Neostin-R is indicated for Dyspepsia, H. pylori infection, Benign gastric and duodenal ulceration, GERD, Acid aspiration during general anesth, Prophylaxis during NSAID treatment, Stress ulceration of upper GI, Zollinger-Ellison syndrome
Precautions and warnings
Exclude malignancy before treating gastric ulcer. Renal and hepatic impairment. Infants, pregnancy and lactation.
Headache, dizziness. Rarely hepatitis, thrombocytopaenia, leucopaenia, hypersensitivity, confusion, gynaecomastia, impotence, somnolence, vertigo, hallucinations.
Potentially Fatal: Anaphylaxis, hypersensitivity reactions.
Delayed absorption and increased peak serum concentration w/ propantheline bromide. Ranitidine minimally inhibits hepatic metabolism of coumarin anticoagulants, theophylline, diazepam and propanolol. May alter absorption of pH-dependent drugs (e.g. ketoconazole, midazolam, glipizide). May reduce bioavailability w/ antacids.
Mode of actions
Ranitidine competitively blocks histamine at H2-receptors of the gastric parietal cells which inhibits gastric acid secretion. It does not affect pepsin secretion, pentagastrin-stimulated intrinsic factor secretion or serum gastrin.
Dosage & Administration
Adult: PO Benign gastric and duodenal ulceration Initial: 300 mg at bedtime or 150 mg twice daily for 4-8 wk depending on the condition.
For prevention of NSAID-associated ulceration: 150 mg bid.
Eradication of H. pylori infection 300 mg once daily or 150 mg twice daily w/ amoxicillin and metronidazole for 2 wk. May continue w/ ranitidine for a further 2 wk.
GERD 150 mg twice daily or 300 mg at bedtime for up to 8 wk. Severe: 150 mg 4 times/day for 12 wk. Pathological hypersecretory conditions Initial: 150 mg 2-3 times/day, up to 6 g/day if needed.
Acid aspiration during general anesth 150 mg 2 hr before induction of anesth and preferably, an additional dose on the previous evening.
Chronic episodic dyspepsia 150 mg twice daily for up to 6 wk.
Short-term symptomatic dyspepsia 75 mg, up to 4 doses/day if needed. Max: 2 wk of continuous use at each time.
Prophylaxis during NSAID treatment 150 mg twice daily.
IV Pathological hypersecretory conditions Initial: 1 mg/kg/hr, may increase slowly after 4 hr if needed. Stress ulceration of upper GI tract Priming dose: 50 mg via inj, then 125-250 mcg/kg/hr via infusion, then transfer to PO 150 mg twice daily once oral feeding is resumed.
IV/IM Acid aspiration during general anesth 50 mg 45-60 mins before the induction of anasth.
Pregnancy & Lactation
Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women OR Animal studies have shown an adverse effect, but adequate and well-controlled studies in pregnant women have failed to demonstrate a risk to the fetus in any trimester.