Ranitidine to protect the stomach

Ranitidine is a gastric protective agent. It belongs to the group of H2 antagonists. This means that ranitidine attaches to and blocks receptors called “H2” in the stomach. The same drug group also includes famotidine, roxatidine, nizatidine and the previously used cimetidine. Only ranitidine and famotidine are available in low doses over the counter. For higher dosages with this active ingredient, the  drugs require a  prescription.

How ranitidine works

Gastric acid is produced in the parietal cells of the stomach. Active ingredients such as ranitidine suppress the formation of gastric acid by competing with histamine at the H2 receptors, the so-called histamine-2 receptors. Histamine activates acid formation and the release of digestive enzymes. H2 antagonists, on the other hand, inhibit acid formation and thus digestion. That protects the stomach.

Ranitidine has an opposite (antagonistic) effect to histamine on the H2 receptor in the stomach. That is why the drug is also called an H2-receptor antagonist. With the help of ranitidine, the gastric juice is neutralized in this way. This makes it less dangerous and aggressive towards the stomach and adjacent organs like the esophagus and small intestine.

When does it apply?

On the one hand, existing mucosal inflammation or mucosal injuries can heal better.  And in addition, the stomach can be protected from the development of such  inflammations in exceptional situations in which the body is under great  stress  .

In which situations can this be the case? When our body is under stress, for example due to an operation or during a long hospital stay, the stomach tends to produce more acid. This is prevented with the help of ranitidine.

Side effects of therapy with ranitidine

Ranitidine is considered safe and well tolerated. Side effects such as gastrointestinal complaints  such as  nausea  and  diarrhea  or headaches, joint and muscle pain as well as  dizziness  and  cardiac arrhythmias occur only rarely  . It is important to note, however, that ranitidine should not be taken in the case of severe liver dysfunction and the disease called porphyria.

Second choice only

Despite the good tolerability of ranitidine, it is only the second choice for gastric protection outside the hospital. On the one hand, this is because the effect of ranitidine is significantly lower than that of the more commonly used  proton pump inhibitors  (PPI). In addition, after stopping ranitidine, there is often the problem that the stomach then produces more acid and inflammation that has already healed flares up again.


Ranitidine is absorbed through the gastric mucosa. If gastric mucosal inflammation is treated concomitantly with antacids or sucralfate, this may worsen the absorption of ranitidine. Therefore, ranitidine must be taken two hours before the drugs mentioned.

Since ranitidine reduces the production of acid in the stomach, this changes the pH value in the stomach. Other drugs, such as the antifungal ketoconazole, which are absorbed in the stomach depending on the pH, may therefore require a different dosage.

Alternatives to ranitidine

Alternatives to ranitidine and H2 antagonists are:

  • proton pump inhibitors
  • M1 antagonists (they also inhibit acid production, but using a different mechanism)
  • Mucosal protective agents that increase the production of mucus to protect the stomach from the acid, eg sucralfate
  • Antacids: Substances that neutralize stomach acid, including the well-known household remedy baking soda (sodium bicarbonate), but the use of which is no longer recommended

Correct dosage and application

Ranitidine may also be used for children after consultation with the attending physician. Depending on the manufacturer’s information, age information is given for children from two, three or ten years of age. In adults, usual doses of ranitidine are one 300 mg tablet at bedtime if you have an ulcer in your stomach or small intestine. Alternatively, 150 mg each can be taken in the morning and evening. 150 mg ranitidine in the evening is sufficient to protect the stomach and small intestine as a precautionary measure if the ulcer has already healed.

Since ranitidine is primarily excreted via the kidneys, special caution must be exercised in people with  chronic renal failure  . Therefore, if the kidney is not working well or is even on the verge of failure, the amount of ranitidine must be significantly reduced. Please discuss exact dosages with your doctor.

Ranitidine in pregnancy

Pregnancy and breast-feeding: Previous research on ranitidine during pregnancy has not revealed any harmful effects on the unborn child. Nevertheless, before taking it during pregnancy, a detailed discussion should be held with the doctor treating you to assess the risk and benefit. Since ranitidine is excreted in human milk, administration during breast-feeding should be avoided.


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