.
2,Patients with liver dysfunction and elderly patients occasionally have mental abnormalities such as orientation disorder, sleepiness and anxiety after taking medicine.
3,Serum creatinine and transaminase increased slightly and returned to the original level in the later stage of treatment.
4,Patients with suspected malignant ulcer should be clearly diagnosed before medication to avoid delaying treatment.
5,If the treatment period exceeds 4-8 weeks and the treatment must be continued, regular examination shall be carried out to prevent accidents.
What is the difference between ranitidine and omeprazole?
1,Mechanism of action: the body mainly promotes gastric acid secretion through three ways, namely H2 receptor, acetylcholine receptor and gastrin receptor. The activation of these three receptors can finally secrete gastric acid through proton pump.
Ranitidine mainly acts on H2 histamine receptor, a branch link of gastric acid secretion, and inhibits gastric acid secretion by antagonizing H2 receptor, Omeprazole mainly acts on the proton pump, the last link of gastric acid secretion, and inhibits gastric acid secretion by inhibiting the proton pump on gastric parietal cells.
2,Acid inhibition intensity and action time: Omeprazole acts on the last link of gastric acid secretion. The acid inhibition effect is strong and lasting. It can significantly increase the pH in the stomach and make the stomach reach the acid free level. The action time can last for 72 hours. However, ranitidine acts on a branch link of gastric acid secretion, and the acid inhibition intensity and action time are lower than omeprazole.
3,Action characteristics: Omeprazole has a good inhibitory effect on gastric acid secretion under basic gastric acid and food stimulation, but usually the human body is excited by the vagus nerve at night, releases acetylcholine and promotes gastric acid secretion.
Therefore, some patients with reflux esophagitis or peptic ulcer are prone to nocturnal acid outbreak, resulting in reflux, heartburn, abdominal pain and other symptoms, Ranitidine has poor effect on gastric acid secretion caused by food stimulation, but it can effectively inhibit basic gastric acid secretion at night. Taking ranitidine before going to bed can help alleviate the above symptoms and promote ulcer healing.
4,Indications: Omeprazole has a strong acid inhibitory effect, which can increase the pH in the stomach, effectively kill Helicobacter pylori and increase the antibiotic concentration in gastric juice. It is often combined with antibiotics to eradicate Helicobacter pylori, while ranitidine has no effect on Helicobacter pylori.
5,Safety: in terms of safety, omeprazole has common adverse reactions such as headache, nausea, vomiting, abdominal pain, diarrhea and gastrointestinal flatulence. Long term use may increase the risk of serious adverse reactions such as acute interstitial nephritis, gastrointestinal malignancy, fracture, pneumonia, pseudomembranous enteritis, B-vitamin deficiency and hypomagnesemia, The lowest dose and shortest course of treatment of omeprazole are recommended. The overall safety of ranitidine is better than omeprazole, but it is easy to be tolerated.