Possible Interaction: Ethanol and Histamine H2 Antagonists

“After alcohol absorption, ethanol elimination was significantly inhibited by both cimetidine (3.99 ± 0.39 vs. 5.68 ± 0.23 mmoles kg−1 … increase in ethanol absorption due to cimetidine but not to ranitidine in man at ethanol serum concentrations below 20 m M. At ethanol … H2‐receptor antagonists ….”

“SummaryThere are conflicting data on the existence of significant first-pass metabolism of alcohol (ethanol) in the human stomach and its inhibition by histamine H2-receptor antagonists.”

“It has been proposed that an appreciable fraction of ingested ethanol is metabolized in the gastric mucosa and that inhibition of this metabolism by H2‐receptor antagonists produces clinically important increases in blood ethanol.”

“ABSTRACT Introduction: In the 1980s–1990s numerous studies were performed on H2-receptor antagonist inhibition of ethanol first-pass metabolism.”

“Considerable controversy persists over the influence of H2‐receptor antagonists on the first pass clearance of ethanol.”

“TO THE EDITOR: The lack of interaction between ranitidine and blood alcohol reported by Casini and … [1] in eight patients with duodenal ulcer does not invalidate the many studies showing that histamine-2 (H2)-receptor antagonists (including ranitidine) increase … alcohol concentrations with small alcohol doses (150 mg/kg) [2].”

“In contrast, H2-receptor blockade aggravated the protein losing effect of ethanol throughout 90 min (p<0.01).”