Renal clearance ranitidine

Renal clearance of creatinine, and of cationic drugs which undergo active proximal tubular excretion, is reduced by cimetidine and to a lesser extent by ranitidine. 

Boom SP, Meyer I, Wouterse AC, et al. A physiologically based kidney model for the renal clearance of ranitidine and the interaction with cimetidine and probenecid in the dog. Biopharm Drug Dispos 1998 19 199-208. 

In a randomized, placebo-controlled study of the effects of cimetidine and ranitidine on the pharmacokinetics and pharmacodynamics of a single dose of dofetilide 500 micrograms in 20 healthy men, ranitidine 150 mg bd did not affect the pharmacokinetics or pharmacodynamics of dofetilide, but there was a dose-dependent increase in exposure to dofetilide with cimetidine (61). With cimetidine 100 and 400 mg bd the AUC of dofetilide increased by 11 and 48%, the maximum plasma dofetilide concentration increased by 11 and 29%, renal clearance fell by 13 and 33%, and non-renal clearance by 5 and 21% dofetilide-induced prolongation of the QT interval was increased by 22 and 33%. The authors suggested that cimetidine inhibited renal tubular dofetilide secretion,... 

The clinical significance of the reduced renal clearance of oxaprozin when it is given concomitantly with ranitidine is not clear (SEDA-12, 87). 

Eiermaim, B., Sommer, N., Winne, D., Schumm, R, Maier, U., and Breyer-Pfaff, U., Renal clearance of pyridostigmine in myasthenic patients and volunteers under the influence of ranitidine and pirenzepine, YenoWotica, 23, 1263, 1993. 

Somoni A, Bochner F. Dose and concentration dependent effect of ranitidine on procainamide di x>sition and renal clearance in man. BrJ Clin Pharmacol 9Z4) 18,175-81. 

SudohT, Fujimura A, HaradaK, SunagaK, Ohmori M, Sakamoto K. Effect of ranitidine on renal clearance of lomefloxacin. EurJ Clin Pharmacol ( 996) 51,95-8. 

Cimetidine and ranitidine probably do not have a clinically relevant effect on the renal clearance of cisplatin. 

Deravirdine (Rescnptor) [Antiretroviral/NNRTI] Uses HIV Infxn Action Nonnucleoside RT inhibitor Dose 400 mg PO tid Caution [C, ] CDC recommends HIV-infected mothers not to breast-feed (transmission risk) w/ renal/hepatic impair Contra Use w/ drugs dependent on CYP3A for clearance (Table VI-8) Disp Tabs SE Fat redistribution, immune reconstitution synd, HA, fatigue, rash, T transaminases, N/V/D Interactions T Effects W/ fluoxetine T effects OF benzodiazepines, cisapride, clarithromycin, dapsone, ergotamine, indinavir, lovastatin, midazolam, nifedipine, quinidine, ritonavir, simvastatin, terfena-dine, triazolam, warfarin effects W/ antacids, barbiturates, carbamazepine, cimetidine, famotidine, lansoprazole, nizatidine, phenobarbital, phenytoin, ranitidine, rifabutin, rifampin effects OF didanosine EMS Use of benzodiazepines and CCBs should be avoided may cause a widespread rash located on upper body and arms OD May cause an extension of nl SEs symptomatic and supportive Deferasirox (Exjade) [Iron Chelator] Uses Chronic iron overload d/t transfusion in pts >2 y Action Oral iron chelator Dose Initial 20 mg/kg... 

Memantine is not a major substrate for hepatic cytochrome P450 isoenzymes and has not been shown to significantly inhibit or induce these enzymes. However, memantine is partially excreted by renal tubular secretion. Thus, concomitant use of other medications that use the same renal system (i.e., triampterene, hydrochlorothiazide, digoxin, cimetidine, ranitidine, metformin, and quinidine) may affect plasma levels of both drugs (Namenda 2005). Memantine should not be used in combination with other NMDA receptor antagonists, such as amantadine or dextromethorphan, because these combinations have not been formally studied. The clearance of memantine can be reduced when the urine is alkalinized, such as with the concomitant use of sodium bicarbonate or carbonic anhy-... 

M, Muirhead, F, Bochnet and A. Somogyi, Pharmacokinetic drug interactions between triamterene and ranitidine in humans Alterations in renal and hepatic clearances and gastrointestinal absorption, /. Pharmacd. Exp. Ther., 244 734-739 (1988). 

Rocci ML, Kosc ou T, Feig i n RK, Vlasses PH. Ranitidine-induced chaises in the renal and hepatic clearances of procainamide are correlated. JP onwaco/7%er (1989) 248,923-8. 

One study found that ranitidine 150 mg twice daily for one day reduced the absorption of procainamide from the gut by 10% and reduced its renal excretion by 19%, increasing the procainamide and A-acetylprocainamide AUC by about 14%. However, no change in the steady-state pharmacokinetics of procainamide was found with ranitidine 150 mg twice daily in another study, except that ranitidine delayed the time to maximum plasma concentration (from 1.4 to 2.7 hours). In a further study, ranitidine 150 mg twice daily for 4 days caused no significant changes in the mean pharmacokinetics of oral procainamide 1 g in 13 healthy subjects. However, it appeared that subjects had either a modest 20% increase or decrease in procainamide clearance, with the direction of change related to their baseline procainamide clearance the higher the baseline clearance the greater the decrease caused by ranitidine. ... 

---