RANITIDINE

Zantac

Reviewed by Carl Kuschel and Brenda Hughes
August 2007
Dose and Pharmacology Newborn Drug Protocol Index Newborn Services Home Page

 

Management of  Ranitidine Administration8

Description

IV preparation

Oral preparation

Prescription

Administration 7,9

Slow IV Infusion

  1. Dilute immediately prior to use to 1 mg/ml by adding. The suggested / recommended way of obtaining the correct dilution is that 0.2 ml (5mg) be added to 4.8ml normal saline making 5mg/5ml (thus 1mg/ml).
  2. Filter prior to administration through a Pall 0.2 micron filter.  May be filtered through a 0.2 micron filter.
  3. Administer by slow IV infusion over 15 minutes using a syringe pump.
  4. Compatible at the Y-site with dobutamine, dopamine, fluconazole and morphine when diluted to concentrations used in the Newborn Services protocols.
  5. Do NOT mix with blood or blood products.
  6. Incompatible with insulin.
  7. Flush line with 0.9% NaCl before and after infusion of ranitidine.

Oral

  1. Oral ranitidine may be given without regard to timing of feeds.
  2. Administer antacids one hour before or two hours after ranitidine.

Observation and Documentation

  1. Monitor for signs of adverse effects.
  2. If bradycardia or arrhythmias occur during administration, discontinue the infusion and notify medical staff.
  3. Observe for signs of hepatic and renal dysfunction.

Storage

IV preparation

Oral

Selected References

1 Northern Neonatal Network. Neonatal Formulary 4. London: BMJ Books,2003
2 Kuusela AL. Long-term gastric pH monitoring for determining optimal dose of ranitidine for critically ill preterm and term neonates. Arch Dis Child Fetal Neonatal Ed 1998;78(2):F151-3.
3 Neonatal Formulary: Drug use in pregnancy and the first year of life (5th ed). Blackwell Publishing, 2007.
4 Zantac (Ranitidine) Data sheet .Auckland: GlaxoSmithKline NZ limited,2005.
5 Medicines for Children. Royal College of Paediatrics and Child Health. London: RCPCH Publications Limited, 2003.
6 Baxter K (ed). Stockley’s Drug Interactions (7th ed.) London: Pharmaceutical Press:2006
7 Mehta DK (ed). BNF for children.London:BMJ Publishing Group Ltd,2006
8 Trissell LA (ed.). Handbook of Injectable Drugs (14th ed.). Bethesda; American Society of Health System Pharmacists:2007.
9 Fary R, SmithR(eds.). RWH Neonatal Pharmacopoeia(2nd ed).  Melbourne: Pharmacy Department, The Royal Women's Hospital,2005
10 Sutphen JL, Dillard VL. Effect of ranitidine on twenty-four hour gastric acidity in infants. J Pediatrics 1989; March: 472-474.
11 Guillet R, Stoll BJ, Cotten, M, et al. Association of H2-blocker therapy and higher incidence of necrotizing enterocolitis in very low birth weight infants. Pediatrics 2006;117(2):e137-42.