Omeprazole, ranitidine, and cimetidine have no effect on peak blood ethanol concentrations, first pass metabolism or area under the time-ethanol curve under 'real-life' drinking conditions.
BACKGROUND
Considerable controversy persists over the influence of H2-receptor antagonists on the first pass clearance of ethanol. The majority of previously published studies have studied the effects of the drugs on low-dose ethanol in the fasting state. We elected to study the possible interaction under simulated real-life conditions.


METHODS
Twenty-three volunteers were given 0.6 g/kg body weight ethanol in the form of 4.8% beer following a standardized meal. Blood ethanol levels were measured over the next 3 h. Studies were repeated using ethanol administered as an intravenous infusion while subjects consumed the same volume of de-alcoholized beer. The effects of a minimum of 2 weeks of dosing with cimetidine, ranitidine and omeprazole were examined.


RESULTS
Following food, and with ethanol taken in the form of beer, mean first pass metabolism of ethanol was 58% (range 34-78%). No statistically significant difference was found following drug treatment in either percentage first pass metabolism, peak blood ethanol concentration or area under the time-blood ethanol curve.


CONCLUSIONS
Under these 'real-life' conditions, the concomitant administration of cimetidine, ranitidine or omeprazole is unlikely to have significant physical, social or forensic implications, since they do not significantly change ethanol elimination.
Department of Medicine, University of Newcastle-upon-Tyne, UK.
A S
AS
Brown
O F
OF
James
D000328:Adult; D000428:Alcohol Drinking; D019540:Area Under Curve; D002492:Central Nervous System Depressants / Q000097:blood / Q000493:pharmacokinetics*; D002927:Cimetidine / Q000494:pharmacology*; D000431:Ethanol / Q000097:blood / Q000493:pharmacokinetics*; D005260:Female; D006635:Histamine H2 Antagonists / Q000494:pharmacology*; D006801:Humans; D008297:Male; D009853:Omeprazole / Q000494:pharmacology*; D011899:Ranitidine / Q000494:pharmacology*; D012016:Reference Values
D002492:Central Nervous System Depressants; D006635:Histamine H2 Antagonists; D000431:Ethanol; D002927:Cimetidine; D011899:Ranitidine; D009853:Omeprazole