Ranitidine use in pediatrics: current evidence-based review and recommendations

Uday A. Pai; Dhanasekhar Kesavelu; Abhay K. Shah; Arun K. Manglik; Arun Wadhwa; Bhaswati Acharya; Deepak Goyal; Lalit Bharadia; Lalit Verma; Nithya Franklyn; Raju C. Shah; Somashekara H. R.; Subhashish Bhattacharyya

doi:10.18203/2349-3291.ijcp20222434

Authors

Uday A. Pai Aangan, Sai Kutir Clinic, Chembur, Mumbai, Maharashtra, India
Dhanasekhar Kesavelu Apollo Children's Hospitals, Chennai, Tamil Nadu, India http://orcid.org/0000-0003-4051-3102
Abhay K. Shah Children’s Hospital and Pediatric Infectious Diseases Center, Ahmedabad, Gujarat, India
Arun K. Manglik Ankur Clinic, Kankurgachi, Kolkata, West Bengal, India
Arun Wadhwa Greater Kailash Part 2, Delhi, India
Bhaswati Acharya AMRI Hospital, Kolkata, West Bengal, India
Deepak Goyal Fortis Hospitals, Fortis Gurgaon and Noida, Uttar Pradesh, India
Lalit Bharadia Santokba Durlabhji Memorial Hospital, Jaipur, Rajasthan, India
Lalit Verma Wockhardt Group of Hospitals, Mumbai, Maharashtra, India
Nithya Franklyn Vijaya Group of Hospitals, Vihaa Hospitals, Chennai, Tamil Nadu, India
Raju C. Shah Ankur Institute of Child Health, Ahmedabad, Gujarat, India
Somashekara H. R. Gleneagles Global Health City, Perumbakkam, Chennai, Tamil Nadu, India
Subhashish Bhattacharyya CSS College of Obstetrics, Gynaecology and Child Health, Kolkata, West Bengal, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20222434

Keywords:

Ranitidine, GERD, Gastritis, Nocturnal acid reflux, PPI, H2RA

Abstract

Ranitidine plays a pivotal role in routine pediatric practice. The multi-dimensional use and safety of ranitidine are not supported by any practical guidelines, which led to recommendations convened by a group of experts based on evidence and the clinical experience of experts. A group of general pediatricians and pediatric gastroenterologists from India were part of this panel. This group of experts reviewed the literature on topics that were unanimously agreed upon, for which no recommendations were available. The Delphi method was implemented to reach unified decisions, which led to the development of evidence-based recommendations. Gastritis and gastroesophageal reflux disease (GERD) are common conditions seen in pediatric practice. Ranitidine has a rapid onset of action compared to proton pump inhibitors (PPIs). It is a preferred drug for on-demand use for gastritis and managing stress-induced gastric lesions in critically ill pediatric patients. Ranitidine has an established role in the management of GERD, and it also prevents nocturnal acid reflux effectively. It helps in reducing gastric fluid volume when used as preoperative prophylaxis. Also, ranitidine has a better safety profile in comparison to PPIs. Recommendations on the use and safety of ranitidine in pediatrics were developed which will be a guiding tool for all practicing clinicians, highlighting the strength and benefits of ranitidine as a better and safe alternative to PPIs in short-term acid suppression for multiple indications.

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