Ranitidine

Miglitol significantly reduced ranitidine bioavailability by approximately 60% in healthy volunteer studies.

H2-receptor antagonist may decrease acalabrutinib concentrations. Take acalabrutinib 2 hours before ranitidine dosing.

Atazanavir absorption may be impaired based on ranitidine's effect on gastric pH. Use with caution and refer to atazanavir label.

May potentiate renal dysfunction when used concomitantly with cyclosporine. Close monitoring of renal function required.

Delavirdine absorption may be impaired with ranitidine due to increased gastric pH. Chronic H2-receptor antagonist use with delavirdine not recommended.

H-2 receptor antagonist decreases erlotinib exposure. Modify dosing schedule; dose increase unlikely to compensate.

H-2 receptor antagonist that decreases erlotinib exposure by increasing gastric pH. Modify dosing schedule.

Weak CYP3A4 inhibitor; concomitant use of multiple weak inhibitors may increase risk of adverse reactions.

Gefitinib exposure reduced by 44% with ranitidine and sodium bicarbonate coadministration. Use with caution.

Glipizide exposure increased by 34% following single 150-mg dose of oral ranitidine in diabetic patients. Use appropriate clinical monitoring.

Oral ketoconazole exposure reduced up to 95% when coadministered with ranitidine regimen maintaining gastric pH above 6. Effect at usual doses unknown.

Weak CYP3A inhibitor that increases lemborexant AUC and Cmax. Maximum recommended dose of lemborexant is 5 mg when used concomitantly.

Cationic drug eliminated by renal tubular secretion with potential for interaction with metformin by competing for common renal tubular transport systems.

Weak CYP 3A4 inhibitor; should be administered with caution.

Weak CYP 3A4 inhibitor; should be administered with caution due to potential vasospasm risk.

Oral midazolam exposure increased up to 65% with 150 mg ranitidine twice daily. Monitor for excessive or prolonged sedation.

Procainamide Ranitidine, a substrate of the renal organic cation transport system, may affect the clearance of other drugs eliminated by this route. High doses of ranitidine (e.g., such as those used in the treatment of Zollinger-Ellison syndrome) have been shown to reduce the renal excretion of procainamide and N-acetylprocainamide resulting in increased plasma levels of these drugs. Although this interaction is unlikely to be clinically relevant at usual ranitidine doses, it may be prudent to monitor for procainamide toxicity when administered with oral ranitidine at a dose exceeding 300 mg per day.

Nonspecific CYP450 inhibitor. Preferred over cimetidine when concomitant use necessary. Patients should be monitored for adverse events associated with quinine.

Nonspecific CYP450 inhibitor. Preferred over cimetidine when concomitant use is necessary. Patients should be monitored closely for adverse events.

Ranitidine increases the bioavailability of risperidone by 26% and increases combined AUC of risperidone and 9-hydroxyrisperidone by 20%.

Sucralfate reduces the bioavailability of ranitidine. Dosing ranitidine 2 hours before sucralfate eliminates the interaction.

Triazolam exposure increased by approximately 30% with ranitidine coadministration due to altered gastric pH affecting absorption.

Reports of altered prothrombin time during concurrent ranitidine and warfarin therapy. Close monitoring of prothrombin time is recommended due to warfarin's narrow therapeutic index.

Agent that decreases stomach acidity; literature suggests it does not greatly alter clonazepam pharmacokinetics.

Produces smaller, nonsignificant increases in diltiazem levels.

Co-administration with ranitidine resulted in 20% increased bioavailability of ibandronate, which was not considered clinically relevant.

Co-administration of ranitidine with ibuprofen had no substantive effect on ibuprofen serum concentrations in human volunteer studies.

Minimal interaction; slightly increases midazolam steady-state concentration but no clinically significant change in sedation or cognitive function observed.

Produces smaller, non-significant increases in nifedipine levels compared to cimetidine.

Ranitidine 150 mg twice daily decreases nisoldipine AUC by 15-20% with no clinically significant pharmacodynamic effects observed.

H2 blocker decreased Cmax of prasugrel active metabolite by 14% but did not change AUC or Tmax.

Potential for drug-drug interaction due to possible competition for active tubular secretion via base-secreting system.