Possible Interaction: Ethanol and Cimetidine

“…,ethanol … cimetidine (3.99 ± 0.39 vs. 5.68 ± 0.23 mmoles kg−1 hr−1, p < 0.02) and ranitidine (4.21 ± 0.14 vs. … ethanol serum concentrations above 20 m M, both H2‐receptor antagonists inhibit ethanol elimination in the rat suggesting inhibition of microsomal ethanol oxidation.”

“We refer to studies, primarily by Lieber and colleagues, indicating that therapeutic doses of cimetidine , ranitidine, and nizatidine, but not famotidine, elevate blood ethanol levels in nonalcoholic men following ingestion of moderate amounts of alcohol (approximately one or two glasses of wine or cans of beer) [2-4].”

“Chronic use of cimetidine and alcohol are commonly associated, but studies on their interactions are the subject of controversy.”

“Consequently, systemic effects of alcohol may be exacerbated in patients receiving cimetidine.”

“These results are at variance with some published data suggesting a significant interaction of cimetidine with the metabolism of alcohol by way of interference either with the hepatic oxidative metabolizing enzymes, or with the activity of alcohol dehydrogenase.”

“These results suggest that cimetidine has a small effect on the handling of ethanol in humans.”

“Since some antisecretory drugs such as cimetidine and ranitidine, interfere with ethanol metabolism by inhibition of hepatic and/or gastric alcohol dehydrogenase, we investigated the effect of lansoprazole, a new protonic pump inhibitor, on gastric and hepatic alcohol dehydrogenase activity.”

“On the contrary, cimetidine increased the AUCs of EtOH blood concentrations after both gastric and intravenous route and, in the in vitro assay, inhibited gastric and hepatic ADH in both man and rat.”

“Since some H2-receptor antagonists, like cimetidine or ranitidine, affect ethanol metabolism by interference with gastric and/or hepatic alcohol dehydrogenase (ADH) it was investigated whether omeprazole has a similar effect and its effects were compared with those of cimetidine, an inhibitor of gastric ADH.”

“In a number of studies, cimetidine in therapeutic doses over 7 days produced a significant increase in the AUC and in the peak plasma concentration after administration of alcohol 0.15 and 0.30 g/kg.”

“It is concluded that some H2-receptor antagonists cimetidine and nizatidine, in particular) can inhibit gastric ethanol oxidation and thus increase blood alcohol levels after drinking.”

“Expert opinion: At doses of 0.15–0.30 mg/kg in the postprandial state (primarily after breakfast), the H2-receptor antagonists: cimetidine , ranitidine, famotidine, and nizatidine have all been found to increase the first-pass metabolism of ethanol.”