The hepatic injury caused by ranitidine is usually rapidly reversible with stopping the medication (Case 1). Rare instances of acute liver failure have been attributed to it, but ranitidine has not been definitively linked to cases of prolonged cholestasis or vanishing bile duct syndrome. Rechallenge usually causes recurrence and should be avoided. Interestingly, there appears to be little cross reactivity in hepatic injury between ranitidine and cimetidine. If acid suppression is required, use of an unrelated proton pump inhibitor is probably prudent for patients with clinically apparent ranitidine induced liver injury.
The H2 receptor blockers include cimetidine, famotidine, nizatidine, and ranitidine. Combined references on all four agents are given together after the Overview section on H2 blockers, as well as specific references after each drug. See also the proton pump inhibitors.