Cisapride increases peak plasma and saliva ethanol levels under fasting conditions.
OBJECTIVE
Alcohol absorption is influenced by gastric first-pass metabolism through an alcohol dehydrogenase and the gastric emptying time. Whilst an influence of antisecretory drugs and aspirin on gastric alcohol metabolism has been described, the role of prokinetic drugs has not been determined.


METHODS
A randomized, placebo-controlled double-blind cross-over study was performed.


METHODS
Out-patient facilities of a referral hospital.


METHODS
Eight male volunteers (age range 25-46 years).


METHODS
Treatment with two doses of either placebo or cisapride 150 micrograms/kg 7 h and 20 min before drinking 0.5 g/kg alcohol either in a fasting state or during a standardized meal (12 kcal/kg).


METHODS
Plasma and saliva ethanol concentrations were measured during 4 h.


RESULTS
Cisapride increased peak plasma ethanol levels in fasting subjects from 15.6 (SD 1.4, 95%-KI 14.7;16.6) to 17.8 (SD 2.7, 95%-KI 15.9;19.7) mmol/L and saliva ethanol 30 min after alcohol ingestion from 11.4 (SD 2.2. 95%-KI 9.9;12.9) to 15.9 (SD 4.3, 95%-KI 12.9;18.8) mmol/L. A significant interaction between fasting state and drug intake was found for the 30 min saliva ethanol values (P < 0.05, ANOVA for repeated measurements).


CONCLUSIONS
Cisapride may increase ethanol levels under fasting conditions. Patients treated with prokinetic drugs should be informed about this possibility.
Dziekan
G
G
Department of Internal Medicine, Kantonsspital, Chur, Switzerland.
Contesse
J
J
Werth
B
B
Schwarzer
G
G
Reinhart
W H
WH
D000328:Adult; D000704:Analysis of Variance; D020117:Cisapride; D018592:Cross-Over Studies; D004311:Double-Blind Method; D000431:Ethanol / Q000097:blood / Q000378:metabolism*; D005215:Fasting; D005746:Gastric Emptying; D005765:Gastrointestinal Agents / Q000494:pharmacology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010880:Piperidines / Q000494:pharmacology*; D012016:Reference Values; D012463:Saliva / Q000378:metabolism*; D013997:Time Factors
D005765:Gastrointestinal Agents; D010880:Piperidines; D000431:Ethanol; D020117:Cisapride