Possible Interaction: Ethanol and Ranitidine

“…,ethanol … ranitidine (4.21 ± 0.14 vs. 5.68 ± 0.23 mmoles kg−1 hr−1, p < 0.02) at high ethanol concentrations (60 to 20 … ethanol serum concentrations above 20 m M, both H2‐receptor antagonists inhibit ethanol elimination in the rat suggesting inhibition of microsomal ethanol oxidation.”

“In addition, all subjects withdrawn from ranitidine (n = 6) had a significant reduction in peak blood ethanol concentration and area under the curve after repeat dosing with oral ethanol.”

“Peak blood ethanol concentrations, and area under the blood ethanol/time curve, were significantly higher in the ranitidine group after oral, but not intravenous, ethanol administration.”

“These findings show that ranitidine increases the bioavailability of low dose ethanol and has possible short term forensic, and longterm physical implications for moderate drinkers who are taking the drug.”

“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].”

“h/dL, respectively, P= 0.07), and a statistically significant increase in mean peak plasma alcohol concentration after dosing with ranitidine (4.92 and 6.47 mg/dL, respectively, P= 0.05).”

“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.”

“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.”

“Both ranitidine and nizatidine enhanced the absorption of small doses of alcohol (0.15 g/kg) in the morning by 63% and 64% and increased Cmax by 48% and 54% respectively (p less than 0.001), effects similar to those reported by others for cimetidine.”

“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.”

“CONCLUSIONS: Cimetidine and ranitidine , but not the other H2RAs, can cause small elevations of serum alcohol level when alcohol and drug are administered concurrently.”

“Small elevations in Cmax were noted when cimetidine (2.71 mg/DL; 95% confidence internal [CI] 1.60, 3.83) or ranitidine (6.95 mg/DL; 95% CI 5.83, 8.08) were coadministered with alcohol.”

“OBJECTIVE Ranitidine increases blood alcohol concentrations by decreasing the first pass metabolism of ethanol.”

“The effect of ranitidine on alcohol levels has been found to be variable when using large doses of alcohol or conditions in which its first pass metabolism is known to be minimal.”