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.
Brown
A S
AS
Department of Medicine, University of Newcastle-upon-Tyne, UK.
James
O F
OF
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