Ранитидин

Histamine H2 receptor antagonist that inhibits gastric acid secretion. Indicated in the treatment of gastric and duodenal ulcer and peptic esophagitis. Oral or intravenous administration in one or two daily doses.

Since 10/2019, preparations of Ranitidine have been withdrawn from the market in several countries because some of them have detected contamination with Nitrosamine (N-Nitrosodimethylamine, NDMA) a carcinogenic product. It is advised, until the situation has cleared up, to switch to omeprazole, cimetidine or famotidine. ^{(RCPCH 2021, FDA 2020, AEMPS 2019)}

It is concentrated in breastmilk and is excreted in moderate quantities ^{(Kearns 1985, Riley 1982 cited in Bennet 1996 p329)}, but is 5 to 25 times lower than the dose used in newborns and infants (2-4 mg/kg/day).

No side effects have been observed in infants whose mothers were taking ranitidine. ^{(Kearns 1985)}

It is commonly used in Pediatrics, even in premature newborns.

It can produce hyperprolactinemia. ^{(Petit 2003)}

Other anti H2s from the same family, like Famotidine or Nizatidine, are excreted less in breastmilk and are preferred. ^{(Hagemann 1998)}

Several medical societies, experts and expert consensus, consider the use of this medication to be safe or very probably safe during breastfeeding. ^{(Hale 2019, Briggs 2017, Rowe 2013, Mahadevan 2006, Richter 2005, Nice 2000)}