ADULTS

• Duodenal ulcers or gastric ulcers and reflux oesophagitis : The standard dosage regimen is 150 mg twice daily or a single bedtime dose of 300 mg. It is not necessary to time the dose in relation to meals. In most cases of duodenal ulcer, benign gastric ulcer and postoperative ulcer, healing occurs in 4 weeks. Healing usually occurs after a further 4 weeks. Healing usually occurs after a further 4 weeks of treatment in those patients whose ulcers have not fully healed after the initial course of therapy. In ulcers following non-steroidal anti-inflammatory drug therapy or associated with continued non-steroidal anti-inflammatory drug, 8-12 weeks treatment with Ranitidine may be necessary.

• Prevention of non-steroidal anti-inflammatory drug associated duodenal ulcers : 150 mg twice daily may be given concomitantly with non-steroidal anti-inflammatory drug therapy.

• Duodenal ulcer : 300 mg twice daily for 4 weeks results in healing rates which are higher than those at 4 weeks with Ranitidine 150 mg twice daily or 300 mg nocte.

• The increased dose has not been associated with an increased incidence of unwanted effects. Maintenance treatment at a reduced dosage of 150 mg at bedtime is recommended for patients who have responded to short-term therapy, particularly those with a history of recurrent ulcer.

• Postoperative ulcer : 150 mg twice daily.

• Reflux oesophagitis : The recommended course of treatment is either 150 mg twice daily or 300 mg at bedtime for up to 8 weeks. In patients with moderate to severe oesophagitis, the dosage of Ranitidine may be increased to 150 mg 4 times daily for up to 12 weeks.

• Zollinger-Ellison syndrome : The starting dose is 150 mg 3 times daily and this may be increased as necessary. Patients with this syndrome have been given increasing doses up to 6 g a day and these doses have been well tolerated.

• Chronic episodic dyspepsia : The recommended course of treatment is one 150 mg tablet twice daily for up to 6 weeks. Anyone not responding or relapsing shortly afterwards should be investigated.

• Prophylaxis of haemorrhage from stress ulceration or recurrent hemorhage in peptic ulceration : Treatment with Ranitidine tablet 150 mg twice daily may be given once oral feeding commences in patients considered to be still at risk from these conditions.

• Risk of Mendelson's syndrome : 150 mg oral dose can be given 2 hours before induction of general anaesthesia and preferably also 150 mg tablet the previous evening. Alternatively, the injection is also available.

• Obstetric patients at commencement of labour : 150 mg oral dose may be given followed by 150 mg at 6 hourly intervals. It is recommended that since gastric emptying and drug absoption are delayed during labour, any patient requiring emergency general anaesthesia should be given, in addition, a non particulate antacid (e.g., sodium citrate) prior to induction of anaesthesia. The usual precautions to avoid acid aspiration should also be taken.

CHILDREN

• The recommended oral dose for the treatment of peptic ulcer is 2-4 mg/kgBW twice daily to a maximum of 300 mg Ranitidine a day.

RENAL IMPAIRMENT

• Accumulation of Ranitidine with resulting elevated plasma concentrations will occur in patients with severe renal impairment (creatinine clearance < 50 ml/minute). It is recommended that the daily dose of Ranitidine in such patients should be 150 mg. In patients undergoing chronic ambulatory peritoneal dialysis or chronic haemodialysis : Ranitidine 150 mg should be taken immediately after dialysis.