Drug Shortage

Shortage of ranitidine for injection

Three-dimensional ball-and-stick model of ranitidine contributed to Wikimedia by Ben Mills (Benjah-bmm27).

The American Society of Health-System Pharmacists reports a shortage of ranitidine for injection. This drug is on the current list of essential medications published by the World Health Organization. The importance of this injectable formulation arises when medications can’t be taken by mouth in order to control damage to the stomach, duodenum, and esophagus from excessive acid production. This is a necessary step in reducing inflammation of the stomach lining, stopping bleeding, healing severe stomach and duodenal ulcers, etc.

Table 1, giving alternatives, is reproduced from the ASHP link above.

Also note from the same ASHP link that famotidine for injection, the main alternative to injectable ranitidine, is also in short supply.

This is yet another example of how one drug shortage drives usage of a second drug and a subsequent second drug shortage.

This class of drugs is called H2 blockers, more specifically histamine type-2 receptor antagonists. As a group they increase the risk of pneumonia in hospitalized patients. If you are interested in that discussion, see my previous blog post below.

The shortage of injectable esomeprazole is over for now, but hospital-acquired pneumonia as a result of the use of H2 blockers remains relevant.