Ranitidine (Zantec): Warning in Immune (autoimmune?) Conditions. Anybody had any problems or have anymore information about this?

[Foggyme]

Hello All. My GP recently prescribed a course of Ranitidine (histamine H2 receptor antagonist) for multiple duodenal ulcers / gastritis / duodenitis.

Prior to taking the tablets I read the patient information leaflet and it said to check with a pharmacist if there were problems with the immune system. Having had a recent positive ANA test (currently being investigated) I queried this with a pharmacist, who stated that she had never heard of this contraindication (despite it being on the PIL), that they were well tolerated, and to go ahead and take them.

Within four days I became very ill with greatly increased shortness of breath and muscle / joint pain. More worryingly, my throat, tongue and lips became completely numb, I had increased difficulty in swallowing and my rubber legs turned to jelly legs and, on occasion, I just could not make them 'go'. On the whole, I felt very ill indeed 😖.

I stopped taking the tablets! Since then the exacerbated symptoms have reduced, although not quite to my normal level of dysfunction.

Just wondering if any body else has had similar trouble with Ranitidine.

Also thought I might flag it up since the contraindication in immune conditions is not recorded in the British National Formulary (BNF) or other websites (although I did find a short mention on WebMD). I'm also not sure if immune conditions also covers autoimmune conditions?

If Ranitidine can cause problems to those with auto / immune problems, there might be others out there who are at risk of exacerbating symptoms without knowing (since pharmacists and doctors appear to be largely unaware of the potential problems).

I haven't been able to find any further information about what the impact might be on those with immune (or autoimmune?) conditions and would be very interested to hear if anybody out there knows what might have been going on.

P.s. - haven't included the problems of giving with low or no stomach acid or the impact on B12 uptake, but know these also exist.

Many thanks.

[Ruthi]

And you can buy it without prescription!

See my response to your query about ulcers. Your doc will know nothing about it, of course!

[Foggyme Administrator in reply to Ruthi]

Thanks Ruthi. Will have a look at your response.

Know what you mean about docs...I'm constantly horrified by not only the lack of knowledge, but also the complete failure to recognise this and try and get some!

Thank goodness for this space and the collectively deficient 😃 👍.

[ndodge]

That sounds awful what you experienced, foggyme. So sorry. I have never taken these pills and so cannot give you any input on this. So glad you are getting back to normal again. Its a pharmaceutical jungle out there! XX

[Foggyme Administrator in reply to ndodge]

Thanks my good friend Ndodge 😀. I'm trying to be normal...always have....but it never quite works!

And you're certainly right about the pharmaceutical jungle...think we should get fbirder to start running his uni course again for all us non-chemists...bet he could teach us a thing or two! 💊💊⚗⚗🔬

[Ruthi]

Normal is boring! And certainly not among my goals.

[Foggyme Administrator in reply to Ruthi]

Here here!

[Gambit62 Administrator]

H2 receptor antagonists work in similar way to PPIs and are known to interfere with B12 absorption

patient.info/doctor/pernici...

if you have low stomach acidity rather than high stomach acidity it is just going to exacerbate all of the symptoms you have as it is just lowering your stomach acidity even further.

[Foggyme Administrator in reply to Gambit62]

Yes...it's a vicious circle, isn't it!

Hmmm....just wondering...based on some of fbirder 's previous responses to posts about low stomach acid and high gastrin levels...could high gastrin levels be responsible for causing duodenal ulcers? (I developed these several months after h. Pylori had been eradicated).

Hmmm again...will have to see if I can find anything.

[fbirder in reply to Foggyme]

I've not read anything about hypergastrinaemia and duodenal ulcers - but I've just read about how it causes Neuroendocrine tumours.

When it comes to the immune system I'm lost - far too much biology.

Additional:

Just did a quick google. Apparently hypergastrinaemia is a causal factor for duodenal ulcers - ncbi.nlm.nih.gov/pmc/articl...

But the ulcers are caused by the extra gastric acid secretion that is stimulated by the extra gastrin. And the extra gastrin is produced by Type II gastric carcinoid tumours associated with Zollinger–Ellison syndrome.

These are different to the Type I carcinoids (NETs) that can be caused by the hypergastrinaemia associated with gastric atrophy.

So achlorhydria would definitely not be a cause of duodenal ulcers.

[Foggyme Administrator in reply to fbirder]

Thanks fbirder. Interesting article. I'm also lost when it comes to the immune system. More reading required, I think!

Funny, the more I read the less I seem to know!

[butterflyEi]

Hi Foggyme

I am a newbie to PAS but have an auto immune disease called PBC and am a contributor on that Health Unlocked page. When I was first diagnosed with PBC I had tummy problems and was given Omneprazole. I later asked for a change to Ranatidine as another contributor who had taken it had a reduction in "the PBC itch". Earlier this year I was told I had a vitamin B12 deficiency and after changing GP surgeries during the summer I have been told I have Pernicious Anaemia hence I am on a huge learning curve and have been reading everyone's posts. Like you the more I learn, read or hear the more confusing these things become.

Anyway to the answer, I was fortunate not to experience any side effects from the ranatidine however I have stopped all medication for the time being as I am due to have an endoscopy within the next couple of months and feel that the less that has been in my system the better picture will be revealed.

It is a great concern that doctors (GPs) who are under so much pressure today are required to have knowledge on such a wide subject matter with so many subsections that for those of us with something a little more difficult it seems any help has to be fought for and always we must be our own advocate. It is very tiring and worrying.

I hope you are feeling much better now.

[fbirder in reply to butterflyEi]

Do you know why they're performing a gastroscopy? It could just be that they're looking for gastric cancer as PA sufferers are more likely to have this than non-PA people.

I would give the endoscopy department a call and ask them if you should stop taking the ranitidine. It may be that they say it's unnecessary.

[butterflyEi in reply to fbirder]

Thank you. I think the specialist is covering every angle. I stopped the Ranatidine when I thought it was a b12 deficiency earlier this year as I had found out indegestion tablets stop a person making b12. I hate taking tablets. Anyway when I get the appointment I will take your advice and ring them about other tablets I am on.

Just want to say what a great bunch of people you have on here and what a proactive site. Thanks for being there and the good advice.

[Foggyme Administrator in reply to butterflyEi]

Thanks butterflyEi. I agree...it is very tiring and worrying when we have to be our own advocates. Thank goodness for this space!

Good luck with the endoscopy...hope all goes well and please let us know how you get on x