Ranitidine + Domperidone + Simethicone Pharmacology

Ranitidine + Domperidone + Simethicone

About Ranitidine + Domperidone + Simethicone
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Mechanism of Action of Ranitidine + Domperidone + Simethicone
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Pharmacokinets of Ranitidine + Domperidone + Simethicone
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Onset of Action for Ranitidine + Domperidone + Simethicone
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Duration of Action for Ranitidine + Domperidone + Simethicone
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Half Life of Ranitidine + Domperidone + Simethicone
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Side Effects of Ranitidine + Domperidone + Simethicone
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Contra-indications of Ranitidine + Domperidone + Simethicone
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Special Precautions while taking Ranitidine + Domperidone + Simethicone
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Pregnancy Related Information
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Old Age Related Information
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Breast Feeding Related Information
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Children Related Information
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Indications for Ranitidine + Domperidone + Simethicone
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Interactions for Ranitidine + Domperidone + Simethicone
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Typical Dosage for Ranitidine + Domperidone + Simethicone
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Schedule of Ranitidine + Domperidone + Simethicone
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Storage Requirements for Ranitidine + Domperidone + Simethicone
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Effects of Missed Dosage of Ranitidine + Domperidone + Simethicone
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Effects of Overdose of Ranitidine + Domperidone + Simethicone
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Ranitidine

About Ranitidine
A histamine H2-receptor antagonist, Furan derivative, Anti-secretory G.I agent,Anti ulcer.
Mechanism of Action of Ranitidine
Ranitidine is a H2 (Histamine) receptor antagonist. Histamine is the most potent stimulus of acid secretion and acts as the common mediator. H2 receptor is a G-protein coupled receptor. It induces adenylate cyclase which converts ATP to cyclic AMP. This cyclic AMP acts on proton pump and exchange extracellular potassium ion for intracellular hydrogen ion across the parietal cell membrane. Ranitidine reversibly competes with Histamine for binding to H2 receptors on the parietal cells and predominantly inhibits basal acid secretion.
Anaesthetic adjuncts: It is used in patients undergoing prolonged operations, caesarian section,obese patients those are at increased risk of gastric regurgitation and aspiration pneumonia. It raises pH of gastric juice and also reduces its volume and thus chances of regurgitation. It is now routinely used before prolonged surgery.
Pharmacokinets of Ranitidine
Absorption: Ranitidine is 50 % absorbed after oral administration. Distribution: Distributed mainly to body tissues in unbound form. Metabolism: Ranitidine undergoes metabolism in the liver. Excretion: It is excreted mainly in urine and in the faeces.
Onset of Action for Ranitidine
60 minutes
Duration of Action for Ranitidine
13hours
Half Life of Ranitidine
1.6- 2.4 hours
Side Effects of Ranitidine
1. Headache
2. Dizziness
3. Constipation
4. Vertigo
5. Confusion
6. Rash
7. Blurred vision
8. Thrombocytopenia
9. Leukopenia
Contra-indications of Ranitidine
1. Hypersensitivity to Ranitidine
Special Precautions while taking Ranitidine
1. Hepatic impairment
2. Renal impairment
3. Acute Porphyria
Pregnancy Related Information
Use with caution
Old Age Related Information
Use with caution
Breast Feeding Related Information
Use with caution
Children Related Information
Use with caution
NEONATES: Contraindicated
Indications for Ranitidine
1. Duodenal ulcer
2. Benign gastric ulcer
3. Zollinger- Ellison syndrome
4. Gastroesophageal reflux
5. Acid indigestion
6. Heart burn
7. Sour stomach
8. Stress ulcers
9. Oesophagitis
10.Preanaesthetic medication
Interactions for Ranitidine
Antacids: Ranitidine absorption may be decreased.
Diazepam: Efficacy of diazepam decreased.
Procainamide: Renal clearance of procainamide decreased.
Sulfonylureas: Hypoglycemic effects of glipizide enhanced.
Theophyllines: Increased efficacy of theophyllines with possible toxicity.
Warfarin: Increased hypoprothrombinemic effects.
Lab tests: False positive tests for urine proteins with multistix may occur.
Typical Dosage for Ranitidine
Adult: 300mg / day
Duodenal ulcer, benign gastric ulcer: 300 mg /day as single dose at bed time or in 2 divided dose (morning and bed time) for minimum of 4 weeks.
Maintenance dose: 150 mg / day at bed time.
Zollinger- Ellison syndrome: 300 - 450 mg / day in 2 - 3 divided doses; dose can be increased if necessary to a maximum up to 6g / day .
Gastroesophageal reflux: 300 mg / day as single dose at bed time or in 2 divided doses (morning and bed time) for maximum 2 months. In severe conditions dose can be increased to 600 mg / day in 4 divided doses for 3 months
Acid indigestion, Heart burn, Sour stomach: Dose: 75 mg once daily to a maximum up to 150 mg / day.
Oesophagitis: 150 mg/ day.
Dyspepsia: 75 - 300 mg / day depending on the severity of disease.
PAM: 150mg given night and in the morning before surgical procedures.
Children:
Duodenal ulcer, benign gastric ulcer: 4 - 8 mg / kg body weight / day in 2 divided doses.
Maximum dose: 300 mg / day
Schedule of Ranitidine
H
Storage Requirements for Ranitidine
Store at 15 - 30 degree C in a tightly closed container. Protect from light.
Effects of Missed Dosage of Ranitidine
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Ranitidine
Give supportive measures and symptomatic treatment. Drug can be removed from the body by inducing emesis and or by gastric lavage. Activated charcoal is given to reduce the absorption of the drug. Haemodialysis can be done if necessary.

Domperidone

About Domperidone
Antidopaminergic, Motility stimulant,Piperidine derivative, Antiemetic, anti-vertigo.
Mechanism of Action of Domperidone
Domperidone is a potent dopamine receptor antagonist. It acts centrally and blocks the Dopamine receptor in the Chemoreceptor trigger zone and produces Antiemetic effect.
Domperidone acts peripherally in the gastrointestinal system and increases oesophageal peristalsis, oesophageal sphincter pressure and gastric motility. These all facilitates gastric emptying. Domperidone is used in migraine to relieve nausea and vomiting.
Anaesthetic adjuncts: It is used preoperatively in order to reduce the post operative vomiting.
Pharmacokinets of Domperidone
Absorption: Domperidone is rapidly absorbed after oral administration. Since it undergoes first pass metabolism oral bioavailability is only 15 %. Distribution: It is widely distributed in the body in protein bound form. Metabolism: Domperidone undergoes metabolism in the liver. Excretion: It is excreted mainly in the faeces and also in the urine.
Onset of Action for Domperidone
30 - 60 minutes
Duration of Action for Domperidone
6 - 8 hours
Half Life of Domperidone
7.5 hours
Side Effects of Domperidone
1.Diarrhoea
2.Dry mouth
3.Galactorrhoea
4.Gynaecomastia
5.Skin rash
6.Abdominal discomfort
7.Dystonic reactions
Contra-indications of Domperidone
1.Hypersensitivity to Domperidone
2.Prolactin releasing pituitary tumour(prolactinoma)
3.Gastrointestinal obstruction
Special Precautions while taking Domperidone
1.Hepatic impairment
2.Renal impairment
Pregnancy Related Information
Contraindicated
Old Age Related Information
Use with caution
Breast Feeding Related Information
Use with caution
Children Related Information
Use with caution
NEONATES: contraindicated
Indications for Domperidone
1.Nausea and vomiting associated with gastrointestinal disorder and migraine.
2.Delayed gastric emptying of functional origin
3.As an Antiemetic in patient receiving cytotoxic drugs
4.Preanaesthetic medication

Interactions for Domperidone
Digoxin: Oral dose of digoxin needs to be reduced.
Aspirin, Paracetamol & Oral Diazepam: Increases absorption of these agents.
Anticholinergic agents: Antagonize the effects of domperidone.
Phenothiazines: CNS depression enhanced by domperidone.
Antimuscarinic agents and opioids: Antagonize GI effects of domperidone.
Suxamethonium: Neuromuscular blockade enhanced by domperidone.
Typical Dosage for Domperidone
Adults: 30 - 40 mg / day in 3 - 4 divided doses 30 minutes before meals and at bed time if required. After 2 weeks dose can be increased to 60 - 80 mg / day if needed.
Migraine: 20 mg by mouth may be taken up to every 4 hours with Paracetamol, as required up to a maximum of 4 doses in 24 hours.
Children: 300 mcg / kg body weight 3 - 4 times daily 30 minutes before meals and at bed time if required
Schedule of Domperidone
H
Storage Requirements for Domperidone
Store at room temperature (15 - 30 degree C). Protect from direct sun light and moisture
Effects of Missed Dosage of Domperidone
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Domperidone
Give supportive measures and symptomatic treatment. Drug can be removed from the body by gastric lavage and absorption of the drug can be reduced by administration of activated charcoal. To control Extrapyramidal reactions give antiparkinsonian or anticholinergic agents.

Simethicone

About Simethicone
Oral anti-foaming agent, Silicones, Antiflatulent.
Mechanism of Action of Simethicone
This anti-gas (anti-flatulence) medication acts in the stomach and intestines to change the surface tension of gas bubbles, enabling smaller bubbles to join together into bigger bubbles. It results elimination of gas more easily by belching or passing flatus.
Pharmacokinets of Simethicone
Excretion- Excreted through feces.
Onset of Action for Simethicone
N/A
Duration of Action for Simethicone
N/A
Half Life of Simethicone
N/A
Side Effects of Simethicone
1. Bloating
2. Constipation
3. Diarrhea
4. Gas
5. Heartburn
Contra-indications of Simethicone
1. Hypersensitivity to the drug
2. Liver disease
3. Kidney disease
4. Serious illness
Special Precautions while taking Simethicone
1.Swallow the tablets and capsules with a full glass of water.
2.Chew the chewable tablets thoroughly before swallowing.
3.Shake the drops well before using them.
4.To make administration easier, the drops can be mixed with 30 ml (2 tablespoons) of water or another liquid.
Pregnancy Related Information
Use with caution
Old Age Related Information
Use with caution
Breast Feeding Related Information
Use with caution
Children Related Information
Use with caution
Indications for Simethicone
1. Abdominal pain which is due to excessive gas in the digestive tract
2. Before gastroscopy or radiography of the bowel
Interactions for Simethicone
N/A
Typical Dosage for Simethicone
Oral-
Adults and teenagers-
60 -125mg four times a day, after meals and at bedtime. Not more than 500 mg should be taken in twenty-four hours.
Chewable tablets:
Adults and teenagers-
40 -125 mg four times a day, after meals and at bedtime or 150 mg three times a day, after meals. Not more than 500 mg should be taken in twenty-four hours.
Suspension:
Adults and teenagers-
40 -95 mg four times a day, after meals and at bedtime. Not more than 500 mg should be taken in twenty-four hours.
Schedule of Simethicone
N/A
Storage Requirements for Simethicone
Stored at room temperature (15-30?C) away from moisture and heat.
Effects of Missed Dosage of Simethicone
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Simethicone
Give symptomatic and supportive treatment.

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