Skip to main content
SpringerLink
Log in

Interactions and Non-interactions with Ranitidine

  • Review Articles
  • Published:
Clinical Pharmacokinetics Aims and scope Submit manuscript

Summary

At present, there are two H2-receptor antagonists available for the treatment of peptic ulcer disease — cimetidine and ranitidine. Cimetidine is well known to interact with a number of concurrently administered drugs. Like cimetidine, ranitidine binds to cytochrome P-450 in the liver where it appears to exert an inhibitory effect, but to a lesser extent than cimetidine. Both H2-receptor antagonists may also reduce hepatic blood flow.

Several drugs which are known to interact with cimetidine have been found not to interact significantly with ranitidine, including propranolol, lignocaine, phenytoin and diazepam. However, significant pharmacokinetic interactions between ranitidine and several other drugs have been established. These interactions may be attributed variously to an effect of ranitidine on hepatic metabolism or to an effect on the absorption of concomitantly administered drugs. For example, the bioavailability of midazolam is significantly increased due to the influence of ranitidine on gastric pH and thus on absorption of midazolam, leading to an increased soporific effect of this benzodiazepine; an effect of ranitidine on oxidative liver metabolism also appears to be a contributory factor in this interaction. Conversely, ranitidine distinctly reduced protein-bound cobalamin absorption from a mean of 7.66% prior to ranitidine administration to 0.84% during treatment with ranitidine 300mg daily.

A significant pharmacokinetic interaction has also been demonstrated between ranitidine and procainamide: the AUC of procainamide increased and the renal clearance fell significantly from a mean of 378 to 309 ml/min with ranitidine co-administration. However, this interaction is due to a different mechanism. In this case, ranitidine appears to compete with procainamide for the common renal proximal tubular secretion site.

The reported interactions of ranitidine with warfarin, metoprolol, nifedipine, theophylline and fentanyl appear to be due to inhibition of cytochrome P-450. In a clinical study, warfarin clearance was significantly reduced from 66.7 to 48.7 ml/min by ranitidine, and by cimetidine to 42.9 ml/min. Similarly, the elimination half-lives of metoprolol and nifedipine were distinctly prolonged and the AUCs significantly increased by ranitidine. However, the latter pharmacokinetic interactions appear unlikely to be of clinical significance since the clinical effects of metoprolol and nifedipine were unaffected by ranitidine treatment. In therapeutic concentrations, ranitidine inhibited the disappearance of fentanyl from an in vitro microsomal preparation, indicating that it inhibits microsomal drug metabolism. In rat experiments, ranitidine also significantly reduced alcohol elimination by 19% (p < 0.01).

The bioavailability of ranitidine itself was decreased by 33% due to concurrent administration of an aluminium-magnesium hydroxide antacid preparation (p < 0.05), and increased by propantheline (p < 0.05). The anticholinergic drug pirenzepine also produced a pharmacodynamic interaction with ranitidine, potentiating the inhibitory effect of the latter on gastric acid secretion.

Thus present data show that ranitidine is involved in drug interactions which may be of clinical relevance. Adverse drug interactions can be avoided by careful monitoring of treated patients and adjustment of the dosage where appropriate.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Abernethy, D.R.; Greenblat, D.J.; Eshelman, F.N. and Shader, R.I.: Ranitidine does not impair oxidative or conjugative metabolism: Noninteraction with antipyrine, diazepam, and lorazepam. Clinical Pharmacology and Therapeutics 35: 188 (1984).

    Article  PubMed  CAS  Google Scholar 

  • Arditi, M.; Cravetto, C.; Molino, G.; Pera, A. and Penti, V.: The effect of chronic treatment with gastric antisecretory drugs on functional liver plasma flow. Gastroenterology 84: 1092 (1983).

    Google Scholar 

  • Barber, H.E.; Petrie, J.C. and Smith, K.J.: A comparison of cimetidine and ranitidine: Effect on liver blood flow. Proceedings of the Pharmacological Society, London, January 4–6 (1984).

  • Breen, K.J.; Bury, R.; Desmond, P.V.; Mostfond, M.L.; Morphelt, B.; Westwood, B. and Shaw, R.G.: Effects of cimetidine and ranitidine on hepatic drug metabolism. Clinical Pharmacology and Therapeutics 31: 297 (1982).

    Article  PubMed  CAS  Google Scholar 

  • Brogden, R.N.; Carmine, A.A.; Heel, R.C.; Speight, T.M. and Avery G.S.: Ranitidine: A review of its pharmacology and therapeutic use in peptic ulcer disease and other allied diseases. Drugs 24: 267 (1982).

    Article  PubMed  CAS  Google Scholar 

  • Brown, H.C.; Carruthers, S.G.; Johnston, G.B.; Kelly, J.G.; McAinsh, J.; McDevitt, D.G. and Shanks, R.G.: Clinical pharmacologic observations on atenolol, a ′8-adrenoceptor blocker. Clinical Pharmacology and Therapeutics 20: 524 (1976).

    PubMed  CAS  Google Scholar 

  • Burroughs, A.K.; Walt, R.P.; Dunk, A.A.; Jenkins, W.J.; Sherlock, S.; Mackie, S. and Dick, R.: Effect of cimetidine on portal hypertension in cirrhotic patients. British Medical Journal 284: 1159 (1982).

    Article  PubMed  CAS  Google Scholar 

  • Carey, P.F.; Martin, L.E. and Owen, P.E.: Determination of ranitidine and its metabolites in human urine by reversed phase ion pair high performance liquid chromatography. Journal of Chromatography 225: 161–168 (1981).

    Article  PubMed  CAS  Google Scholar 

  • Chau, N.P.; Zech, P.Y.; Pozet, N. and Hadj-Aissa, A.: Ranitidine kinetics in normal subjects. Clinical Pharmacology and Therapeutics 31: 770 (1982).

    Article  PubMed  CAS  Google Scholar 

  • Dammann, G.H.; Müller, P. and Simon, B.: 24-Hour intragastric acidity and single night-time doses of three H2-blockers. Lancet 2: 1078 (1983).

    Article  PubMed  CAS  Google Scholar 

  • Desmond, P.V.; Mashford, M.L.; Harman, P.J.; Morphett, B.J.; Breen, K.J. and Wang, Y.M.: Decreased oral warfarin clearance after ranitidine and cimetidine. Clinical Pharmacology and Therapeutics 35: 338 (1984).

    Article  PubMed  CAS  Google Scholar 

  • Desmond, P.V.; Shaw, G.; Bury, R.W. and Breen, K.J.: No effect of ranitidine on the disposition or elimination of chlormethiazole or indocyanide green. Scandinavian Journal of Gastroenterology 17: 50 (1982).

    Google Scholar 

  • Dobbs, J.H.; Skoutakis, V.A.; Acchiander, S.R. and Dobbs, B.R.: Effect of aluminium hydroxide on the absorption of propranolol. Current Therapeutic Research 21: 887 (1977).

    CAS  Google Scholar 

  • Dunk, L.A.; Jenkins, W.J.; Burroughs, A.K.; Watt, R.P.; Osuafar, T.O.K.; Sherlock, S.; Mackie, A. and Dick, R.: The effect of ranitidine on the plasma clearance and hepatic extraction of indocyanine green in patients with chronic liver disease. British Journal of Clinical Pharmacology 16: 117 (1983).

    Article  PubMed  CAS  Google Scholar 

  • Elliot, P.; Dundee, J.W.; Elwood, R.J.; Collier, P.S. and McClean, E.: The influence of two H2-receptor antagonists on the systemic availability of two benzodiazepines, midazolam and temazepam. Proceedings of the British Pharmacological Society, London, January 4-6 (1984).

  • Elwood, R.J.; Hildebrand, P.J.; Dundee, J.W. and Collier, P.S.: Ranitidine influences uptake of oral midazolam. British Journal of Clinical Pharmacology 15: 743 (1983).

    Article  PubMed  CAS  Google Scholar 

  • Eshelman, F.N.; Plachetka, J.R. and Brown, B.C.P.: Effect of antacid and anticholinergic medication on ranitidine absorption. Clinical Pharmacology and Therapeutics 33: 216 (1983).

    Google Scholar 

  • Feely, J. and Guy, E.: Ranitidine also reduces liver blood flow. Lancet 1: 169 (1982).

    Article  Google Scholar 

  • Feely, J. and Guy, E.: Lack of effect of ranitidine on the disposition of lidocaine. British Journal of Clinical Pharmacology 15: 378 (1983).

    Article  PubMed  CAS  Google Scholar 

  • Feely, J.; Wilkinson, G.R. and Wood, A.R.: Reduction of liver blood flow and propanolol metabolism by cimetidine. New England Journal of Medicine 304: 692 (1981).

    Article  PubMed  CAS  Google Scholar 

  • Fernandez, E. and Melewicz, F.M.: Ranitidine and theophylline. Annals of Internal Medicine 100: 459 (1984).

    Google Scholar 

  • Garg, D.C.; Weidler, D.J.; Jallad, S. and Eshelman, F.N.: The effects of ranitidine and cimetidine on hepatic blood flow. Clinical Pharmacology and Therapeutics 31: 228 (1982).

    Google Scholar 

  • Garg, D.C.; Weidler, D.J. and Eshelmann, F.N.: Ranitidine bio-availability and kinetics in normal male subjects. Clinical Pharmacology and Therapeutics 33: 445 (1983).

    Article  PubMed  CAS  Google Scholar 

  • Gledhill, T.; Howard, D.M.; Buck, M.; Paul, A. and Hunt, R.H.: Single nocturnal dose of an H2-receptor antagonist for the treatment of duodenal ulcer. Gut 24: 904 (1983).

    Article  PubMed  CAS  Google Scholar 

  • Gugler, R.; Brand, M. and Somogyi, A.: Impaired cimetidine absorption by antacids and metoclopramide. European Journal of Clinical Pharmacology 20: 225 (1981).

    Article  PubMed  CAS  Google Scholar 

  • Hansen, W.E. and Bertl, S.: Hemmung der Azetylcholinesterasen — ein relevanter Nebeneffekl von Ranitidin?. Zeitschrift für Gastroenlerologie 21: 164 (1983).

    CAS  Google Scholar 

  • Heagerty, A.M.; Castleden, C.M. and Patel, L.: Failure of ranitidine to interact with propranolol. British Medical Journal 284: 1304 (1982).

    Article  PubMed  CAS  Google Scholar 

  • Heagerty, A.M.; Donovan, M.A.; Castleden, C.M.; Pohl, J.I.; Patel, L. and Hedges, A.: Influence of cimetidine on pharmacokinetics of propranolol. British Medical Journal 282: 1917 (1981).

    Article  PubMed  CAS  Google Scholar 

  • Hecken van, A.M.; Tjandramaga, T.B.; Mullie, A.; Verbesselt, R. and De Schepper, F.J.: Ranitidine single dose pharmacokinetics and absolute bioavailablity in man. British Journal of Clinical Pharmacology 14: 195 (1982).

    Article  PubMed  Google Scholar 

  • Henry, B.A.; MacDonald, I.A.; Kitelington, G.; Bill, G.D. and Longman, M.J.S.: Cimetidine and ranitidine comparison of effects on hepatic drug metabolism. British Medical Journal 281: 775 (1980).

    Article  PubMed  CAS  Google Scholar 

  • Hoensch, H.; Hartmann, F.; Schomerus, H.; Bieck, P. and Dölle, W.: Monooxygenase enzyme activity in alcoholics with varying degrees of liver disease. Gut 20: 666 (1979).

    Article  PubMed  CAS  Google Scholar 

  • Hoensch, H.; Hutzel, H.; Kirch, W. and Ohnhaus, E.E.: Isolation of human hepatic microsomes and their inhibition by cimetidine and ranitidine. European Journal of Clinical Pharmacology (In press, 1984).

  • Jackson, J.E.; Bentley, J.B.; Glass, S.; Banner, W. and Plachetka, J.B.: The effects of H2 blockers on lidocaine disposition. (Abstract.) Clinical Pharmacology and Therapeutics 33: 255 (1983).

    Google Scholar 

  • Kanto, J.; Allonen, H.; Jalonen, H. and Härtyle, R.: The effect of metoclopramide and propanethline on the gastro-intestinal absorption of cimetidine. British Journal of Clinical Pharmacology 11: 527 (1981).

    Article  Google Scholar 

  • Kelly, J.G.; Shanks, R.G. and McDevitt, D.G.: Influence of ranitidine on plasma metoprolol concentrations. British Medical Journal 287: 1218 (1983).

    Article  Google Scholar 

  • Kirch, W.; Hoensch, H.; Ohnhaus, E.E. and Janisch, H.D.: Ranitidin-Nifedipin Interaktion. Deutsche Medizinische Wochenschrift 109: 1223 (1984).

    PubMed  CAS  Google Scholar 

  • Kirch, W.; Janisch, H.D.; Heidemann, H.; Rämsch, K. and Ohnhaus, E.E.: Der Einfluβ von Cimetidin und Ranitidin auf Pharmakokinctik und antihypertensiven Effekt von Nifedipin. Deutsche Medizinische Wochenschrift 108: 1757 (1983a).

    Article  PubMed  CAS  Google Scholar 

  • Kirch, W.; Köhler, H.; Mutschler, E. and Schäfer, M.: Pharmacokinetics of atenolol in relation to renal function. European Journal of Clinical Pharmacology 19: 65 (1981c).

    Article  PubMed  CAS  Google Scholar 

  • Kirch, W.; Köhler, H.; Spahn, H. and Mutschler, E.: Interaction of cimetidine with metoprolol, propranolol or atenolol. Lancet 2: 331 (1981a).

    Google Scholar 

  • Kirch, W.; Schäfer-Korting, M.; Mutschler, E.; Ohnhaus, E.E. and Brown, W.: Clinical experience with atenolol in patients with chronic liver disease. Journal of Clinical Pharmacology 23: 171 (1983b).

    PubMed  CAS  Google Scholar 

  • Kirch, W.; Schäfer-Korting, H.; Axthelm, T.; Köhler, H. and Mutschler, E.: Interaction of atenolol with concurrent administration of furosemide, calcium or aluminium hydroxide. Clinical Pharmacology and Therapeutics 30: 429 (1981b).

    Article  PubMed  CAS  Google Scholar 

  • Klotz, U.; Reimann, I.W. and Ohnhaus, E.E.: Effect of ranitidine on steady state pharmacokinetics of diazepam. European Journal of Clinical Pharmacology 24: 357 (1983).

    Article  PubMed  CAS  Google Scholar 

  • Klotz, U. and Reimann, J.: Influence of cimetidine on pharmacokinetics of desmethyldiazepam and oxazepam. European Journal of Clinical Pharmacology 18: 517 (1980).

    Article  PubMed  CAS  Google Scholar 

  • Koch-Weser, J. and Klein, S.W.: Procainamide dosage schedules, plasma concentrations and clinical effects. Journal of the American Medical Association 215: 1454 (1971).

    Article  PubMed  CAS  Google Scholar 

  • Lebert, P.A.; Macleod, S.M.; Mahon, W.A.; Soldin, S.J.; Fenge, P. and Vandenberghe, H.M.: Ranitidine kinetics and dynamics: I. Oral dose studies. Clinical Pharmacology and Therapeutics 30: 439 (1981a).

    Article  Google Scholar 

  • Lebert, P.A.; Mahon, W.A.; MacLeod, S.M.; Soldin, S.J.; Fenje, P. and Vandenberghe, H.M.: Ranitidine kinetics and dynamics: II. Intravenous dose studies and comparison with cimetidine. Clinical Pharmacology and Therapeutics 30: 457 (1981b).

    Google Scholar 

  • Lebrec, D.; Goldfarb, G. and Benhamou, J.P.: Reduction of liver blood flow by cimetidine. New England Journal of Medicine 305: 100 (1981).

    Article  Google Scholar 

  • Lecoque, F.R. and McPhaul, J.J.: The effects of starvation, high fat diets and before infusions on uric acid balance. Metabolism 14: 186 (1965).

    Article  Google Scholar 

  • Lee, M.R.; Gandolfi, A.J.; Sipes, I.G. and Bentley, J.: Effect of histamine H2-receptors on fentanyl metabolism. Pharmacologist 24: 282 (1982).

    Google Scholar 

  • Leevy, C.M.; Leevy, C.B. and Howard, N.M.: Indocyanine green and the liver; in Davidson (Ed). Problems in Liver Disease, p. 42 (Stratton, New York 1979).

    Google Scholar 

  • Lelaiche, J.; Catton, D.; Zittonn, J.; Marguet, J. and Yvart, J.: Effect of ranitidine on cobalamin absorption. Digestive Diseases and Science 28: 667 (1983).

    Google Scholar 

  • Lennard, M.S.; Silas, J.H.; Freestone, S.; Ramsey, L.E.; Tucker, G.T. and Woods, H.F.: Oxidative phenotype — a major determinant of metoprolol metabolism and response. New England Journal of Medicine 307: 1558 (1982).

    Article  PubMed  CAS  Google Scholar 

  • Londong, W.; Londong, V.; Ebert, H.; Pöch, G.; Bozler and Gugler, R.: Interaktion von Ranitidin und Pirenzipin. Zeitschrift fur Gastroenterologie 384: 384 (1983).

    Google Scholar 

  • Louis, W.J.; Mihaly, G.W.; Hanson, R.G.; Anderson, A.; McNeil, J.J.; Yeomans, N.D. and Smallwood, R.A.: Pharmacokinetic and gastric secretory studies of ranitidine in man. Scandinavian Journal of Gastroenterology 16 (Suppl. 69): 11 (1981).

    CAS  Google Scholar 

  • Martin, L.E.; Bell, J.A.; Carey, P.F.; Dallas, F.A.A.; Dixon, G.T. and Jenner, W.N.: A review of pharmacokinetics and metabolism of ranitidine in animals and man; in Misiewicz and Wormsley (Eds) The Clinical Use of Ranitidine, Medicine Publishing Foundation Series 5, pp. 23–31 (Medicine Publishing Foundation, Oxford 1982).

    Google Scholar 

  • Mashford, M.L.; Harman, P.J.; Morphett, B.J.; Breen, K.J. and Desmond, P.V.: Ranitidine does not affect chlormethiazole or indocyanine green disposition. Clinical Pharmacology and Therapeutics 34: 231 (1983).

    Article  PubMed  CAS  Google Scholar 

  • Mayersohn, M.: Physiological factors that modify systemic drug availability and pharmacologic response in clinical practice in Blanchard et al. (Eds.) Principles and Perspectives in Drug Bioavailability, p. 211 (Karger, Basel 1979).

    Google Scholar 

  • McGowan, W.A.W. and Dundee, J.W.: The effect of intravenous cimetidine on the absorption of orally administered diazepam and lorazepam. British Journal of Clinical Pharmacology 14: 207 (1982).

    Article  PubMed  CAS  Google Scholar 

  • McCarthy, B.M.: Ranitidine or cimetidine. Annals of Internal Medicine 99: 551 (1983).

    PubMed  CAS  Google Scholar 

  • McFadyen, M.L.; Folb, P.I.; Miller, R.; Marks, I.N. and Moshal, M.G.: The pharmacokinetics of ranitidine in patients with chronic duodenal ulceration: A comparison of responders and non-responders. European Journal of Clinical Pharmacology 24: 441 (1983).

    Article  PubMed  CAS  Google Scholar 

  • McGonigle, R.J.S.; Williams, L.C.; Amphlett, G.E.; England R.J. and Parsons, V.: The pharmacokinetics of ranitidine in renal disease; in Misiewicz and Wormsley (Eds). The Clinical Use of Ranitidine, Medicine Publishing Foundation Series 5, p. 41 (Medicine Publishing Foundation, Oxford1982).

    Google Scholar 

  • Mignon, M.; Chau, N.P.; Nguyen-Phuoc, B.K.; Sauvage, B.; Leguy, F. and Bonfils, S.: Ranitidine upon meal-induced gastric secretion: Oral pharmacokinetics and plasma concentration effect relationships. British Journal of Clinical Pharmacology 14: 187 (1982).

    Article  PubMed  CAS  Google Scholar 

  • Mihaly, G.W.; Marino, A.T.; Webster, L.K. and Jones, D.B.: High doses of antacid (Mylama II) reduces bioavailability of ranitidine. British Medical Journal 285: 998 (1982).

    Article  PubMed  CAS  Google Scholar 

  • Mitchell, M.C.; Schenker, S. and Speeg, K.V.: Differential effects of cimetidine and other H2-receptor antagonists on acetaminophen metabolism. Clinical Research 79: 758 (1981).

    Google Scholar 

  • Ohnhaus, E.E.: The effect of different administration periods on the time course of enzyme induction in man. Clinical Pharmacology and Therapeutics 33: 259 (1983).

    Google Scholar 

  • Patel, L. and Weerasuriya, K.: Effect of cimetidine and ranitidine on propranolol clearance. British Journal of Clinical Pharmacology 15: 152 (1983).

    Google Scholar 

  • Powell, J.R.; Rogers, J.F.; Wargin, W.A.; Cross, R.E. and Eshelman, F.N.: Influence of cimetidine versus ranitidine on theophylline pharmacokinetics. Clinical Pharmacology and Therapeutics 31: 261 (1982).

    Google Scholar 

  • Puurunen, J.; Sotaniemi, E. and Pelkonen, O.: Effect of cimetidine on microsomal drug metabolism in man. European Journal of Clinical Pharmacology 18: 185 (1980).

    Article  PubMed  CAS  Google Scholar 

  • Reeves, P.R.; McAinsh, J.; McIntosh, D.A.D. and Winrow, M.J.: Metabolism of atenolol in man. Xenobiotica 8: 313 (1978).

    Article  PubMed  CAS  Google Scholar 

  • Reimann, W.; Klotz, U. and Fröhlich, J.C.: Effects of cimetidine on steady state propranolol kinetics. Clinical Pharmacology and Therapeutics 32: 749 (1982).

    Article  PubMed  CAS  Google Scholar 

  • Rendić, S.; Alebic-Kolbah, T. and Kajfez, F.: Interaction of ranitidine with liver microsomes. Xenobiotica 12: 9 (1982).

    Article  PubMed  Google Scholar 

  • Rendić, S.; Kajfez, F. and Ruf, H.H.: Characterization of cimetidine, ranitidine and related structures. Interaction with cytochrome P 450. Drug Metabolism and Disposition 11: 137 (1983).

    PubMed  Google Scholar 

  • Roberts, A.P.; Harrison, C.; Dixon, G.T. and Curtis, J.R.: Plasma ranitidine concentrations after intravenous administration in normal volunteers and haemodialysis patients. Postgraduate Medical Journal 59: 25 (1983).

    Article  PubMed  CAS  Google Scholar 

  • Roberts, C.J.C.: Clinical pharmacokinetics of ranitidine. Clinical Pharmacokinetics 9: 211 (1984).

    Article  PubMed  CAS  Google Scholar 

  • Rowland, M.; Benet, L.Z. and Graham, G.G.: Clearance concepts in pharmacokinetics. Journal of Pharmacokinetics and Biopharmaceutics 1: 123 (1973).

    Article  PubMed  CAS  Google Scholar 

  • Schiller, K.F.R.: Short term treatment of duodenal ulcer. Comparisons of ranitidine with cimetidine: UK data; in Misiewicz and Wormsley (Eds) The Clinical Use of Ranitidine Medicine Publishing Foundation Series 5, p. 157 (Medicine Publishing Foundation, Oxford 1982).

    Google Scholar 

  • Seitz, H.K.; Bösche, J.; Cruppa, P.; Simon, B. and Veith, S.: Effekt der H2-Rezeptoren Antagonisten Cimetidin und Ranitidin auf die in-vivo Äthanolelimination bei der Ratte. Zeitschrift für Gastroenterologie 20: 493 (1982).

    Google Scholar 

  • Seitz, H.K.; Bösch, J.; Czyan, P.; Veith, S.; Simon, B. and Kaonmerell, B.: Increased blood alcohol levels following cimetidine but not ranitidine. Lancet 1: 760 (1983).

    Article  PubMed  CAS  Google Scholar 

  • Serlin, M.J.; Sibeon, R.G. and Breckenridge, A.M.: Lack of effect of ranitidine on warfarin action. British Journal of Clinical Pharmacology 12 791 (1981).

    Article  PubMed  CAS  Google Scholar 

  • Serlin, M.J.; Sibeon, R.G.; Mossmann, S.; Breckenridge, A.M.; Williams, J.R.B.; Atwood, J.L. and Willoughby, J.M.T.: Cimetidine: Interaction with oral anticoagulants in man. Lancet 2: 317 (1979).

    Article  PubMed  CAS  Google Scholar 

  • Seqing, K.-Fr.: Pharmacodynamics and pharmacokinetics of ranitidine in man; in Misiewicz and Wormsley (Eds) The Clinical Use of Ranitidine, Medicine Publishing Foundation Series 5, pp. 32–40 (Medicine Publishing Foundation, Oxford 1982).

    Google Scholar 

  • Somogyi, A. and Gugler, R.: Drug interaction with cimetidine. Clinical Pharmacokinetics 7: 23 (1982).

    Article  PubMed  CAS  Google Scholar 

  • Somogyi, A. and Heinzow, B.: Cimetidine reduces procainamide elimination. New England Journal of Medicine 304: 1080 (1982).

    Google Scholar 

  • Somogyi, A. and Bochner, F.: Dose and concentration dependent effect of ranitidine on procainamide disposition and renal clearance in man. British Journal of Clinical Pharmacology 18: 175–181 (1984).

    Article  PubMed  CAS  Google Scholar 

  • Spahn, H.; Kirch, W. and Mutschler, E.: The interaction of cimetidine with metoprolol, atenolol, propranolol, pindolol and penbutolol. British Journal of Clinical Pharmacology 15: 500 (1983a).

    Article  PubMed  CAS  Google Scholar 

  • Spahn, H.; Mutschler, E.; Kirch, W.; Ohnhaus, E.E. and Janisch, H.D.: Influence of ranitidine on plasma metoprolol and atenolol concentrations. British Medical Journal 286: 1546 (1983b).

    Article  PubMed  CAS  Google Scholar 

  • Speeg, K.V.; Rattmandhan, R.V.; Amant, G.R.; Mitchell, M.C. and Schenker, S.C.: Inhibition of microsomal drug metabolism by histamine-H2-receptor antagonists studied in vivo and in vitro in rodents. Gastroenterology 82: 89 (1982).

    PubMed  CAS  Google Scholar 

  • Staiger, C.; Simon de Vries, B.; Katter, H. and Walter, E.: Untersuchungen zur Wirkung von Ranitidine auf den Antipyrin-Metabolismus. Zeitschrift für Gastroenterologie 18: 601 (1980).

    PubMed  CAS  Google Scholar 

  • Streeter, A.M.; Goulston, K.J.; Bathur, F.A.; Hilmer, R.S.; Crone, G.G. and Pheils, M.T.: Cimetidine and malabsorption of cobalamin. Digestive Diseases and Science 27: 13 (1982).

    Article  CAS  Google Scholar 

  • Tarditi, E.; Valenti, G.; Scarpignato, C. and Bentaccini, G.: Impared TSH response to TRH after intravenous ranitidine in man. Experientia 39: 109 (1983).

    Article  PubMed  CAS  Google Scholar 

  • Walt, R.P.; Male, P.J.; Rawlings, J.; Hunt, R.H.; Milton-Thompson, G.J. and Misiewicz, J.J.: Comparison of the effects of ranitidine, cimetidine and placebo on the 24-hour intragastric acidity and nocturnal acid secretion in patients with duodenal ulcer. Gut 22: 49 (1981).

    Article  PubMed  CAS  Google Scholar 

  • Watts, R.W.; Hetzel, D.J.; Bochner, F.; Hallpike, J.F.; Hann, C.S. and Sherman, B.J.: Lack of interaction between ranitidine and phenytoin. British Journal of Clinical Pharmacology 15: 499 (1983).

    Article  PubMed  CAS  Google Scholar 

  • Wilkinson, G.R. and Shand, D.G.: A physiological approach to hepatic drug clearance. Clinical Pharmacology and Therapeutics 18: 337 (1975).

    Google Scholar 

  • Young, C.J.; Daneshmend, T.K. and Roberts, C.J.: Effects of cirrhotic and ageing on the elimination and bioavailability of ranitidine. Gut 23: 819 (1982).

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Medical Department, University of Essen School of Medicine, Essen, Germany

    W. Kirch, H. Hoensch & H. D. Janisch

  2. Department of Gastroenterology, Klinikum Charlottenburg, Berlin, Germany

    W. Kirch, H. Hoensch & H. D. Janisch

Authors
  1. W. Kirch
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. H. Hoensch
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. H. D. Janisch
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kirch, W., Hoensch, H. & Janisch, H.D. Interactions and Non-interactions with Ranitidine. Clin Pharmacokinet 9, 493–510 (1984). https://doi.org/10.2165/00003088-198409060-00002

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00003088-198409060-00002

Keywords

Search

Navigation