| Formulary Chapter 1: Gastro-intestinal system - Full Chapter
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| 01.03.01 |
H2-receptor antagonists |
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Ranitidine
(Tablets 150mg, 300mg, Oral solution SF 75mg/5ml)
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First Choice
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Prescribe standard release tablets only; modified release (MR) preparations are non-formulary.
The supply disruption recommendations relating to H2As as a result of the issues around ranitidine are likely to remain prevalent for the foreseeable future. Where a patient has previously been prescribed ranitidine, the most likely course of action will be to step up to PPIs or down to antacids/alginates. H2As should be reserved as an option of last resort for patients who do not respond to other treatments and combinations.
Please reserve H2As for exceptional cases in order to preserve supplies. Where an H2A is indicated, please use the lowest dose of the least costly agent available in your locality. You will need to liaise with local community pharmacists to establish availability in your area as national availability will not necessarily translate to local availability
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Ranitidine (Effervescent tablet)
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Second Choice
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For use in patients with swallowing difficulties or via nasogastric tubes only.
The supply disruption recommendations relating to H2As as a result of the issues around ranitidine are likely to remain prevalent for the foreseeable future. Where a patient has previously been prescribed ranitidine, the most likely course of action will be to step up to PPIs or down to antacids/alginates. H2As should be reserved as an option of last resort for patients who do not respond to other treatments and combinations.
Please reserve H2As for exceptional cases in order to preserve supplies. Where an H2A is indicated, please use the lowest dose of the least costly agent available in your locality. You will need to liaise with local community pharmacists to establish availability in your area as national availability will not necessarily translate to local availability
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Ranitidine Bismuth Citrate (Pylorid®)
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Non Formulary
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Key |
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Cytotoxic Drug
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Controlled Drug
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High Cost Medicine
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Cancer Drugs Fund
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NHS England |
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Homecare |
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CCG |
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Traffic Light Status Information
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Description |
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Prescribing in children
The APC notes that the informed use of unlicensed medicines or of licensed medicines for unlicensed applications (‘off-label’ use) is often necessary in paediatric practice.
The APC advises GPs to consider specialist prescribing recommendations for Green and Amber medicines that are not subject to ESCAs or RICaDs in combination with the information provided in the BNFC which goes beyond that of marketing authorisations. The BNFC has been designed for rapid reference and the information presented has been carefully selected to aid decisions on prescribing.
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Medicines suitable for routine use within primary care. Initiation and maintenance of prescribing by Specialists, GPs and other qualified clinicians. |
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Amber Specialist Initiation: Initiation and maintenance of prescribing by Specialists and transfer to Primary Care prescribing when appropriate. This may be supported by a RICaD, annotated within the formulary entry. |
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Amber Specialist Recommendation: Initiation and maintenance of prescribing in Primary Care following recommendation from a Specialist. |
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Amber Shared Care: Initiation and maintenance of prescribing by Specialists and transfer to Primary Care prescribing, in accordance with an ESCA, annotated within the formulary entry. |
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Medicines for initiation and maintenance prescribing by Specialists only. |
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Non-formulary Medicines which APC/Trust DTC has actively reviewed and do not recommend for use. |
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Positive NICE TA and/or awaiting local clarification on place in therapy; Please contact your Medicines Optimisation team for more information. |
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The term 'Specialist' refers to Consultants, General Practitioners and Independant Prescribers with a Specialist Interest. |
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