Side Effects of Ranitidine

Summary

Ranitidine was first marketed in 1981; since then many patients have been treated such that much experience has been accumulated on the safety of this histamine H2-receptor antagonist in the treatment of gastroduodenal disease. A wide array of ranitidine-associated side effects has been described, but infrequently. As so much information is now available, the aim of this review is to assess the weight of evidence for a causal link between ranitidine and the reported side effects.

Overall, ranitidine is well tolerated. The incidence of general side effects at less than 2% is very similar to placebo. Headaches, tiredness, dizziness and mild gastrointestinal disturbance (e.g. diarrhoea, constipation and nausea) are among the most frequent complaints, but have very seldom resulted in stopping treatment.

Cardiovascular side effects are extremely rare and unpredictable with the usual doses of oral ranitidine (at most 1 in 1 million patients). They mostly comprise sinusal bradycardia and atrioventricular blockade, especially after rapid intravenous administration, receding after cessation of the drug. Clinical studies, however, have not shown a significant pharmacological effect of ranitidine on the cardiovascular system via H2-receptors, even though individual sensitivities cannot be ruled out in a few isolated reports.

Ranitidine is unlikely to be directly hepatotoxic: a transient change in liver function tests has been noted in only 1 in 100 to 1 in 1000 patients. Several cases of mixed hepatitis have been reported, but very few were fully documented. The incidence of ranitidine-associated acute hepatitis has been estimated to be less than 1 in 100 000 patients.

Neuropsychiatric complications may be less common and clinically quite similar to those reported with cimetidine, i.e. confusion, disorientation, hallucinations, delirium. These side effects have occurred especially in critically ill and multiple-therapy patients, or patients with chronic renal or hepatic failure, so that the direct causal link with ranitidine treatment was often difficult to ascertain. Even though an H2-receptor-mediated effect is an attractive hypothesis (since similar complications were noted with other H2-receptor antagonists), other mechanisms have been suggested to play a role, e.g. cholinergic or histaminic effects. The overall incidence of neuropsychiatric complications is probably markedly less than 1%.

White cell injury (i.e. agranulocytosis) appears to be the most frequent haematological complication, even though case reports are very few and poorly documented. The mechanism is unknown but ranitidine is unlikely to be markedly haematotoxic. Anecdotal reports of thrombocytopenia and anaemia have been published.

In disagreement with a few poorly documented case reports and in contrast to cimetidine, clinical studies have shown that ranitidine has no side effects on endocrine functions, in particular androgenic function or prolactin secretion.

Among other side effects associated with ranitidine treatment, cutaneous effects include nonspecific skin reactions as well as urticaria, contact dermatitis and vasculitis. In contrast to cimetidine, ranitidine failed to enhance the immune responsiveness both in animals and in humans.

Drug interactions with ranitidine have been controversial. Although it can be loosely bound to cytochrome P450 components, there is no conclusive clinical evidence that interactions may occur with many drugs such as oral anticoagulants, anticonvulsants, β-blocking drugs, calcium antagonists, lidocaine (lignocaine), benzodiazepines, tricyclic antidepressants or oral hypoglycaemic drugs. A few clinical case reports suggest that ranitidine may interfere with theophylline, although all human pharmacokinetic studies have been negative.

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

References

  1. Abernethy DR, Greenblatt DJ, Eshelman FN, Shader RI. Ranitidine does not impair oxidative or conjugative metabolism: noninteraction with antipyrine, diazepam and lorazepam. Clinical Pharmacology and Therapeutics 35: 188–192, 1984.

    PubMed  CAS  Google Scholar 

  2. Adams LJ, Antonow DR, McClain CJ, McAllister R. Effect of ranitidine on bioavailability of nifedipine. Gastroenterology 90: 1320, 1986.

    Google Scholar 

  3. Adebayo GI, Coker HAB. Lack of efficacy of cimetidine and ranitidine as inhibitors of tolbutamide metabolism. European Journal of Clinical Pharmacology 34: 653–656, 1988.

    PubMed  CAS  Google Scholar 

  4. Aglietta M, Stacchini A, Sanavio F, Piacibello W. H2 receptor antagonists and human granulopoiesis. Experientia 41: 375–376, 1985.

    PubMed  CAS  Google Scholar 

  5. Agura ED, Vila E, Petersen FB, Shields AF, Thomas ED. The use of ranitidine in bone marrow transplantation. Transplantation 46: 53–56, 1988.

    PubMed  CAS  Google Scholar 

  6. Ahonen J, Paimela H, Kauste A, Hayry P, Eklund B, et al. Ranitidine and cimetidine in renal transplantation: a clinical trial. International Journal of Tissue Reaction 5: 373–379, 1983.

    CAS  Google Scholar 

  7. Allegri G, Pellegrini K, Dobrilla G. First-degree atrioventricular block in a young doudenal ulcer patient treated with a standard oral dose of ranitidine. Agents and Actions 24: 237–242, 1988.

    PubMed  CAS  Google Scholar 

  8. Amos RJ, Kirk B, Amess JAL, Jones AL, Hinds CJ. Bone marrow hypolasia during intensive care: bone marrow culture studies implicating ranitidine in the suppression of haemopoiesis. Human Toxicology 6: 503–506, 1987.

    PubMed  CAS  Google Scholar 

  9. Aymard JP, Aymard B, Netter P, Bannwarth B, Trechot P, et al. Haematological adverse effects of histamine H2-receptor antagonists. Medical Toxicology 3: 430–448, 1988.

    PubMed  CAS  Google Scholar 

  10. Baciewicz AM, Baciewicz FA. Effect of cimetidine and ranitidine on cardiovascular drugs. American Heart Journal 118, 144–154, 1989

    PubMed  CAS  Google Scholar 

  11. Baciewicz AM, Morgan PJ. Ranitidine-warfarin interaction. Annals of Internal Medicine 112: 76–77, 1990.

    PubMed  CAS  Google Scholar 

  12. Bacigalupo A, Van Lint MT, Peralvo J, Figari GPO, Marmont AM. Ranitidine and hematologic recovery in aplastic anemia. Haematologica 72: 378–379, 1987.

    PubMed  CAS  Google Scholar 

  13. Bader A, Carrigan T, Gopalswamy N, Trubzsch DV. Reversible hematologic suppression during ranitidine treatment. Drug Intelligence and Clinical Pharmacy 23: 508–509, 1989.

    CAS  Google Scholar 

  14. Balestrazzi P, Gregori G, Bernasconi S, Giovannelli G. Bradycardia and neurologic disorders associated with ranitidine in a child. American Journal of Diseases of Children 139: 442, 1985.

    PubMed  CAS  Google Scholar 

  15. Bailer D, Huchzermeyer H. Histaminwirkungen am Herzen unter besonderer Berücksichtigung kardialer Nebenwirkungen von H2-Rezeptor-antagonisten. Klinische Wochenshcrift 67: 743–755, 1989.

    Google Scholar 

  16. Barbat J, Warrington SJ. Effects of cimetidine and rantidine on some non-invasive indices of cardiac function. British Journal of Pharmacology 72: 131P, 1981

    Google Scholar 

  17. Barr GD, Piper DW. Possible ranitidine hepatotoxicity. Medical Journal of Australia 2: 421, 1981.

    PubMed  CAS  Google Scholar 

  18. Baylac-Domengetroy F, Gallimard JF, Allai J, Rousseau G, Barraine R. Troubles de la conduction auriculo-ventriculaire sous ranitidine intra-veineuse. Annales de Médecine Interne 138: 140–141, 1987.

    PubMed  CAS  Google Scholar 

  19. Belaïche J, Zittoun J, Marquet J, Nurit Y, Yvart J. Effet de la ranitidine sur la sécrétion de facteur intrinsèque gastrique et sur l’absorption de la vitamine B12. Gastroentérologie Clinique et Biologique 7: 381–384, 1983.

    PubMed  Google Scholar 

  20. Bertaccini G, Licchin L, Bonoldi C, Felder H, Dobrilla G. Absence of cholinergic-like activity of ranitidine on human salivary and lacrimal secretions. Italian Journal of Gastroenterology 13: 253–254, 1981.

    Google Scholar 

  21. Bianchi Porro G, Cheli R. Gynaecomastia and ranitidine. Italian Journal of Gastroenterology 16: 56, 1984.

    Google Scholar 

  22. Bianchi Porro G, Petrillo M, Recchia G. The safety of ranitidine. Clinical Trials Journal 22: 441–447, 1985.

    Google Scholar 

  23. Billings RF, Stein MB. Depression associated with ranitidine. American Journal of Psychiatry 143: 915–916, 1986.

    PubMed  CAS  Google Scholar 

  24. Black M. Hepatotoxic and hepatoprotective potential of histamine (H2)-receptor antagonists. American Journal of Medicine 83 (Suppl. 6A): 68–75, 1987.

    PubMed  CAS  Google Scholar 

  25. Black M, Scott WC, Kanter R. Possible ranitidine hepatotoxicity. Annals of Internal Medicine 101: 208–210, 1984.

    PubMed  CAS  Google Scholar 

  26. Boehning W. Effect of cimetidine and ranitidine on plasma theophylline in patients with chronic obstructive airways disease treated with theophylline and corticosteroids. European Journal of Clinical Pharmacology 38: 43–45, 1990.

    PubMed  CAS  Google Scholar 

  27. Bories P, Michel H, Duclos B, Beraud JJ, Mirouze J. Use of ranitidine without mental confusion in patient with renal failure. Lancet 2: 1071, 1980.

    Google Scholar 

  28. Braito E, Oberlechner R, Camberlato M, Amplatz S, Dobrilla G. Heart rate and blood pressure in non-cardiopathic volunteers receiving acute intravenous loads of H2-antagonists: trial based on Holter-Edwards dynamic electrocardiography. Italian Journal of Gastroenterology 17: 176, 1985.

    Google Scholar 

  29. Bramhall D, Levine M. Possible interaction of ranitidine with phenytoin. Drug Intelligence and Clinical Pharmacy 22: 979–980, 1988.

    PubMed  CAS  Google Scholar 

  30. Brayko CM. Ranitidine. New England Journal of Medicine 310: 1601–1602, 1984.

    Google Scholar 

  31. Bredfeldt JE, Von Huene C. Ranitidine, acetaminophen, and hepatotoxicity. Annals of Internal Medicine 101: 719, 1984.

    PubMed  CAS  Google Scholar 

  32. Breen KJ, Bury R, Desmond PV, Mashford ML, Morphett B, et al. Effects of cimetidine and ranitidine on hepatic drug metabolism. Clinical Pharmacology and Therapeutics 31: 297–300, 1982.

    PubMed  CAS  Google Scholar 

  33. Brenner LO. Agranulocytosis and ranitidine. Annals of Internal Medicine 104: 896–897, 1986.

    PubMed  CAS  Google Scholar 

  34. Brockmeyer NH, Breithaupt H, Hattingberg MV, Ohnhaus EE. Metabolism of mexiletine alone and in combination with cimetidine and ranitidine in vivo and in vitro. Proceedings of the BPS, 8–10 April: 246P, 1987

    Google Scholar 

  35. Burkard WP. Histamine H2-receptor binding with 3H-cimetidine in brain. European Journal of Pharmacology 50: 449–450, 1978.

    PubMed  CAS  Google Scholar 

  36. Camarri E, Chirone E, Fanteria G, Zocchi M. Ranitidine induced bradycardia. Lancet 2: 160, 1982.

    PubMed  CAS  Google Scholar 

  37. Caraman PL, Lietter P, Semin-Cosson AM, Panot B, Trechot P, et al. Recurrent parotitis with H2-receptor antagonists. Lancet 2: 1455–1456, 1986.

    PubMed  CAS  Google Scholar 

  38. Cate EW, Rogers JF, Powell JR. Inhibition of tolbutamide elimination by cimetidine but not ranitidine. Journal of Clinical Pharmacology 26: 372–327, 1986.

    PubMed  CAS  Google Scholar 

  39. Chenery RJ, Emery S, Norman SJ, Oldham HG. The effect of cimetidine and ranitidine on paracetamol glucuronidation and sulphation in cultured rat hepatocytes. British Journal of Pharmacology 84: 164P, 1985

    Google Scholar 

  40. Cherqui B, Desaint B, Legendre C, Levy VG. Hépatite mortelle chez une patiente traitée par la ranitidine. Gastroentérologie Clinique et Biologique 13: 952–953, 1989.

    PubMed  CAS  Google Scholar 

  41. Chow JSF, Wang RYC, Wong PHC, Chen WWC, Lai CL. Intravenous ranitidine has no hemodynamic effects in subjects with normal lung function and patients with chronic obstructive airway disease. Australian and New Zealand Journal of Medicine 13: 261–263, 1983.

    PubMed  CAS  Google Scholar 

  42. Curry SH, De Vane CL, Wolfe MM. Lack of interaction of ranitidine with amitriptyline. European Journal of Clinical Pharmacology 32: 317–320, 1987.

    PubMed  CAS  Google Scholar 

  43. Dal Negro R, Pomari C, Zoccatelli O, Trevisan F, Carloni C, et al. Pharmacokinetics of theophylline and the H2-antagonist drugs cimetidine and ranitidine. International Journal of Clinical Pharmacology, Therapy and Toxicology 22: 221–226, 1984.

    Google Scholar 

  44. Dal Negro R, Turco P, Zoccatelli O, Trevisan F, Pomari C. H2-antagonist derangement of the kinetics of sustained-release oral theophylline. International Journal of Clinical Pharmacology, Therapy and Toxicology 23: 329–332, 1985.

    Google Scholar 

  45. Dalton MJ, Powell JR, Messenheimer JA. Ranitidine does not alter single dose carbamazepine pharmacokinetics in healthy adults. Drug Intelligence and Clinical Pharmacy 19: 941–944, 1985.

    PubMed  CAS  Google Scholar 

  46. Davies WA. Mental confusion associated with ranitidine. Medical Journal of Australia 16: 478, 1983.

    Google Scholar 

  47. De Giacomo C, Maggiore G, Scotta MS. Ranitidine and loss of colour vision in a child. Lancet 2: 47, 1984.

    PubMed  Google Scholar 

  48. Delerue O, Muller JP, Destee A, Warot P. Mania-like episodes associated with ranitidine. American Journal of Psychiatry 145: 271, 1988.

    PubMed  CAS  Google Scholar 

  49. Delitala G, Devilla L, Pende A, Canessa A. Effects of the H2 receptor antagonist ranitidine on anterior pituitary hormone secretion in man. European Journal of Clinical Pharmacology 22: 207–211, 1982.

    PubMed  CAS  Google Scholar 

  50. Delle Fave G, Annibale B, Puoti M, Forte A, Giordano E, et al. Reversible sustained hypergastrinemia in subjects long term treated with H2 antagonists (H2 A). Gastroenterology 92: 1367, 1987.

    Google Scholar 

  51. Desaint B, Alperine M, Legendre C, Florent C, Levy VG. Hépatite á la ranitidine. Gastroentérologie Clinique et Biologique 9: 746–747, 1985.

    PubMed  CAS  Google Scholar 

  52. Descotes J. Immunotoxicology of drugs and chemicals, 2nd ed., Elsevier Science Publishers, Amsterdam, 1988.

    Google Scholar 

  53. Desmonds PV, Mashford ML, Harman PJ, Morphett BJ, Breen KJ, et al. Decreased oral warfarin clearance after ranitidine and cimetidine. Clinical Pharmacology and Therapeutics 35: 338–341, 1984.

    Google Scholar 

  54. Desmonds PV, Shaw R, Westwood B, Bury RW, Morphett B, et al. Comparison of the effect of cimetidine and ranitidine on hepatic drug metabolism. Australian New Zealand Journal of Medicine 13: 314, 1983.

    Google Scholar 

  55. Dietemann-Molard A, Popin E, Oswald-Mammosser M, Colas Des Francs V, Pauli G. Intoxication à la théophylline par interaction avec la ranitidine à dose élevée. Presse Mèdicale 17: 280, 1988.

    CAS  Google Scholar 

  56. Dobbs JH, Muir JG, Smith RN. H2-antagonists and hepatitis. Annals of Internal Medicine 105: 803, 1986.

    PubMed  CAS  Google Scholar 

  57. Dobrilla G, de Petris G, Piazzi L, Chilvoi F, Comerlato M, et al. Is ethanol metabolism affected by oral administration of cimetidine and ranitidine at therapeutic doses? Hepatogastroenterology 31: 35–37, 1984.

    PubMed  CAS  Google Scholar 

  58. Dobrilla G, Felder M, Chilovi F, De Pretis G. Exacerbation of glaucoma associated with both cimetidine and ranitidine. Lancet 1: 1078, 1982.

    PubMed  CAS  Google Scholar 

  59. Donn KH, Powell JR, Rogers JF, Esthelman FN. The influence of H2-receptors antagonists on steady-state concentrations of propranolol and 4-hydroxypropranolol. Journal of Clinical Pharmacology 24: 500–508, 1984a.

    PubMed  CAS  Google Scholar 

  60. Donn KH, Powell JR, Rogers JF, Plachetka JR. Lack of effect of histamine H2-receptors antagonists on indocyanine green disposition measured by two methods. Journal of Clinical Pharmacology 24: 360–370, 1984b.

    PubMed  CAS  Google Scholar 

  61. Duane PD, Shallcross TM, Heatley RV. Duodenal carcinoid tumour in a patient with rheumatoid-arthritis receiving long term ranitidine treatment. British Medical Journal 300: 124–125, 1990.

    PubMed  CAS  Google Scholar 

  62. Dubois A, Nakache N, Zerbib A, Raffanel C. Aplasie médullaire et ranitidine. Annales de Gastroentérologie et Hépatologie 24: 261, 1988.

    CAS  Google Scholar 

  63. Ducluzeau R, Vial T, Pobel D, Descotes J. Effets neuropsychiques de la cimétidine et de la ranitidine: à propos d’un cas. Journal de Toxicologie Clinique et Expérimentale 10: 37–39, 1990.

    PubMed  CAS  Google Scholar 

  64. Dunk AA, Jenkins WJ, Burroughs AK, Walt RP, Osuafor TO, et al. 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: 117–120, 1983.

    PubMed  CAS  Google Scholar 

  65. Eandi M, de Carli GF, Recchia G, Colonna CV. Ranitidine: eight years of post-marketing drug surveillance. Post-Marketing Surveillance 4: 1–8, 1990.

    Google Scholar 

  66. Ehrinpreis MN, Dhar R, Narula A. Cimetidine-induced galactorrhea. American Journal of Gastroenterology 84: 563–565, 1989.

    PubMed  CAS  Google Scholar 

  67. Einarson TR, Turchet EN, Golstein JE, McNay KR. Gout-like arthritis following cimetidine and ranitidine. Drug Intelligence and Clinical Pharmacy 19: 201–202, 1985.

    PubMed  CAS  Google Scholar 

  68. Eisendrath SJ, Ostroff JW. Ranitidine-associated delirium. Psychosomatics 31: 98–99, 1990.

    PubMed  CAS  Google Scholar 

  69. Elliot P, Dundee JW, Collier PS, McClean E. The influence of two H2-receptor antagonists, cimetidine and ranitidine, on the systemic availability of temazepam. British Journal of Anaesthesia 54: 800P–801P, 1986

    Google Scholar 

  70. Elwood RJ, Hidebrand PJ, Dundee JW, Collier PS. Ranitidine influences the uptake of oral midazolam. British Journal of Clinical Pharmacology 15: 743–745, 1983.

    PubMed  CAS  Google Scholar 

  71. Emery S, Oldham HG, Norman SJ, Chenery RJ. The effect of cimetidine and ranitidine on paracetamol glucuronidation and sulphation in cultured rat hepatocytes. Biochemical Pharmacology 34: 1415–1421, 1985.

    PubMed  CAS  Google Scholar 

  72. Epstein CM. Ranitidine and confusion. Lancet 1: 1071, 1984.

    Google Scholar 

  73. Epstein CM, Klopper J. Ranitidine headache. Headache 25: 392–393, 1985.

    PubMed  CAS  Google Scholar 

  74. Epstein CM, Sawyer WT. Phenytoin interactions with cimetidine and ranitidine: a critical analysis of the literature. Advances in Therapy 5: 245–256, 1988.

    Google Scholar 

  75. Farinati F, Farini R, Leandro G, Di Mario F, Vianello F, et al. Changes in the gastric mucosa after ranitidine treatment of duodenal ulcer. Italian Journal of Gastroenterology 14: 114–115, 1982.

    Google Scholar 

  76. Fee JPH, Dundee JW, Collier PS, McCLean E. Diazepam disposition following cimetidine or ranitidine. British Journal of Clinical Pharmacology 17: 617P–618P, 1984

    Google Scholar 

  77. Feely J, Guy E. Ranitidine also reduces liver blood flow. Lancet 1: 169, 1982.

    Google Scholar 

  78. Feely J, Guy E. Lack of effect of ranitidine on the disposition of lidocaine. British Journal of Clinical Pharmacology 15: 378–379, 1983.

    PubMed  CAS  Google Scholar 

  79. Fennelly ME, Earnshaw G, Soni N. Ranitidine-induced mental confusion. Critical Care Medicine 15: 1165–1166, 1987.

    PubMed  CAS  Google Scholar 

  80. Fernandez E, Melewicz CZ. Ranitidine and theophylline. Annals of Internal Medicine 100: 459, 1984.

    Google Scholar 

  81. Filingeri V, Giacomelli R, Famularo G, Rosati R, Nardi S, et al. Evidence of drug interaction between cyclosporin A and H2-receptor antagonists (cimetidine, ranitidine and famotidine) in Sprague-Dawley rats. Drugs Under Experimental and Clinical Research 15: 159–164, 1989.

    PubMed  CAS  Google Scholar 

  82. Fujimura A, Ohashi K, Sudo T, Sakamoto K, Oka T, et al. Effects of H2-receptor antagonists on plasma aldosterone response to angiotensin II in healthy subjects; comparison of cimetidine and ranitidine. Journal of Clinical Pharmacology 29: 230–233, 1989.

    PubMed  CAS  Google Scholar 

  83. Gafter U, Zevin D, Komlos L, Livni E, Levi J. Thrombocytopenia associated with hypersensitivity to ranitidine: possible cross-reactivity with cimetidine. American Journal of Gastroenterology 84: 560–562, 1989.

    PubMed  CAS  Google Scholar 

  84. Gardner MJ, Sikorsky GW. Ranitidine and theophylline. Archives of Internal Medicine 102: 559, 1985.

    CAS  Google Scholar 

  85. Garemore R. Extrapyramidal reaction to a drug. Journal of Emergency Nursing 11: 65, 1985.

    PubMed  CAS  Google Scholar 

  86. Garg DC, Weidler DJ, Jailad S, Enheiman FN. The effects of ranitidine and cimetidine on hepatic blood flow. Clinical Pharmacology and Therapeutics 31: 228, 1982.

    Google Scholar 

  87. Gelwan JS, Schmitz RL, Pellechia C. Ranitidine and leukocytosis. American Journal of Medicine 81: 685–687, 1986.

    CAS  Google Scholar 

  88. Gibson PR, Pidcock ME. Immune mediated thrombocytopenia associated with ranitidine therapy. Medical Journal of Australia 145: 661–662, 1986.

    PubMed  CAS  Google Scholar 

  89. Giovannini M, Bourliere M, Laugier R, Monges A. Effets neuropsychiatriques de la ranitidine: à propos de 2 cas. Annals de Gastroentérologie et d’Hépatologie 23: 281, 1987.

    CAS  Google Scholar 

  90. Goelzer SL, Farin-Rush C, Coursin DB. Ranitidine produces minimal hemodynamic depression in stable intensive care unit patients: a double-blind, prospective study. Critical Care Medicine 16: 8–10, 1988.

    PubMed  CAS  Google Scholar 

  91. Goff DG, Garber HJ, Jenike MA. Partial resolution of ranitidine-associated delirium with physostigmine: case report. Journal of Clinical Psychiatry 46: 400–401, 1985.

    PubMed  CAS  Google Scholar 

  92. Goh CL, Ng SK. Allergic contact dermatitis to ranitidine. Contact Dermatitis 11: 252, 1984.

    PubMed  CAS  Google Scholar 

  93. Grainger SI, Ainley CC, Thompson RPH. Do H2-receptor antagonists affect liver blood flow and why? Gut 25: 571 A, 1984

    Google Scholar 

  94. Grange JD. Duodenal erosions during ranitidine treatment. British Medical Journal 293: 823, 1986.

    Google Scholar 

  95. Grant SM, Langtry HD, Brogden RN. Ranitidine: an updated review of its pharmacodynamic and pharmacokinetic properties and therapeutic use in peptic ulcer disease and other allied diseases. Drugs 37: 801–870, 1989.

    PubMed  CAS  Google Scholar 

  96. Greenblatt DJ, Kowalsky SF. Benzodiazepine interaction with cimetidine and ranitidine: a critical literature analysis. Advances in Therapy 5: 191–209, 1988.

    Google Scholar 

  97. Greenblatt DJ, Locknisar A, Ochs HR, Harmatz JS, Shader RI. Kinetics of intravenous and oral midazolam: interaction with cimetidine and ranitidine. Journal of Clinical Pharmacology 25: 460, 1986.

    Google Scholar 

  98. Greer IA, Fellows K. Anaphylactoid reaction to ranitidine in labour. British Journal of Clinical Practice 44: 78, 1990.

    PubMed  CAS  Google Scholar 

  99. Guay DR, Meatherall RC, Chalmers JL, Grahame GR, Hudson RJ. Ranitidine does not alter pethidine disposition in man. British Journal of Clinical Pharmacology 20: 55–59, 1985.

    PubMed  CAS  Google Scholar 

  100. Guslandi M, Testoni PA, Masci E. Effect of H2-receptor blockade on gastric mucus composition: a comparative study with ranitidine and famotidine. Journal of International Medical Research 15: 224–226, 1987.

    PubMed  CAS  Google Scholar 

  101. Gwee MCE, Cheah LS. Actions of cimetidine and ranitidine at some cholinergic sites: implications in toxicology and anesthesia. Life Sciences 39: 383–388, 1986.

    PubMed  CAS  Google Scholar 

  102. Haboubi N, Asquith P. Rash mediated by immune complexes associated with ranitidine treatment. British Medical Journal 296: 897, 1988.

    PubMed  CAS  Google Scholar 

  103. Hamborg B, Kittang E, Schjonsby H. The effect of ranitidine on the absorption of food cobalamins. Scandinavian Journal of Gastroenterology 20: 756–758, 1985.

    PubMed  CAS  Google Scholar 

  104. Hansen WE, Berti S. Inhibition of cholinesterases by ranitidine. Lancet 1: 235, 1984.

    Google Scholar 

  105. Harmon DC, Shuman R. Ranitidine. New England Journal of Medicine 310: 1604, 1984.

    Google Scholar 

  106. Hart AM. Cardiac arrest associated with ranitidine. British Medical Journal 299: 519, 1989.

    PubMed  CAS  Google Scholar 

  107. Heagerty AM, Castleden CM, Patel L. Failure of ranitidine to interact with propranolol. British Medical Journal 284: 1304, 1982.

    PubMed  CAS  Google Scholar 

  108. Hegarty JE. Ranitidine and hepatotoxicity. Lancet 1: 223, 1985.

    PubMed  CAS  Google Scholar 

  109. Henann N, Carpenter D, Janda S. Famotidine-associated mental confusion in elderly patients. Drug Intelligence and Clinical Pharmacy 22: 967–968, 1988.

    Google Scholar 

  110. Herrera A, Solal-Celigny P, Dresch C, Vallin J, Bernades P. Ranitidine. New England Journal of Medicine 310: 1604–1605, 1984.

    Google Scholar 

  111. Herrmann R, Shaw RG, Fone DJ. Ranitidine-associated recurrent acute pancreatitis. Australian and New Zealand Journal of Medicine 20: 243–244, 1990.

    PubMed  CAS  Google Scholar 

  112. Hiesse C, Cantarovich M, Santelli C, Francais P, Charpentier B, et al. Ranitidine hepatotoxicity in renal transplant patient. Lancet 1: 1280, 1985.

    PubMed  CAS  Google Scholar 

  113. Hine KR, Holmes GKT, Milnes JP, Phillips A, Poynter D, et al. Microscopic examination of gastric biopsies from patients treated with ranitidine. Gastroenterology 82: 1085, 1982.

    Google Scholar 

  114. Hirsch E. Famotidine and ranitidine but not cimetidine cause severe, disabling headache. American Journal of Gastroenterology 84: 202–203, 1989.

    PubMed  CAS  Google Scholar 

  115. Hoensch HP, Hutzel H, Kirch W, Ohnhaus EE. Isolation of human hepatic microsomes and their inhibition by cimetidine and ranitidine. European Journal of Clinical Pharmacology 29: 199–206, 1985.

    PubMed  CAS  Google Scholar 

  116. Hofman J, Michalska I, Kuczewska B, Chyrek-Borowska S. The influence of cimetidine and ranitidine on basophil histamine release and bronchial reactivity in asthmatic patients. Agents and Actions 20: 317–319, 1987.

    PubMed  CAS  Google Scholar 

  117. Holtzman JL, Gebhard RL, Eckfeldt JH, Mottonen LR, Finley DK, et al. The effects of several weeks of ethanol consumption on ethanol kinetics in normal men and women. Clinical Pharmacology and Therapeutics 38: 157–163, 1985.

    PubMed  CAS  Google Scholar 

  118. Hughes DG, Dowling EA, Demeersman RE, Garnett WR, Karnes HT. Cardiovascular effects of H2-receptor antagonists. Journal of Clinical Pharmacology 29: 472–477, 1989.

    PubMed  CAS  Google Scholar 

  119. Hughes RD, Reed WD, Sergeant CS. Mental confusion associated with ranitidine. Medical Journal of Australia 2: 12–13, 1983.

    PubMed  CAS  Google Scholar 

  120. Hussey EK, Dukes GE. Do all histamine2-antagonists cause a warfarin drug interaction? Drug Intelligence and Clinical Pharmacy 23: 675–679, 1989.

    CAS  Google Scholar 

  121. Iliopoulou A, Kontogiannis D, Tsoutos D, Moulopoulos S. Quinidine-ranitidine adverse reaction. European Heart Journal 7: 360, 1986.

    PubMed  CAS  Google Scholar 

  122. Inman WHW. Zantac. PEM News: August 9–13, 1983.

  123. Jack D, Smith RN, Richards DA. Histamine H2 antagonists and the heart. Lancet 2: 1281, 1982.

    PubMed  CAS  Google Scholar 

  124. Jack D, Thomas M, Skidmore IF. Ranitidine and paracetamol metabolism. Lancet 2: 1067, 1985.

    PubMed  CAS  Google Scholar 

  125. Jackson G, Upward JW. Cimetidine, ranitidine and heart rate. Lancet 2: 266, 1982.

    Google Scholar 

  126. Jackson JE, Bentley JB, Glass SJ, Fukui T, Gandolfi AJ, et al. Effects of histamine-2 receptor blockade on lidocaine kinetics. Clinical Pharmacology and Therapeutics 37: 544–548, 1985.

    PubMed  CAS  Google Scholar 

  127. Jansen EC, Brynskov J, Thysssen HH. Influence of ranitidine on postural stability. Lancet 1: 55–56, 1982.

    PubMed  CAS  Google Scholar 

  128. Jarowenko MV, Van Buren CT, Kramer WG, Lorber MI, Flechner SM, et al. Ranitidine, cimetidine and the cyclosporinetreated recipient. Transplantation 42: 311–312, 1986.

    PubMed  CAS  Google Scholar 

  129. Jensen JC, Gugler R. Relevant inhibition of acetylcholinesterase with H2-receptor antagonists. Zeitschrift für Gastroenterology 22: 109–112, 1984.

    CAS  Google Scholar 

  130. Jensen RT, Collen MJ, Pandol SJ, Allende HD, Raufman JP, et al. Cimetidine-induced impotence and breast changes in patients with gastric hypersecretory states. New England Journal of Medicine 308: 883–887, 1983.

    PubMed  CAS  Google Scholar 

  131. Johnson WS, Miller DR. Ranitidine and bradycardia. Annals of Internal Medicine 108: 493, 1988.

    PubMed  CAS  Google Scholar 

  132. Kagevi I, Wahlby L. CSF concentrations of ranitidine. Lancet 1: 164–165, 1985.

    PubMed  CAS  Google Scholar 

  133. Karachalios GN. Ranitidine and hepatitis. Annals of Internal Medicine 103: 634–635, 1985.

    PubMed  CAS  Google Scholar 

  134. Kelly HW. Lack of evidence for reduction of theophylline clearance by ranitidine. American Journal of Medicine 86: 629–630, 1989.

    PubMed  CAS  Google Scholar 

  135. Kelly HW, Powell JR, Donohue JF. Ranitidine at very large doses does not inhibit theophylline elimination. Clinical Pharmacology and Therapeutics 39: 577–581, 1986.

    PubMed  CAS  Google Scholar 

  136. Kelly JG, Salem SAM, Kinney CD, Shanks RG, McDevitt DG. Effects of ranitidine on the disposition of metoprolol. British Journal of Clinical Pharmacology 19: 219–224, 1985.

    PubMed  CAS  Google Scholar 

  137. Kendall MJ, Laugher SJ, Wilkins MR. Ranitidine, cimetidine and metoprolol: a pharmacokinetic interaction study. Gastroenterology 90: 1490, 1986a.

    Google Scholar 

  138. Kendall MJ, Lobo J, Wilkins MR. Ranitidine, cimetidine and nifedipine: a pharmacokinetic interaction study. Gastroenterology 90: 1490, 1986b.

    Google Scholar 

  139. Kenyon CJ, Fraser R, Birnie GG, Connell JMC, Lever AF. Dose related in vitro effects of ranitidine and cimetidine on basal and ACTH-stimulated steroidogenesis. Gut 27: 1143–1146, 1986.

    PubMed  CAS  Google Scholar 

  140. Khera DC, Smith SL, Slabic SF. Ranitidine-induced bradycardia. American Journal of Gastroenterology 83: 332–333, 1988.

    PubMed  CAS  Google Scholar 

  141. Kirch W, Hoensch H, Janisch HD. Interactions and non-interactions with ranitidine. Clinical Pharmacokinetics 9: 493–510, 1984a.

    PubMed  CAS  Google Scholar 

  142. Kirch W, Hutt HJ, Heidemann H, Ramsch K, Janisch HD, et al. Drug interactions with nitrendipine. Journal of Cardiovascular Pharmacology 6 (Suppl. 7): S982–S985, 1984b

    PubMed  CAS  Google Scholar 

  143. Kirch W, Milferstädt S, Halabi A, Rocher I, Efthymiopoulos C, et al. Interaction of tertatolol with rifampicin and ranitidine pharmacokinetics and antihypertensive activity. Cardiovascular Drugs and Therapy 4: 487–492, 1990.

    PubMed  CAS  Google Scholar 

  144. Kirch W, Ramsch K, Janisch HD, Ohnhaus EE. The influence of two histamine H2-receptor antagonists, cimetidine and ranitidine, on the plasma levels and clinical effect of nifedipine and metoprolol. Archives of Toxicology (Suppl. 7): 256–259, 1984c.

    PubMed  CAS  Google Scholar 

  145. Klotz U, Arvela P, Rosenkranz BZ. Effect of single doses of cimetidine and ranitidine on the steady-state plasma levels of midazolam. Clinical Pharmacology and Therapeutics 38: 652–625, 1985.

    PubMed  CAS  Google Scholar 

  146. Klotz U, Reimann IW, Ohnhaus EE. Effect of ranitidine on the steady state pharmacokinetics of diazepam. European Journal of Clinical Pharmacology 24: 357–360, 1983.

    PubMed  CAS  Google Scholar 

  147. Knigge U, Thuesen B, Dejgaard A, Bennett P, Christiansen PM. Plasma concentrations of pituitary and peripheral hormones during ranitidine treatment for two years in men with duodenal ulcer. European Journal of Clinical Pharmacology 37: 305–307, 1989.

    PubMed  CAS  Google Scholar 

  148. Knodell RG, Hotlzman JL, Crankshaw DL, Steele NW, Stanley LN. Drug metabolism by rat and human hepatic microsomes in response to receptor antagonists. Gastroenterology 82: 84–88, 1982.

    PubMed  CAS  Google Scholar 

  149. Kohn A, Suriano G, Prantera C, Annibale B, Delle Fave G. Hypergastrinaemia after long-term H2-blocker treatment. Lancet 2: 1466–1467, 1987.

    PubMed  CAS  Google Scholar 

  150. Kowalsky SF. Lidocaine interaction with cimetidine and ranitidine: a critical analysis of the literature. Advances in Therapy 5: 229–244, 1988.

    Google Scholar 

  151. Kubacka R, Antal EJ, Juhl RP. The effects of cimetidine and ranitidine on glyburide pharmacokinetics. Drug Intelligence and Clinical Pharmacy 19: 461, 1985.

    Google Scholar 

  152. Kubacka R, Antal EJ, Juhl RP. The paradoxical effect of cimetidine and ranitidine on glibenclamide pharmacokinetics and pharmacodynamics. British Journal of Clinical Pharmacology 23: 743–751, 1987.

    PubMed  CAS  Google Scholar 

  153. Kurowski M, Reim HG. Metabolische Interaktion zwischen Cimetidin, Ranitidin und Amitriptylin/Chlordiazepoxid. Zeitschrift für Gastroenterologie 24: 627–634, 1986.

    PubMed  CAS  Google Scholar 

  154. Lalonde RL, North DS, Mattern AL, Kapil RP. Tocainide pharmacokinetics after H2-antagonists. Clinical Pharmacology and Therapeutics 41: 241, 1987.

    Google Scholar 

  155. Lane GP, Speed B. Agranulocytosis after ranitidine administration. Medical Journal of Australia 150: 595–596, 1989.

    PubMed  CAS  Google Scholar 

  156. Lanzon-Miller S, Pounder RE, Hamilton MR, Ball S, Cronos NAF, et al. Twenty-four-hour intragastric acidity and plasma gastrin concentration before and during treatment with either ranitidine or omeprazole. Alimentary Pharmacology and Therapeutics 1: 239–251, 1987.

    PubMed  CAS  Google Scholar 

  157. Lauritsen K, Havelund T, Rask-Madsen J, Fenger C. Ranitidine and hepatotoxicity. Lancet 2: 1471, 1984.

    PubMed  CAS  Google Scholar 

  158. La Vecchia C, Negri E, D’Avanzo B, Franceschi S. Histamine-2-receptor antagonists and gastric cancer risk. Lancet 2: 355–357, 1990.

    Google Scholar 

  159. Lehmann AB. Reversible chorea due to ranitidine and cimetidine. Lancet 2: 158, 1988.

    PubMed  CAS  Google Scholar 

  160. Leonard TB, Morgan DG, Dent JG. Ranitidine-acetaminophen interaction: effects on acetaminophen-induced hepatotoxicity in Fischer 344 rats. Hepatology 5: 480–487, 1985.

    PubMed  CAS  Google Scholar 

  161. Lewis JH. Hepatic effects of drugs used in the treatment of peptic ulcer disease. American Journal of Gastroenterology 82: 987–1003, 1987.

    PubMed  CAS  Google Scholar 

  162. Liedberg G, Fletcher E, Davies J. Cimetidine, ranitidine and heart rate. Lancet 2: 265, 1982.

    Google Scholar 

  163. List AF, Beaird DH, Kummet T. Ranitidine-induced granulocytopenia: recurrence with cimetidine administration. Annals of Internal Medicine 108: 566–567, 1988.

    PubMed  CAS  Google Scholar 

  164. Lombardo L. Reversible amenorrhoea after ranitidine treatment. Lancet 1: 224, 1982.

    PubMed  CAS  Google Scholar 

  165. Lombardo L. More about ranitidine and hyperprolactinaemia. Lancet 2: 42–43, 1983.

    PubMed  CAS  Google Scholar 

  166. Mani RB, Spellun JS, Frank JH, Laureno R. H2-receptor blockers and mental confusion. Lancet 2: 98, 1984.

    Google Scholar 

  167. Martinez-Abad M, Gomis FD, Ferrer JM, Morales-Olivas FJ. Ranitidine-induced confusion with concomitant morphine. Drug Intelligence and Clinical Pharmacy 22: 914–915, 1988.

    PubMed  CAS  Google Scholar 

  168. Mashford ML, Harman PJ, Morphett BJ, Breen KJ, Desmonds PV. Ranitidine does not affect chlormethiazole or indocyanine green disposition. Clinical Pharmacology and Therapeutics 34: 231–233, 1983.

    PubMed  CAS  Google Scholar 

  169. Mavier P, Preaux AM, Delchier JC, Beauchaut M, Dhumeaux D. Comparaison des effets de la cimétidine et de la ranitidine in vivo et in vitro sur le système enzymatique microsomial hépatique chez le rat. Gastroentérologie Clinique et Biologique 7: 244–250, 1983.

    PubMed  CAS  Google Scholar 

  170. McDermott AJ, Insole J, Kaufman B. Acute confusional episodes during treatment with ranitidine. British Medical Journal 294: 1616, 1987.

    Google Scholar 

  171. McEwen J, Moreland TA, McMurdo ME. Influence of pretreatment with 300 mg/day ranitidine, 800 mg/day cimetidine and placebo on the pharmacokinetics of oral theophylline in healthy subjects. Gastroenterology 90: 1542, 1986.

    Google Scholar 

  172. McWalter RS, El Debani AH, Feely J, Stevenson IH. Potentation by ranitidine of the hypoglycaemic response to glipizide in diabetic patients. Proceedings of the BPS, 11–14 September, 121P, 1984

    Google Scholar 

  173. Merrett AC, Marks R, Dudley FJ. Cimetidine-induced erythema annulare centrifugum: no cross sensitivity with ranitidine. British Medical Journal 283: 698, 1981.

    PubMed  CAS  Google Scholar 

  174. Mignon M, Vallot T, Bonfils S. Gynaecomastia and histamine H2-antagonists. Lancet 2: 499, 1982.

    PubMed  CAS  Google Scholar 

  175. Miller JM, Nelson HS. Suppression of immediate skin tests by ranitidine. Journal of Allergy and Clinical Immunology 84: 895–899, 1989.

    PubMed  CAS  Google Scholar 

  176. Mills JG, Wood JR. The pharmacology of histamine H2-receptor antagonists. Methods and Findings in Experimental and Clinical Pharmacology 11 (Suppl. 1): 87–95, 1989.

    PubMed  CAS  Google Scholar 

  177. Mitchard M, Harris A, Mullinger BM. Ranitidine drug interactions — a literature review. Pharmacology and Therapeutics 32: 293–325, 1987.

    PubMed  CAS  Google Scholar 

  178. Mutschler E, Spahn H, Kirch W. The interaction between H2-receptor antagonists and β-adrenoreceptor blockers. British Journal of Clinical Pharmacology 17: 51S–57S, 1984

    PubMed  Google Scholar 

  179. Nakatini T. Granulocytopenia associated with ranitidine in a patient with renal transplant. British Medical Journal 295: 333, 1987.

    Google Scholar 

  180. Nicholson AN, Stone BM. The H2-antagonists, cimetidine and ranitidine: studies on performance. European Journal of Clinical Pharmacology 26: 579–582, 1984.

    PubMed  CAS  Google Scholar 

  181. Nielsen HJ, Moesgaard F, Kehlet H. Ranitidine for prevention of postoperative suppression of delayed hypersensitivity. American Journal of Surgery 157: 291–294, 1989.

    PubMed  CAS  Google Scholar 

  182. O’Reilly RA. Comparative interaction of cimetidine and ranitidine with racemic warfarin in man. Archives of Internal Medicine 144: 989–991, 1984.

    PubMed  Google Scholar 

  183. Ochs HR, Greenblatt DJ, Mattis R, Weinbrenner J. Interaction of ibuprofen with the H2 receptor antagonists ranitidine and cimetidine. Clinical Pharmacology and Therapeutics 38: 648–651, 1985.

    PubMed  CAS  Google Scholar 

  184. Offit K, Sojka DA. Ranitidine. New England Journal of Medicine 310: 1603, 1984.

    Google Scholar 

  185. Oikkonen M, Rosenberg PH, Saarnivaara L. Cimetidine and ranitidine do not affect enflurane metabolism in surgical patients. Acta Anaesthesiologica Scandinavica 33: 129–131, 1989.

    PubMed  CAS  Google Scholar 

  186. Oldham HG, Norman SJ, Chenery RJ. Primary cultures of adult rat hepatocytes: a model for the toxicity of histamine H2-receptor antagonists. Toxicology 36: 215–229, 1986.

    Google Scholar 

  187. Parkin JV, Ackroyd EB, Glickman S, Hobsley M, Lorenz W. Release of histamine by H2-receptor antagonists. Lancet 2: 938–939, 1982.

    PubMed  CAS  Google Scholar 

  188. Pasquali R, Corinaldesi R, Miglioli M, Melchionda N, Capelli M, et al. Effect of prolonged administration of ranitidine on pituitary and thyroid hormones, and their response to specific hypothalamic-releasing factors. Clinical Endocrinology 15: 457–462, 1981.

    PubMed  CAS  Google Scholar 

  189. Patterson JF. Mania associated with intravenous ranitidine therapy. Southern Medical Journal 80: 1467, 1987.

    PubMed  CAS  Google Scholar 

  190. Pearson MW. Thrombocytopenia associated with ranitidine. British Medical Journal 292: 489, 1986.

    Google Scholar 

  191. Peden NR, Boyd EJS, Browning MCK, Saunders JHB, Wormsley KG. Effects of two histamine H2-receptor blocking drugs on basal levels of gonadotrophins, prolactin, testosterone and oestradiol-17β during treatment of duodenal ulcer in male patients. Acta Endocrinologica 96: 564–568, 1981.

    PubMed  CAS  Google Scholar 

  192. Peden NR, Wormsley KG. Alleged impotence with ranitidine. Lancet 2: 798, 1983.

    Google Scholar 

  193. Pedrazzoli S, Petrin P, Pasquali C, Militello C, Sperti C, et al. Ranitidine reverses cimetidine-induced mental confusion in a patient with Zollinger-Ellison syndrome. Archives of Surgery 118: 256, 1983.

    PubMed  CAS  Google Scholar 

  194. Penston J, Wormsley KG. Adverse reactions and interactions with H2-receptor antagonists. Medical Toxicology 1: 192–216, 1986.

    PubMed  CAS  Google Scholar 

  195. Penston J, Wormsley KG. Efficacy and safety of long-term maintenance therapy of duodenal ulcers. Scandinavian Journal of Gastroenterology 24: 1145–1152, 1989.

    PubMed  CAS  Google Scholar 

  196. Perret G, Hugues JN, Louchahi M, Varoquaux O, Modigliani E. Effect of a short-term oral administration of cimetidine and ranitidine on the basal and thyrotropin-releasing hormone-stimulated serum concentrations of prolactin, thyrotropin and thyroid hormones in healthy volunteers: a double-blind crossover study. Pharmacology 32: 101–108, 1986.

    PubMed  CAS  Google Scholar 

  197. Phillips P, Hansky J. Phenytoin toxicity secondary to cimetidine administration. Medical Journal of Australia 141: 602, 1984.

    PubMed  CAS  Google Scholar 

  198. Picardo M, Santucci B. Urticaria from ranitidine. Contact Dermatitis 9: 327, 1983.

    PubMed  CAS  Google Scholar 

  199. Pixley JS, McKintosh FR, Sahr E, Zanjani ED. Mechanism of ranitidine associated anemia. American Journal of the Medical Sciences 297: 369–371, 1989.

    PubMed  CAS  Google Scholar 

  200. Plummer JL, Wanwimolruk S, Jenner MA, de la Hall P, Cousins MJ. Effects of cimetidine and ranitidine on halothane metabolism and hepatotoxicity in an animal model. Drug Metabolism and Disposition 12: 106–110, 1984.

    PubMed  CAS  Google Scholar 

  201. Poulakos JJ, Gertner SB. Studies on the cardiovascular actions of central histamine H1 and H2 receptors. Journal of Pharmacology and Experimental Therapeutics 250: 500–507, 1989.

    PubMed  CAS  Google Scholar 

  202. Powell JR, Donn KH. Histamine H2-antagonist drug interactions in perspective: mechanistic concepts and clinical implications. American Journal of Medicine 77 (Suppl. 5B): 57–84, 1984.

    PubMed  CAS  Google Scholar 

  203. Powell JR, Rogers JF, Wargin WA, Cross RE, Eshelman FN. Inhibition of theophylline clearance by cimetidine but not ranitidine. Archives of Internal Medicine 144: 484–486, 1984.

    PubMed  CAS  Google Scholar 

  204. Price W, Coli L, Brandstetter RD, Gotz P. Ranitidine-associated hallucinations. European Journal of Clinical Pharmacology 29: 375–376, 1985.

    PubMed  CAS  Google Scholar 

  205. Proctor JD. Hepatitis associated with ranitidine. Journal of the American Medical Association 251: 1554, 1984.

    PubMed  CAS  Google Scholar 

  206. Reid CDL, Kirk A. Ranitidine fails to suppress the growth in vitro of haemopoietic progenitors from human peripheral blood and bone marrow. Human Toxicology 8: 19–22, 1989.

    PubMed  CAS  Google Scholar 

  207. Reimann IW, Klotz U, Frolich JC. Effects of cimetidine and ranitidine on steady-state propranolol kinetics and dynamics. Clinical Pharmacology and Therapeutics 32: 749–757, 1982.

    PubMed  CAS  Google Scholar 

  208. Rendic S, Alebic-Kolbah T, Kajfez F, Ruff HH. Interaction of ranitidine with liver microsomes. Xenobiotica 12: 9–17, 1982.

    PubMed  CAS  Google Scholar 

  209. Rendic S, Ruff HH, Weber P, Kajfez F. Cimetidine and ranitidine: their interaction with human and pig liver microsomes and with purified cytochrome P-450. European Journal of Drug Metabolism and Pharmacokinetics 9: 195–200, 1984.

    PubMed  CAS  Google Scholar 

  210. Ribert A, Balas D, Bastie MJ, Senegas-Balas F, Escourrou J, et al. Long term effects of H2-receptor antagonists (cimetidine and ranitidine) on the human gastric and duodenal mucosa. Scandinavian Journal of Gastroenterology 16 (Suppl. 70): 155–174, 1981.

    Google Scholar 

  211. Robson RA, Wing LMH, Miners JO, Lillywhite KJ, Birkett DJ. The effect of ranitidine on the disposition of lignocaine. British Journal of Clinical Pharmacology 20: 170–173, 1985.

    PubMed  CAS  Google Scholar 

  212. Rodvold KA, Paloucek FP, Jung D, Gallastegui J. Interaction of steady-state procainamide with H2-receptor antagonists cimetidine and ranitidine. Therapeutic Drug Monitoring 9: 378–383, 1987.

    PubMed  CAS  Google Scholar 

  213. Rogers SA, Gale KC, Newton JF, Dent JG, Leonard TB. Inhibition by ranitidine of acetaminophen conjugation and its possible role in ranitidine potentation of acetaminophen-induced hepatotoxicity. Journal of Pharmacology and Experimental Therapeutics 245: 887–894, 1988.

    PubMed  CAS  Google Scholar 

  214. Romaguera C, Grimait F, Vilaplana J. Epidemic of occupational contact dermatitis from ranitidine. Contact Dermatitis 18: 177–178, 1988.

    PubMed  CAS  Google Scholar 

  215. Rosse RB. Cimetidine and mental status change. Journal of Clinical Psychiatry 47: 99, 1986.

    PubMed  CAS  Google Scholar 

  216. Roy AK, Cuda MP, Levine RA. Induction of theophylline toxicity and inhibition of clearance rates by ranitidine. American Journal of Medicine 85: 525–527, 1988.

    PubMed  CAS  Google Scholar 

  217. Roy AK. Induction of theophylline toxicity and inhibition of clearance rates by ranitidine. American Journal of Medicine 86: 513, 1989.

    PubMed  CAS  Google Scholar 

  218. Ruff F. Interférences médicamenteuses de la théophylline: absence d’interaction théophylline-ranitidine. Nouvelle Presse Médicale 11: 3512, 1982.

    PubMed  CAS  Google Scholar 

  219. Rycroft RJG. Allergic contact dermatitis from a novel diamino intermediate, 5-[(2-aminoethyl)thiomethyl]-N,N-dimethyl-2-furanmethanamine, in laboratory synthesis. Contact Dermatitis 9: 456–458, 1983.

    PubMed  CAS  Google Scholar 

  220. Sachs G, Kowalsky SF. Acetaminophen interaction with cimetidine and ranitidine: a critical analysis of the literature. Advances in Therapy 5: 257–272, 1988.

    Google Scholar 

  221. Sancho JM, Robles RG, Mcheno E. Interference by ranitidine with aldosterone secretion in vivo. European Journal of Clinical Pharmacology 27: 495, 1984.

    PubMed  CAS  Google Scholar 

  222. Sax MJ. Analysis of possible drug interactions between cimetidine (and ranitidine) and β-blockers. Advances in Therapy 5: 210–228, 1988.

    Google Scholar 

  223. Sax MJ, Sawyer WT. Warfarin interactions with cimetidine and ranitidine: a critical analysis of the literature. Advances in Therapy 5: 153–167, 1988.

    Google Scholar 

  224. Scavone JM, Greenblatt DJ, Matlis R, Harmatz JS. Interaction of oxaprozin with acetaminophen, cimetidine, and ranitidine. European Journal of Clinical Pharmacology 31: 371–374, 1986.

    PubMed  CAS  Google Scholar 

  225. Scobie IN, Saunders J, Barnes GD, Hoad J, Wheeler MJ, et al. A comparative study of the effects of ranitidine and cimetidine on carbohydrate tolerance, growth hormone secretion and the hypothalamic-pituitary-gonadal axis in man. Current Medical Research and Opinion 10: 285–290, 1986.

    PubMed  CAS  Google Scholar 

  226. Seggev JS, Barzilay M, Schey G. No evidence for interaction between ranitidine and theophylline. Archives of Internal Medicine 147: 179–180, 1987.

    PubMed  CAS  Google Scholar 

  227. Seitz HK, Bösche J, Czygan P, Veith S, Simon B, et al. Increased blood ethanol levels following cimetidine but not ranitidine. Lancet 1: 760, 1983.

    PubMed  CAS  Google Scholar 

  228. Serlin MJ, Sibeon RG, Breckenridge AM. Lack of effect of ranitidine on warfarin action. British Journal of Clinical Pharmacology 12: 791–794, 1981.

    PubMed  CAS  Google Scholar 

  229. Shah RR. Symptomatic bradycardia in association with H2-receptor antagonists. Lancet 2: 1108, 1982.

    PubMed  CAS  Google Scholar 

  230. Shields LI, Files JA, Doll DC, Greenberg BR. Ranitidine and agranulocytosis. Annals of Internal Medicine 104: 128, 1986.

    PubMed  CAS  Google Scholar 

  231. Shimp LA, Smith MA, Wahr DW. Ranitidine-induced chest pain. Drug Intelligence and Clinical Pharmacy 23: 224–226, 1989.

    CAS  Google Scholar 

  232. Silverstone PH. Ranitidine and confusion. Lancet 1: 1071, 1984.

    Google Scholar 

  233. Simon B, Muller P, Dammann HG. Safety profile of ranitidine. In Riley & Salmon (Eds) Ranitidine: proceedings of an International Symposium held in the context of the Seventh World Congress of Gastroenterology, pp. 181–189, Excerpta Medica, Amsterdam, 1982

    Google Scholar 

  234. Sirgo MA. Rocci ML, Ferguson RK, Eshelman FN, Vlasses PH. Effects of cimetidine and ranitidine on the conversion of prednisone to prednisolone. Clinical Pharmacology and Therapeutics 37: 534–538, 1985.

    PubMed  CAS  Google Scholar 

  235. Skinner MH, Lenert L, Blaschke TF. Theophylline toxicity subsequent to ranitidine administration: a possible drug-drug interaction. American Journal of Medicine 86: 129–132, 1989.

    PubMed  CAS  Google Scholar 

  236. Smith CL, Bardgett DM, Hunter JM. Haemodynamic effects of the IV administration of cimetidine or ranitidine in the critically ill patient. British Journal of Anaesthesia 59: 1397–1402, 1987a.

    PubMed  CAS  Google Scholar 

  237. Smith RN, Elsdon-Dew RW. Alleged impotence with ranitidine. Lancet 2: 798, 1983.

    Google Scholar 

  238. Smith SR, Kendall MJ. Ranitidine versus cimetidine. A comparison of their potential to cause clinically important drug interactions. Clinical Pharmacokinetics 15: 44–56, 1988.

    PubMed  CAS  Google Scholar 

  239. Smith SR, Kendall MJ, Lobo J, Beerahee A, Jack DB, et al. Ranitidine and cimetidine: drug interactions with single dose and steady-state nifedipine administration. British Journal of Clinical Pharmacology 23: 311–315, 1987b.

    PubMed  CAS  Google Scholar 

  240. Somogyi A, 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.

    PubMed  CAS  Google Scholar 

  241. Sonnenblick M, Yinnon A. Mental confusion as a side effect of ranitidine. American Journal of Psychiatry 143: 257, 1986.

    PubMed  CAS  Google Scholar 

  242. Souza Lima MA. Hepatitis associated with ranitidine. Annals of Internal Medicine 101: 207–208, 1984.

    PubMed  CAS  Google Scholar 

  243. Souza Lima MA. Ranitidine and hepatic injury. Annals of Internal Medicine 105: 140, 1986.

    PubMed  CAS  Google Scholar 

  244. Spahn H, Mutschler E, Kirch W, Ohnhaus EE, Janisch HD. Influence of ranitidine on plasma metoprolol and atenolol concentrations. British Medical Journal 286: 1546–1547, 1983.

    PubMed  CAS  Google Scholar 

  245. Speeg KV, Christian DC, Mitchell MC. Ranitidine and acetaminophen hepatotoxicity. Annals of Internal Medicine 100: 315–316, 1984.

    PubMed  CAS  Google Scholar 

  246. Speeg KV, Maldonado AL. Acetaminophen hepatotoxicity: lack of potentiation by ranitidine. Gastroenterology 90: 1770, 1986.

    Google Scholar 

  247. Spina E, Koike Y. Differential effects of cimetidine and ranitidine on imipramine demethylation and desmethylimipramine hydroxylation by human liver microsomes. European Journal of Clinical Pharmacology 30: 239–242, 1986.

    PubMed  CAS  Google Scholar 

  248. Spurling NW, Selway SAM, Poynter D. An evaluation of the safety of ranitidine during seven years daily oral administration to beagle dogs. Human Toxicology 8: 23–32, 1989.

    PubMed  CAS  Google Scholar 

  249. Spychal RT, Wickham NWR. Thrombocytopenia associated with ranitidine. British Medical Journal 291: 1687, 1985.

    PubMed  CAS  Google Scholar 

  250. Staiger C, Simon B, Walter E, Kather H. Influence of ranitidine on antipyrine pharmacokinetics in healthy volunteers. Digestive Diseases and Sciences 25: 894, 1980.

    PubMed  CAS  Google Scholar 

  251. Sullivan KM, Small RE, Rock WL, Cox SR, Willis HE. Effects of cimetidine or ranitidine on the pharmacokinetics of flurbiprofen. Clinical Pharmacy 5: 586–589, 1986.

    PubMed  CAS  Google Scholar 

  252. Sutherland DL, Remillard AJ, Haight KR, Brown MA, Old L. The influence of cimetidine versus ranitidine on doxepin pharmacokinetics. European Journal of Clinical Pharmacology 32: 159–164, 1987.

    PubMed  CAS  Google Scholar 

  253. Swedish Adverse Drug Reactions Advisory Committee. Ranitidine and arthralgia. Bulletin 55: 2, 1990

    Google Scholar 

  254. Tanner LA, Arrowsmith JB. Bradycardia and H2 antagonists. Annals of Internal Medicine 109: 434, 1988.

    PubMed  CAS  Google Scholar 

  255. Texereau P, Ancelin P, Briaud M, Moussie D. Un cas d’agranulocytose aiguë chez un malade traité par ranitidine. Gastroentérologie Clinique et Biologique 11: 829–830, 1987.

    PubMed  CAS  Google Scholar 

  256. Theofilopoulos N, Szabadi E, Bradshaw CM. Comparison of the effects of ranitidine, cimetidine and thioridazine on psychomotor functions in healthy volunteers. British Journal of Clinical Pharmacology 18: 135–144, 1984.

    PubMed  CAS  Google Scholar 

  257. Tomasko MA, Luskin AT. Recurrent parotitis with H2-receptor antagonists in a patient with Sjögren’s syndrome. American Journal of Medicine 85: 271, 1988.

    PubMed  CAS  Google Scholar 

  258. Toon S, Davidson EM, Garstang FM, Batra H, Bowes RJ, et al. The racemic metoprolol H2-antagonist interaction. Clinical Pharmacology and Therapeutics 43: 283–289, 1988.

    PubMed  CAS  Google Scholar 

  259. Toon S, Hopkins KJ, Garstang FM, Rowland M. Comparative effects of ranitidine and cimetidine on the pharmacokinetics and pharmacodynamics of warfarin in man. European Journal of Clinical Pharmacology 32: 165–172, 1987.

    PubMed  CAS  Google Scholar 

  260. Tosi S, Cagnoli M. Painful gynaecomastia with ranitidine. Lancet 2: 160, 1982.

    PubMed  CAS  Google Scholar 

  261. Viana L. Probable case of impotence due to ranitidine. Lancet 2: 635, 1983.

    PubMed  CAS  Google Scholar 

  262. Walt RP, LaBrooy SJ, Avgerinos A, Oehr T, Riley A, et al. Investigations on the penetration of ranitidine into the cerebro-spinal fluid and a comparison of the effects of ranitidine and cimetidine on male sex hormones. Scandinavian Journal of Gastroenterology 69 (Suppl. 16): 19–24, 1981.

    CAS  Google Scholar 

  263. Wang C, Wong KL, Lam KC, Lai CL. Ranitidine does not affect gonadal function in man. British Journal of Clinical Pharmacology 16: 430–432, 1983.

    PubMed  CAS  Google Scholar 

  264. Wanwimolruk S, Sunbhanich M, Pongmarutai M, Patamasucon P. Effects of cimetidine and ranitidine on the pharmacokinetics of quinine. British Journal of Clinical Pharmacology 22: 346–350, 1986.

    PubMed  CAS  Google Scholar 

  265. Watts RW, Hetzel DJ, Bochner F, Hallpike JF, Hann CS, et al. Lack of interaction between ranitidine and phenytoin. British Journal of Clinical Pharmacology 15: 499–500, 1983.

    PubMed  CAS  Google Scholar 

  266. Webster LK, Jones DB, Smallwood RA. Influence of cimetidine and ranitidine on ethanol pharmacokinetics. Australian and New Zealand Journal of Medicine 15: 359–360, 1985.

    PubMed  CAS  Google Scholar 

  267. Webster LK, Mihaly GW, Jones DB, Smallwood RA, Phillips JA, et al. Effect of cimetidine and ranitidine on carbamazepine and sodium valproate pharmacokinetics. European Journal of Clinical Pharmacology 27: 341–343, 1984.

    PubMed  CAS  Google Scholar 

  268. Wells BG, Pieper JA, Self TH, Stewart CF, Waldon SL, et al. The effect of ranitidine and cimetidine on imipramine disposition. European Journal of Clinical Pharmacology 31: 285–290, 1986.

    PubMed  CAS  Google Scholar 

  269. Wilson CM, Robinson FP, Thompson EM, Dundee JW, Elliot P. Effect of pretreatment with ranitidine on the hypnotic action of single doses of midazolam, temazepam and zopiclone: a clinical study. British Journal of Anaesthesia 58: 483–486, 1986.

    PubMed  CAS  Google Scholar 

  270. Winship LC, McKenney JM, Wright J, Wodd JH, Goodman RP. The effect of ranitidine and cimetidine on single-dose diltiazem pharmacokinetics. Pharmacotherapy 5: 16–19, 1985.

    PubMed  CAS  Google Scholar 

  271. Woodworth GE, Sears DH, Grove TM, Ruff RH, Kosek PS, et al. The effect of cimetidine and ranitidine on the duration of action of succinylcholine. Anesthesia and Analgesia 68: 295–297, 1989.

    PubMed  CAS  Google Scholar 

  272. Zazgornik J, Schindler J, Gremmel F, Balcke P, Kopsa H, et al. Ranitidine does not influence the blood cyclosporin levels in renal transplant patients. Kidney International 28: 401, 1985.

    Google Scholar 

  273. Zimmerman TW, Schenker S. A comparative evaluation of cimetidine and ranitidine. Rational Drug Therapy 19: 1–7, 1985.

    PubMed  CAS  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to Dr Thierry Vial.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Vial, T., Goubier, C., Bergeret, A. et al. Side Effects of Ranitidine. Drug-Safety 6, 94–117 (1991). https://doi.org/10.2165/00002018-199106020-00002

Download citation

Keywords

  • Theophylline
  • Clinical Pharmacology
  • Cimetidine
  • Ranitidine
  • Famotidine