Ranitidine overdose in paediatric patients [Abstract]

Crawford, C. L., Adams, R. D., Cooper, G., Spears, R., Thompson, John Paul, Jackson, G. and Bateman, D. N. 2012. Ranitidine overdose in paediatric patients [Abstract]. Clinical Toxicology 50 (4) , p. 298. 10.3109/15563650.2012.669957

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Abstract

Objective: To investigate the circumstances and etiology of ranitidine overdose in patients aged under 3 years old reported to the UK National Poisons Information Service (NPIS) between November 2008 and October 2011. Disproportionately high levels of therapeutic error have been noted during calls to NPIS centres. The causes of this are investigated. Methods: Using data extracted from UKPID, a centralised NPIS telephone enquiry database, we reviewed the number and nature of incidents involving ranitidine from November 2008 to October 2011. Results: 244 calls were made to the NPIS between 01/11/2008 and 31/10/2011 regarding poisoning with ranitidine alone. One hundred and ninety- six incidents (80.3%) involved children aged under 3 and 205 (84.0%) involved children aged under 5; by contrast, in the fi nancial year 2010 – 2011, only 28.8% of all calls made to the NPIS involved children aged under 5 (p � 0.0001). In those patients aged under 3, 86.7% (170/196) of ranitidine overdoses were due to therapeutic error, compared to 7.0% of all calls for the same age group taken in the same time period (p � 0.0001). Of those patients who overdosed as a result of therapeutic error, 146 (85.9%) ingested ranitidine syrup, and 43 of these patients (29.5%) were given a 10 times overdose of 75 mg/5 mL syrup. Medical intervention was required in 19.4% (38/196) of all patients under 3, most commonly investigations (16/38 or 42.1% of patients). 11/196 patients (5.6%) were referred to A&E and 12/196 patients (6.1%) were referred to their GP. 85.2% (167/196) patients were asymptomatic; 10.2% (20/196) patients had minor features, and 1 patient (0.5%) had moderate features (multiple episodes of vomiting and diarrhoea). Conclusion: Ranitidine overdose is a common enquiry to the NPIS. Although usually asymptomatic these cases often required some sort of medical intervention. Cases frequently involved paediatric patients. Overdose commonly occurred due to administration of 10x the prescribed dose of ranitidine syrup, suggesting a preventable dosing error by carers. Although the consequences of ranitidine overdose are usually benign, these results suggest that formulation changes could reduce risk and prevent unnecessary presentations to health professionals.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine
Subjects:	R Medicine > R Medicine (General) R Medicine > RJ Pediatrics
Additional Information:	Abstracts of the 2012 International Congress of the European Association of Poisons Centres and Clinical Toxicologists, 25 May-1 June 2012, London, UK
Publisher:	Taylor & Francis
ISSN:	1556-3650
Last Modified:	09 Feb 2022 11:26
URI:	https://orca.cardiff.ac.uk/id/eprint/43535

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