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

ABSTRACT

 

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.

 

Conclusion:

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.