Drug Information

Ranitidine is a member of the H-2 (histamine blocker) family of drugs, which prevents the release of acid into the stomach. Ranitidine is used to treat stomach and duodenal ulcers, gastroesophageal reflux disease, erosive esophagitis, and Zollinger-Ellison syndrome. Ranitidine is available as a prescription drug and also as a nonprescription over-the-counter product for relief of heartburn.

Common brand names:

Zantac, Zantac 150 Maximum Strength, Zantac 75

Summary of Interactions with Vitamins, Herbs, & Foods

Types of interactions: Beneficial Adverse Check

Replenish Depleted Nutrients

  • Copper

    There is some evidence that other vitamins and minerals, such as folic acid1 and copper,2 require the presence of stomach acid for optimal absorption. Long-term use of H-2 blockers may therefore promote a deficiency of these nutrients. Individuals requiring long-term use of H-2 blockers may therefore benefit from a multiple vitamin/mineral supplement.

  • Folic Acid

    Folic acid is needed by the body to utilize vitamin B12. Antacids, including ranitidine, inhibit folic acid absorption.3 People taking antacids are advised to supplement with folic acid.

  • Iron

    Stomach acid may facilitate iron absorption. H-2 blocker drugs reduce stomach acid and are associated with decreased dietary iron absorption.4 People with ulcers may also be iron deficient due to blood loss and benefit from iron supplementation. Iron levels in the blood can be checked with lab tests.

  • Beta-Carotene

    Omeprazole , a drug closely related to lansoprazole, taken for seven days led to a near-total loss of stomach acid in healthy people and interfered with the absorption of a single administration of 120 mg of beta-carotene.5 It is unknown whether repeated administration of beta-carotene would overcome this problem or if absorption of carotenoids from food would be impaired. Persons taking omeprazole and related acid-blocking drugs for long periods may want to have carotenoid blood levels checked, eat plenty of fruits and vegetables, and consider supplementing with carotenoids.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Vitamin B12

    Stomach acid is needed to release vitamin B12 from food so it can be absorbed by the body. H-2 blocker drugs reduce stomach acid and are associated with decreased dietary vitamin B12 absorption.6 The vitamin B12 found in supplements is available to the body without the need for stomach acid. Lab tests can determine vitamin B12 levels.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.

Reduce Side Effects

  • none

Support Medicine

  • none

Reduces Effectiveness

Potential Negative Interaction

  • none

Explanation Required 

  • none

The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers’ package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a new supplement with your doctor or pharmacist.

References

1. Russell RM, Krasinski SD, Samloff IM. Correction of impaired folic acid (Pte Glu) absorption by orally administered HCl in subjects with gastric atrophy. Am J Clin Nutr 1984;39:656.

2. Tompsett SL. Factors influencing the absorption of iron and copper from the alimentary tract. Biochem J 1940;34:961-9.

3. Russell RM, Golner BB, Krasinski SD, et al. Effect of antacid and H2 receptor antagonists on the intestinal absorption of folic acid. J Lab Clin Med 1988;112:458-63.

4. Aymard JP, Aymard B, Netter P, et al. Haematological adverse effects of histamine H2-receptor antagonists.Med Toxicol Adverse Drug Exp 1988;3:430-48.

5. Tang G, Serfaty-Lacronsniere C, Camilo ME, Russell RM. Gastric acidity influences the blood response to a beta-carotene dose in humans. Am J Clin Nutr 1996;64:622-6.

6. Aymard JP, Aymard B, Netter P, et al. Haematological adverse effects of histamine H2-receptor antagonists.Med Toxicol Adverse Drug Exp 1988;3:430-48.

7. Bachmann KA, Sullivan TJ, Jauregui L, et al. Drug interactions of H2-receptor antagonists. Scand J Gastroenterol Suppl 1994;206:14-9.