Ranitidine dosage guidelines
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Ranitidine Dosage Guidelines for Adults
Standard Dosage for Reflux Oesophagitis and Erosive Esophagitis
The most commonly recommended adult dosage for ranitidine in the treatment of reflux oesophagitis and erosive esophagitis is 150 mg twice daily (b.d.) or 150 mg four times daily (q.d.s.)14510. Studies show that both 150 mg b.d. and 150 mg q.d.s. are effective, but higher frequency dosing (q.d.s.) may result in higher healing rates and faster symptom relief145. For more severe cases, higher doses such as 300 mg twice daily (b.d.) or 300 mg four times daily (q.d.s.) have also been used, with increased efficacy but similar safety profiles145.
Alternative Dosage Regimens
Ranitidine 300 mg b.d. is also effective and may be considered as an alternative to 150 mg q.d.s., especially for patients who prefer less frequent dosing. Both regimens are well-tolerated and can be chosen based on patient preference and clinical response45.
Intravenous Ranitidine in Hospitalized and Critically Ill Patients
For stress ulcer prophylaxis in hospitalized adults, intravenous ranitidine is often administered at 50 mg every 8 to 12 hours (totaling 100–150 mg/day), or as a continuous infusion. In critically ill patients, a daily dose of 200 mg intravenously has been shown to be effective, and increasing the dose to 300 mg/day does not provide additional benefit in maintaining gastric pH. Continuous infusion regimens of 0.125 mg/kg/h are generally sufficient, but higher doses (0.25 mg/kg/h) may be needed for patients with multiple risk factors. These regimens are effective in maintaining gastric pH above 4, which is important for ulcer prevention39.
Dosage Adjustments in Special Populations
Patients with Chronic Kidney Disease
Ranitidine dosage should be adjusted in patients with chronic kidney disease (CKD). Over half of ranitidine prescriptions in CKD patients were found to be in line with renal dosing guidelines, which typically recommend dose reduction to prevent drug accumulation and adverse effects.
Pediatric Patients
In children, the recommended intravenous ranitidine dose is 2–4 mg/kg/day. However, evidence suggests that a minimum of 3 mg/kg/day is needed to achieve adequate gastric pH control in critically ill pediatric patients. Doses should be titrated to maintain a gastric pH of 4 or higher.
Common Dosage Forms and Frequencies
Oral ranitidine is commonly prescribed as 150 mg tablets taken twice daily. Intravenous ranitidine is often given as 50 mg/2 ml every 12 hours for stress ulcer prophylaxis in hospitalized patients. These regimens are consistent with established guidelines and are widely used in clinical practice.
Conclusion
Ranitidine is typically dosed at 150 mg twice daily or four times daily for adults with reflux oesophagitis or erosive esophagitis, with higher doses reserved for more severe cases. Intravenous dosing in hospitalized or critically ill patients is usually 200 mg/day, with adjustments for renal impairment and pediatric patients. Both oral and intravenous regimens are effective and well-tolerated, and dosing should be tailored to individual patient needs and risk factors13456789+1 MORE.
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