The availability of ranitidine is extremely limited. Famotidine IV/oral is currently funded for hospital use, and 20 mg tablets will be fully funded in community from 1st January 2020 under Section 29 (unlicensed medicine).
See Medsafe’s statement for more details on the product recall – https://www.medsafe.govt.nz/safety/Alerts/MedicinesAndNDMA.asp
Alternative management options include:
Gastroesophageal reflux disease (GORD):
- consider trialling cessation of H2-antagonist therapy
- lifestyle modification (e.g. avoiding foods that trigger symptoms, such as alcohol and caffeine)
- antacids e.g. aluminium (e.g. Alu-tab 600 mg tablets – fully funded)
- alginates (Gaviscon Double Strength®tablets and Acidex® liquid – partially funded)
- proton-pump inhibitors – omeprazole, pantoprazole and lansoprazole are all fully funded. Also suitable to use in pregnancy
- See HealthPathways for more guidance https://canterbury.communityhealthpathways.org/24341.htm (Canterbury only)
- non-sedating oral antihistamines are first-line (note higher doses than that used in allergic rhinitis are often used, e.g. up to 20 mg twice a day of cetirizine or loratadine). See HealthPathways https://canterbury.communityhealthpathways.org/20869.htm (Canterbury only) or Dermnet dermnetnz.org
- consider referral to Dermatology department.