From the Guidelines
Ranitidine injection can be given in pregnancy when necessary, as it is considered safe to use during this period, according to the most recent guidelines. The study published in the Annals of Oncology in 2019 1 provides recommendations for systemic treatment and supportive medication during pregnancy, including the use of ranitidine.
Key Points to Consider
- The guidelines suggest that ranitidine, along with other medications like metoclopramide, 5HT3 antagonists, proton pump inhibitors, methylprednisolone, prednisolone, or hydrocortisone, can be used if necessary during pregnancy.
- It is essential to weigh the benefits against the risks and consider the mother's condition before making a decision.
- The dosage and administration of ranitidine should be based on the individual patient's needs and medical condition.
Clinical Considerations
- Ranitidine is typically used to reduce stomach acid in conditions like gastroesophageal reflux disease (GERD), peptic ulcers, or for stress ulcer prophylaxis in critically ill patients.
- The decision to use ranitidine injection during pregnancy should be made after careful consideration of the mother's condition and potential benefits versus risks, ideally in consultation with both obstetric and gastroenterology specialists.
- Other H2-blockers like famotidine or proton pump inhibitors like omeprazole may also be considered, depending on the clinical situation.
From the FDA Drug Label
Pregnancy Teratogenic Effects Pregnancy Category B Reproduction studies have been performed in rats and rabbits at oral doses up to 160 times the human oral dose and have revealed no evidence of impaired fertility or harm to the fetus due to ranitidine. There are, however, no adequate and well-controlled studies in pregnant women Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.
Ranitidine use in pregnancy should be done with caution. The drug label indicates that ranitidine is classified as Pregnancy Category B, and while animal studies have shown no evidence of harm to the fetus, there are no adequate and well-controlled studies in pregnant women. Therefore, ranitidine should be used during pregnancy only if clearly needed 2.
From the Research
Administration of Ranitidine in Pregnancy
- Ranitidine can be given in pregnancy, particularly for the treatment of gastroesophageal reflux disease (GERD) when symptoms are not adequately relieved by lifestyle modifications and first-line medical therapies such as antacids and sucralfate 3, 4.
- Histamine-2 receptor antagonists like ranitidine are preferred during pregnancy due to their safety profile compared to other options like proton pump inhibitors (PPIs), which should be used with caution 3, 5.
- The treatment approach for GERD in pregnancy typically follows a step-up methodology, starting with lifestyle modifications, then introducing antacids, sucralfate, histamine-2 receptor antagonists like ranitidine, and finally PPIs if necessary 5, 6.
- Studies have shown that ranitidine does not have significant adverse effects on fetal development or postnatal growth when administered during the organogenesis period in animal models 7.
- It is essential for healthcare providers to discuss the risks and benefits of ranitidine and other medications with pregnant patients, considering the severity of their symptoms and the potential impact on the mother and fetus 4, 6.