Clinical Pharmacokinetics

, Volume 33, Issue 2, pp 79–90 | Cite as

Pharmacokinetic Interactions Between Alcohol and Other Drugs

  • Alan G. Fraser
Leading Article


The frequent use of alcohol (ethanol) together with prescription drugs gives any described pharmacokinetic interaction significant clinical implications. The issue is both the effect of alcohol on the pharmacokinetics of various drugs and also the effect of those drugs on the pharmacokinetics of alcohol. This review discusses these pharmacokinetic interactions but also briefly describes some other effects of alcohol that are clinically relevant to drug prescribing.

The use of several different study designs may be required before we can confidently state the presence or absence of any alcohol-drug interaction. Short term administration of alcohol in volunteers is the most common study design but studies of social drinking and prolonged moderate alcohol intake can be important in some situations. Community-based studies may illustrate the clinical relevance of any interaction.

Alcohol can affect the pharmacokinetics of drugs by altering gastric emptying or liver metabolism (by inducing cytochrome P450 2E1). Drugs may affect the pharmacokinetics of alcohol by altering gastric emptying and inhibiting gastric alcohol dehydrogenase. The role of gastric alcohol dehydrogenase in the first-pass metabolism of alcohol is reviewed in this article and the arguments for and against any potential interaction between alcohol and H2 receptor antagonists are also discussed. The inhibition of the metabolism of acetaldehyde may cause disulfiram-like reactions.

Pharmacodynamic interactions between alcohol and prescription drugs are common, particularly the additive sedative effects with benzodiazepines and also with some of the antihistamine drugs; other interactions may occur with tricyclic antidepressants. Alcohol intake may be a contributing factor to the disease state which is being treated and may complicate treatment because of various pathophysiological effects (e.g. impairment of gluconeogenesis and the risk of hypoglycaemia with oral hypoglycaemic agents). The combination of nonsteroidal anti-inflammatory drugs and alcohol intake increases the risk of gastrointestinal haemorrhage.


Cimetidine Gastric Emptying Ranitidine Famotidine Ethanol Ingestion 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Lieber CS. Mechanisms of ethanol-drug-nutrition interactions. J Toxicol Clin Toxicol 1994; 32: 631–81PubMedCrossRefGoogle Scholar
  2. 2.
    Lieber CS. Susceptibility to alcohol-related liver injury. Alcohol Alcohol 1994; Suppl. 2: 315–26Google Scholar
  3. 3.
    Holford NHG. Clinical pharmacokinetics of ethanol. Clin Pharmacokinet 1987; 13: 273–92PubMedCrossRefGoogle Scholar
  4. 4.
    Castaneda R, Sussman N, Westreich L, et al. A review of the effects of moderate alcohol intake on the treatment of anxiety and mood disorders. J Clin Psych 1996; 57: 207–12Google Scholar
  5. 5.
    Ghodse H. Combined use of drugs and alcohol. Curr Opin Psychiatry 1994; 7: 249–51CrossRefGoogle Scholar
  6. 6.
    Adams WL. Interactions between alcohol and other drugs. Int J Addict 1995; 30: 1903–23PubMedGoogle Scholar
  7. 7.
    Smit JWA, Wijnne HJA, Schobben F, et al. Effects of alcohol consumption on pharmacokinetics, efficacy, and safety of fluvastatin. Am J Cardiol 1995; 76: 89–96CrossRefGoogle Scholar
  8. 8.
    Morgan DJ, McLean AJ. Clinical pharmacokinetic and pharmacodynamic considerations in patients with liver disease. Clin Pharmacokinet 1995; 29: 370–91PubMedCrossRefGoogle Scholar
  9. 9.
    Thompson PJ. Social nocturnal alcohol consumption and pharmacokinetics of theophylline. Chest 1992; 101: 156–9PubMedCrossRefGoogle Scholar
  10. 10.
    Kendall MJ, Spannuth F, Walt RP, et al. Lack of effect of H2-receptor antagonists on the pharmacokinetics of alcohol consumed after food at lunchtime. Br J Clin Pharmacol 1994; 37: 371–4PubMedCrossRefGoogle Scholar
  11. 11.
    Gupta AM, Baraona E, Lieber CS. Significant increase of blood alcohol by cimetidine after repetitive drinking of small alcohol doses. Alcohol Clin Exp Res 1995; 19: 1083–7PubMedCrossRefGoogle Scholar
  12. 12.
    Jones AW, Jonsson KA. Between subject and within-subject variations in pharmacokinetics of ethanol. Br J Clin Pharmacol 1994; 37: 427–31PubMedCrossRefGoogle Scholar
  13. 13.
    Fraser AG, Rosalki SB, Gamble GG, et al. Inter-individual and intra-individual variability of ethanol concentration-time profiles: comparison of ethanol ingestion before or after an evening meal. Br J Clin Pharmacol 1995; 40: 387–92PubMedCrossRefGoogle Scholar
  14. 14.
    Friel PN, Baer JS, Logan BK. Variability of ethanol absorption and breath concentrations during a large-scale alcohol administration study. Alcohol Clin Exp Res 1995; 19: 1055–60PubMedCrossRefGoogle Scholar
  15. 15.
    Riley SA, Sutcliffe F, Kim M, et al. The influence of gastrointestinal transit on drug absorption in healthy volunteers. Br J Clin Pharmacol 1992; 34: 32–9PubMedCrossRefGoogle Scholar
  16. 16.
    Brophy CM, Moore JG, Christian PE, et al. Variability of gastric emptying measurements in man employing standardized radiolabelled meals. Dig Dis Sci 1986; 31: 799–806PubMedCrossRefGoogle Scholar
  17. 17.
    Jones AW, Jonsson KA. Food-induced lowering of blood-ethanol profiles and increased rate of metabolism immediately after a meal. J Forsensic Sci 1994; 39: 1084–93Google Scholar
  18. 18.
    Rogers J, Smith J, Starmer GA, et al. Differing effects of carbohydrate, fat and protein on the rate of ethanol metabolism. Alcohol Alcohol 1987; 22: 345–53PubMedGoogle Scholar
  19. 19.
    Pikaar NA, Wedel M, Hermus RJJ. Influence of several factors on blood alcohol concentrations after drinking alcohol. Alcohol Alcohol 1988; 23: 289–97PubMedGoogle Scholar
  20. 20.
    Pfeiffer A, Hogl B, Kaess H. Effect of ethanol ingestion and commonly ingested alcoholic beverages on gastric emptying and gastro-intestinal transit. Clin Investig 1992; 70: 487–91PubMedCrossRefGoogle Scholar
  21. 21.
    Wegener M, Schaffstein J, Digler U, et al. Gastrointestinal transit of solid-liquid meal in chronic alcoholics. Dig Dis Sci 1991; 36: 917–23PubMedCrossRefGoogle Scholar
  22. 22.
    Kitson KE. Ethanol and acetaldehyde metabolism: past, present, and future. Ethanol Clin Exp Res 1996; 20Suppl. 8: 82A–92ACrossRefGoogle Scholar
  23. 23.
    Wynne HA, Wood P, Herd B, et al. The association of age with the activity of alcohol dehygrogenase in human liver. Age Aging 1992; 21: 417–20CrossRefGoogle Scholar
  24. 24.
    Asai H, Imaoka S, Kuroki T, et al. Microsomal ethanol oxidising system activity by human hepatic cytochrome P450’s. J Pharmacol Exp Ther 1996; 277: 1004–9PubMedGoogle Scholar
  25. 25.
    Song BJ. Ethanol-inducible cytochrome P450 (CYP2E1): biochemistry, molecular biology and clinical relevance: 1996 update. Alcohol Clin Exp Res 1996; 20(8 Suppl.): 138A–46APubMedCrossRefGoogle Scholar
  26. 26.
    Lane EA, Guthrie S, Linnoila M. Effect of ethanol on drug and metabolite pharmacokinetics. Clin Pharmacokinet 1985; 10: 228–47PubMedCrossRefGoogle Scholar
  27. 27.
    Sternebring B, Liden A, Andersson K, et al. Carbamazepine kinetics and adverse effects during and after ethanol exposure in alcoholics and in healthy volunteers. Eur J Clin Pharmacol 1992; 43: 393–7PubMedCrossRefGoogle Scholar
  28. 28.
    Desmond PV, Patwardhan RV, Schenker S, et al. Short-term ethanol administration impairs the elimination of chlordiazepoxide in man. Eur J Clin Pharmacol 1980; 18: 275–8PubMedCrossRefGoogle Scholar
  29. 29.
    Hoyumpa AM, Patwardhan R, Maples M, et al. Effect of short-term ethanol adminstration on lorazepam clearance. Hepatology 1981; 1: 47–53PubMedCrossRefGoogle Scholar
  30. 30.
    Tsutumi R, Leo MA, Kim C, et al. Interaction of ethanol with enflurane metabolism and toxicity: role of P450IIE1. Alcohol Clin Exp Res 1990; 14: 174–9CrossRefGoogle Scholar
  31. 31.
    Bonkovsky HL, Kane RE, Jones DP, et al. Acute hepatic and renal toxicity from low doses of acetaminophen in the absence of alcohol abuse or malnutrition: evidence for increased susceptibility to drug toxicity due to cardiopulmonary and renal insufficiency. Hepatology 1994; 19: 1141–8PubMedCrossRefGoogle Scholar
  32. 32.
    Collins C, Starmer GA. A review of the hepatoxicity of paracetamol at therapeutic or near therapeutic dose levels, with particular reference to alcohol users. Drug Alcohol Rev 1995; 14: 63–79PubMedCrossRefGoogle Scholar
  33. 33.
    Zimmerman HJ, Maddrey WC. Acetaminophen (paracetamol) hepatotoxicity with regular intake of alcohol: analysis of instances of therapeutic misadventure. Hepatology 1995; 22: 767–73PubMedCrossRefGoogle Scholar
  34. 34.
    Lieber CS, Garro A, Leo MA, et al. Alcohol and cancer. Hepatology 1986; 6: 1005–19PubMedCrossRefGoogle Scholar
  35. 35.
    Horowitz M, Maddox A, Harding PE, et al. Relationships between gastric emptying of solid and caloric liquid meals and alcohol absorption. Am J Physiol 1987: 256: G291–8Google Scholar
  36. 36.
    Roine R, Heikkonen E, Salaspuro M. Cisapride enhances alcohol absorption and leads to high blood alcohol levels [abstract]. Gastroenterology 1992; 102: A507Google Scholar
  37. 37.
    Edelbroek MA, Horowitz M, Wishart JM, et al. Effects of erythromycin on gastric emptying, alcohol absorption and small intestinal transit in normal subjects. J Nucl Med 1993; 34: 582–8PubMedGoogle Scholar
  38. 38.
    Hebbard GS, Sun WM, Bochner F, et al. Pharmacokinetic considerations in gastrointestinal motor disorders. Clin Pharmacokinet 1995; 28: 41–66PubMedCrossRefGoogle Scholar
  39. 39.
    Caballeria J, Frezza M, Hernandez Munoz R, et al. Gastric origin of the first-pass metabolism of ethanol in humans: effect of gastrectomy. Gastroenterology 1989; 97: 1205–9PubMedGoogle Scholar
  40. 40.
    Levitt MD. Antagonist: the case against first-pass metabolism of ethanol in the stomach. J Lab Clin Med 1994; 123: 28–31PubMedGoogle Scholar
  41. 41.
    Gentry RT, Baraona E, Lieber CS. Agonist: gastric first pass metabolism of alcohol. J Lab Clin Med 1994; 123: 21–6PubMedGoogle Scholar
  42. 42.
    Ammon E, Schafer C, Hofmann U, et al. Disposition and first-pass metabolism of ethanol in humans: is it gastric or hepatic and does it depend on gender. Clin Pharmacol Ther 1996; 59: 503–13PubMedCrossRefGoogle Scholar
  43. 43.
    Saint-Blanquet G, Fritisch P, Deranche R. Alcohol dehydrogenase activity of the gastric mucosa following administration of alcohol to the rat. Pathol Biol 1972; 20: 249Google Scholar
  44. 44.
    Lamboeuf Y, De Saint-Blanquent G, Deranche R. Mucosal alcohol dehydrogenase and aldehyde dehydrogenase mediated ethanol oxidation in the digestive tract of the rat. Biochem Pharmacol 1981; 30: 542–5PubMedCrossRefGoogle Scholar
  45. 45.
    Yin S-J, Wang M-F, Liao C-S, et al. Identification of a human stomach alcohol dehydrogenase with distinctive kinetic properties. Biochem Int 1990; 22: 829–35PubMedGoogle Scholar
  46. 46.
    Pares X, Moreno A, Cederlund E, et al. Class IV mammalian alcohol dehydrogenase: structural data of the rat stomach enzyme reveal a new class well seperated from those already characterised. FEBS Lett 1990; 277: 115–8PubMedCrossRefGoogle Scholar
  47. 47.
    Moreno A, Pares X. Purification and characterisation of a new alcohol dehydrogenase from human stomach. J Biol Chem 1991; 266: 1128–33PubMedGoogle Scholar
  48. 48.
    Barona E, Yokoyama A, Ishii H, et al. Lack of alcohol dehydrogenase isoenzymes in the stomach of Japanese subjects. Life Sci 1991; 49: 1929–34CrossRefGoogle Scholar
  49. 49.
    Frezza M, di Padova C, Pozzato G, et al. High blood alcohol levels in women: the role of decreased gastric alcohol dehydrogenase activity and first-pass metabolism. N Engl J Med 1990; 322: 95–9PubMedCrossRefGoogle Scholar
  50. 50.
    Thomasson HR. Gender differences in alcohol metabolism. Physiological responses to ethanol. Recent Dev Alcohol 1995; 12: 163–79PubMedCrossRefGoogle Scholar
  51. 51.
    Seitz HK, Simanowski UA, Waldherr R, et al. Human gastric alcohol dehygroenase activity: effect of age, sex and alcoholism. Gut 1993; 34: 1433–7PubMedCrossRefGoogle Scholar
  52. 52.
    Brown AS, Fiatarone JR, Wood P, et al. The effect of gastritis on human gastric alcohol dehydrogenase activity and ethanol metabolism. Aliment Pharmacol Ther 1995; 9: 57–61PubMedCrossRefGoogle Scholar
  53. 53.
    Pedrosa MC, Russell RM, Saltzman JR, et al. Gastric emptying and first pass metabolism of ethanol in elderly subjects with and without atrophic gastritis. Scand J Gastroenterol 1996; 31: 671–7PubMedCrossRefGoogle Scholar
  54. 54.
    Lim Jr RT, Gentry RT, Ito D, et al. First-pass metabolism of ethanol is predominantly gastric. Alcohol Clin Exp Res 1993; 17: 1337–44PubMedCrossRefGoogle Scholar
  55. 55.
    Julkensen RJ, DiPadova C, Lieber CS. First pass metabolism of ethanol: a gastrointestinal barrier against systemic toxicity of ethanol. Life Sci 1985; 37: 567–73CrossRefGoogle Scholar
  56. 56.
    Di Padova C, Worner TM, Julkunen RJ, et al. Effects of fasting and chronic alcohol consumption on the first-pass metabolism of ethanol. Gastroenterology 1987; 92: 1169–73Google Scholar
  57. 57.
    Levitt MD, Levitt DG. The critical role of the rate of ethanol absorption in the interpretation of studies purporting to demonstrate gastric metabolism of ethanol. J Pharmacol Exp Ther 1994; 269: 297–304PubMedGoogle Scholar
  58. 58.
    Byrne AJ, McNeil JJ, Harrison PM, et al. Stable oral availability of sustained release propranolol when co-administered with hydralazine or food: evidence implicating substrate delivery rates as a determinant of pre-systemic drug interactions. Br J Clin Pharmacol 1984; 17: 45S–50SPubMedCrossRefGoogle Scholar
  59. 59.
    Smith T, DeMaster EG, Furne JK, et al. First-pass gastric mucosal metabolism of ethanol is negligible in the rat. J Clin Invest 1992; 89: 1801–6PubMedCrossRefGoogle Scholar
  60. 60.
    Hernadez-Munoz R, Caballeria J, Baraona E, et al. Human gastric alcohol dehydrogenase: it’s inhibition by H2-receptor antagonists, and it’s effect on the bioavailability of ethanol. Alcohol Clin Exp Res 1990; 14: 946–50CrossRefGoogle Scholar
  61. 61.
    Caballeria J, Baraona E, Deulofeu R, et al. Effects of H2-receptor antagonists on gastric alcohol dehydrogenase activity. Dig Dis Sci 1991; 36: 1673–9PubMedCrossRefGoogle Scholar
  62. 62.
    Mallat A, Roudot-Thoraval F, Bergmann J-F, et al. Inhibition of gastric alcohol dehydrogenase activity by histamine H2-receptor antagonists has no influence on the pharmacokinetics of ethanol after a moderate dose. Br J Clin Pharmacol 1994; 37: 208–11PubMedCrossRefGoogle Scholar
  63. 63.
    Raufman JP, Notar-Francesco V, Rasffaniello RD. Histamine2-receptor antagonists and serum ethanol levels. Ann Int Med 1993; 119: 953–5Google Scholar
  64. 64.
    Seitz HK, Veith S, Czygan P, et al. In vivo interactions between H2-receptor antagonists and ethanol metabolism in man and in rats. Hepatology 1984; 4: 1231–4PubMedCrossRefGoogle Scholar
  65. 65.
    Dobrilla G, de Pretis G, Piazzi L, et al. Is ethanol metabolism affected by oral administration of cimetidine and ranitidine at therapeutic doses? Hepatogastroenterology 1984; 31: 35–7PubMedGoogle Scholar
  66. 66.
    Tanaka E, Nakamura K. Effects of H2-receptor antagonists on ethanol metabolism in Japanese volunteers. Br J Clin Pharmacol 1988; 26: 96–9PubMedCrossRefGoogle Scholar
  67. 67.
    Norpoth T, Kneip M, Oehmichen M, et al. The effect of the administration H2-receptor blockers on alcohol kinetics and psycophysical fitness. Beitr Geschtl Med 1986; 44: 1–4Google Scholar
  68. 68.
    Jonsson KA, Jones AW, Bostrom H, et al. Lack of effect of omeprazole, and ranitidine on the pharmacokinetics of ethanol in fasting male volunteers. Eur J Clin Pharmacol 1990; 42: 209–12CrossRefGoogle Scholar
  69. 69.
    Brown AS, James OFW. Cimetidine, ranitidine and omeprazole have no effect on peak blood ethanol concentration, first pass metabolism or area under the time/ethanol curve under real life conditions. Hepatology 1996; 23: 1–42CrossRefGoogle Scholar
  70. 70.
    Toon S, Khan AZ, Holt BI, et al. Absence of effect of ranitidine on blood alcohol concentrations when taken morning, midday, or evening with or without food. Clin Pharmacol Ther 1994; 55: 385–91PubMedCrossRefGoogle Scholar
  71. 71.
    Fraser AG, Prewett EJ, Hudson M, et al. Ranitidine has no effect on post-prandial absorption of alcohol (0.6g/kg) after an evening meal. Eur J Gastroenterol Hepatol 1992; 4: 43–8Google Scholar
  72. 72.
    Fraser AG, Hudson M, Sawyer AM, et al. Ranitidine, cimetidine, famotidine have no effect on post-prandial absorption of ethanol 0.8 g/kg taken after an evening meal. Aliment Pharmacol Ther 1992; 6: 693–700PubMedCrossRefGoogle Scholar
  73. 73.
    Bye A, Lacey LF, Gupta S, et al. Effect of ranitidine hydrochloride (150mg twice daily) on the pharmacokinetics of increasing doses of ethanol (0.15, 0.3, 0.6g/kg1). Br J Clin Pharmacol 1996; 41: 129–33PubMedCrossRefGoogle Scholar
  74. 74.
    Holtzman JL, Gebhard RL, Eckfield JH, et al. The effects of several weeks of ethanol consumption on ethanol kinetics in normal men and women. Clin Pharmacol Ther 1985; 38: 157–63PubMedCrossRefGoogle Scholar
  75. 75.
    Webster LK, Jones DB, Smallwood RA. Influence of cimetidine and ranitidine on ethanol pharmacokinetics. Aust NZ J Med 1985; 15: 359–60CrossRefGoogle Scholar
  76. 76.
    Guram M, Howden CW, Holt S. Further evidence for an interaction between alcohol and certain H2-receptor antagonists. Alcohol Clin Exper Res 1991; 15: 1084–5CrossRefGoogle Scholar
  77. 77.
    Johnson KI, Fenzl E, Hein B. Influence of cimetidine on the elimination and effects of alcohol. Arzneimettel Forschung 1984; 34: 734–6Google Scholar
  78. 78.
    Feely J, Wood AJ. Effects of cimetidine on the elimination of ethanol. JAMA 1982; 247: 2819–21PubMedCrossRefGoogle Scholar
  79. 79.
    Gupta SK, Ellinwood EH, Muir KT, et al. Ethanol pharmacodynamics at low blood concentrations. Am J Ther 1996; 3: 375–82PubMedCrossRefGoogle Scholar
  80. 80.
    Caballeria J, Baraona E, Rodamilans M, et al. Effects of cimetidine on gastric alcohol dehydrogenase activity and blood ethanol levels. Gastroenterology 1989; 96: 388–92PubMedGoogle Scholar
  81. 81.
    DiPadova C, Roine R, Frezza M, et al. Effects of ranitidine on blood alcohol levels after ethanol ingestion: comparison with other H2-receptor antagonists. JAMA 1992; 267: 83–6PubMedCrossRefGoogle Scholar
  82. 82.
    Sharma R, Gentry T, Lim Jr RT. First-pass metabolism of alcohol: absence of diurnal variation and its inhibition by cimetidine after evening meal. Dig Dis Sci 1995; 40: 2091–7PubMedCrossRefGoogle Scholar
  83. 83.
    Dauncey H, Chesher GB, Palmer RH. Cimetidine and ranitidine. Lack of effect on the pharmacokinetics of an acute ethanol dose. J Clin Gastroenterol 1993; 17: 189–94PubMedCrossRefGoogle Scholar
  84. 84.
    Casini A, Pizzigallo AM, Mari F, et al. Prolonged bedtime treatment with H2-receptor antagonists (ranitidine and famotidine) does not affect blood alcohol levels after ethanol ingestion in male patients with duodenal ulcer. Am J Gastroenterol 1994; 89: 745–9PubMedGoogle Scholar
  85. 85.
    Fraser AG, Prewett EJ, Hudson M, et al. The effect of ranitidine, cimetidine or famotidine on low-dose post-prandial alcohol absorption. Aliment Pharmacol Ther 1991; 5: 263–72PubMedCrossRefGoogle Scholar
  86. 86.
    Fraser AG, Sawyer AM, Hudson M, et al. The effect of ranitidine on post-breakfast alcohol absorption. Am J Gastroenterol 1993; 88: 217–21PubMedGoogle Scholar
  87. 87.
    Kleine MW, Erlt D. Comparative trial in volunteers to investigate possible ethanol-ranitidine interaction. Ann Pharmacother 1993; 27: 841–5PubMedGoogle Scholar
  88. 88.
    Brown AS, Fiaterone JR, Day CP, et al. Ranitidine increases the bioavailability of postprandial ethanol by the reduction of first pass metabolism. Gut 1995; 37: 413–7PubMedCrossRefGoogle Scholar
  89. 89.
    Fraser AG, Hudson M, Sawyerr AM, et al. The effect of ranitidine on the post-prandial absorption of a low dose of alcohol. Aliment Pharmacol Ther 1992; 6: 267–71PubMedCrossRefGoogle Scholar
  90. 90.
    Palmer RH, Frank WO, Nambi P, et al. Effects of various concomitant medications on gastric alcohol dehydrogenase and the first-pass metabolism of ethanol. Am J Gastroenterol 1991; 86: 1749–55PubMedGoogle Scholar
  91. 91.
    Dunbar JA, Pentilla A, Pikkarainen J. Drinking and driving: choosing the legal limits. BMJ 1987; 95: 1458–60CrossRefGoogle Scholar
  92. 92.
    Palmer RH. Cimetidine and alcohol. Drug Investig 1994; 8: 63–5CrossRefGoogle Scholar
  93. 93.
    Levitt MD. Lack of clinical significance of the interaction between H2-receptor antagonists and ethanol. Aliment Pharmacol Ther 1993; 7: 131–8PubMedCrossRefGoogle Scholar
  94. 94.
    Gugler R. H2-antagonists and alcohol: do they interact? Drug Saf 1994; 10: 271–80PubMedCrossRefGoogle Scholar
  95. 95.
    Pipkin GA, Mills JG, Woods JR. Does ranitidine affect blood alcohol concentrations? Pharmacotherapy 1994; 14: 273–81PubMedGoogle Scholar
  96. 96.
    Koppa SD. H2 antagonists and alcohol: none for the road? Drug Ther 1993; 23: 52–4Google Scholar
  97. 97.
    Houghton LA, Read NW. A comparative study of the effect of cimetidine and ranitidine on the rate of gastric emptying of liquid and solid test meals in man. Aliment Pharmacol Ther 1987; 1: 401–8PubMedCrossRefGoogle Scholar
  98. 98.
    Kerrigan DD, Mangnall YF, Read NW, et al. Influence of acid-pepsin secretion on gastric empying of solids in humans: studies with cimetidine. Gut 1991; 32: 1295–7PubMedCrossRefGoogle Scholar
  99. 99.
    Amir I, Anwar N, Baraona E, et al. Ranitidine increases the bioavailability of imbibed alcohol by accelerating gastric emptying. Life Sci 1996; 58: 511–8PubMedCrossRefGoogle Scholar
  100. 100.
    Burnham DB, Miller D, Karlstadt R, et al. Famotidine increases plasma alcohol concentration in healthy subjects. Aliment Pharmacol Ther 1994; 8: 55–61PubMedCrossRefGoogle Scholar
  101. 101.
    Teyssen S, Chari ST, Singer MV. Effect of a 28-day therapy with the H2-receptor antagonist famotidine on blood levels of alcohol and gastrin in healthy human subjects. Gut 1994; 35Suppl. 4: 83Google Scholar
  102. 102.
    Pozzato G, Franzin F, Moretti M, et al. Effects of omeprazole on ethanol metabolism: an in vitro and in vivo rat and human study. Pharmacol Res 1994; 29: 47–58PubMedCrossRefGoogle Scholar
  103. 103.
    Rahal PS, Rahal SK, Katragadda R, et al. Effect of omeprazole on blood ethanol kinetics [abstract]. Clin Res 1994; 42: 241AGoogle Scholar
  104. 104.
    Roine R, Hernandez-Munoz R, Baraona E, et al. Effect of omeprazole on gastric first-pass metabolism of ethanol. Dig Dis Sci 1992; 37: 891–6PubMedCrossRefGoogle Scholar
  105. 105.
    Minocha A, Singh Rahal P, Brier ME, et al. Omeprazole therapy does not affect pharmacokinetics of orally administered ethanol in healthy male subjects. J Clin Gastroenterol 1995; 21: 107–9PubMedCrossRefGoogle Scholar
  106. 106.
    Girre C, Coutelle C, David P, et al. Lack of effect of lansoprazole on the pharmacokinetics of ethanol in male volunteers. Gastroenterology 1994; 106 Suppl.: 504Google Scholar
  107. 107.
    Teyssen S, Singer MV, Heinze H, et al. Pantoprazole does not influence the pharmacokinetics of ethanol in healthy volunteers. Gastroenterology 1996: 110 Suppl.: 277Google Scholar
  108. 108.
    Johansson B. A review of the pharmacokinetics and pharmacodynamics of disulfiram and its metabolites. Acta Psychiatr Scand Suppl 1992; 369: 15–26PubMedCrossRefGoogle Scholar
  109. 109.
    Lassman HB, Hubbard JW, Chen BL, et al. Lack of interaction between cefpirome and alcohol. J Antimicrob Chemother 1992; 29Suppl. A: 47–50PubMedCrossRefGoogle Scholar
  110. 110.
    Vasiliou V, Malamas M, Marselos M. The mechanism of alcohol intolerance produced by various therapeutic drugs. Acta Pharmacol Toxicol 1986; 58: 303–10Google Scholar
  111. 111.
    Fett DL, Vukov LF. An unusual case of severe griseofulvin-alcohol interaction. Ann Emerg Med 1994; 24: 95–7PubMedCrossRefGoogle Scholar
  112. 112.
    Lau AH, Lam NP, Piscitelli SC, et al. Clinical pharmacokinetics of metronidazole and other nitroimidazole anti-infectives. Clin Pharmacokinet 1992; 23: 328–64PubMedCrossRefGoogle Scholar
  113. 113.
    Seitz C, Garcia P, Arancibia A. Influence of ethanol ingestion on tetracycline kinetics. Int J Clin Pharmacol Ther 1995; 33: 462–4PubMedGoogle Scholar
  114. 114.
    Larsen FG, Jakobsen P, Knudsen J, et al. Conversion of acitretin to etretinate in psoriatic patients is influenced by ethanol. J Invest Dermatol 1993; 100: 623–7PubMedCrossRefGoogle Scholar
  115. 115.
    Wittes RC, Saginur R. Adverse reaction to mefloquine associated with ethanol ingestion. Can Med Assoc J 1995; 152: 515–7Google Scholar
  116. 116.
    Vuurman EFPM, Muntjewerff ND, Uiterwijk MMC, et al. Effects of mefloquine along and with alcohol on psychomotor and driving performance. Eur J Clin Pharmacol 1996; 50: 475–82PubMedCrossRefGoogle Scholar
  117. 117.
    Haffner HT, Wehner HD, Scheytt KD, et al. The elimination kinetics of methanol and the influence of ethanol. Int J Legal Med 1992; 105: 111–4PubMedCrossRefGoogle Scholar
  118. 118.
    D’Arcy PF, Griffin JP. Interactions with drugs used in the treatment of depressive illness. Adv Drug Reactions Toxicol Rev 1992; 14: 211–31Google Scholar
  119. 119.
    Tiller JWG. Antidepressants, alcohol and psychomotor performance. Acta Psychiatr Scand 1990; Suppl. 360: 13–7Google Scholar
  120. 120.
    Hyatt MC, Bird MA. Amitrypyline augments and prolongs ethanol-induced euphoria. J Clin Pyschopharmacol 1987; 7: 277–8CrossRefGoogle Scholar
  121. 121.
    Dorian P, Sellers EM, Reed KL. Amitriptyline and ethanol: pharmacokinetic and pharmacodynamic interaction. Eur J Clin Pharmacol 1983; 25: 325–31PubMedCrossRefGoogle Scholar
  122. 122.
    Lemberg L, Rowe H, Berstrom RF, et al. The effect of fluoxetine on pysychomotor performance, physiologic response, and kinetics of ethanol. Clin Pharmacol Ther 1985; 37: 658–64CrossRefGoogle Scholar
  123. 123.
    Kerr JS, Fairweather DB, Mahendran R, et al. The effects of paroxetine, alone and in combination with ethanol on psychomotor performance and cognitive function in the elderly. Int Clin Psychopharmacol 1992; 7: 101–8PubMedGoogle Scholar
  124. 124.
    Van Harten J, Stevens LA, Raghoebar M, et al. Fluvoxamine does not interact with ethanol or potentiate alcohol-related impairment of cognitive function. Clin Pharmacol Ther 1992; 52: 427–35PubMedCrossRefGoogle Scholar
  125. 125.
    Hoyovadillo C, Mandema JW, Danhof M. Pharmacodynamic interaction between midazolam and a low dose of ethanol in vivo. Life Sci 1995; 57: 325–33CrossRefGoogle Scholar
  126. 126.
    Lichtor JL, Korttila K, Apfelbaum J, et al. Alcohol after midazolam sedation: does it really matter? Anesth Analg 1990; 70 Suppl.: 237CrossRefGoogle Scholar
  127. 127.
    Linnoila M, Stapleton JM, Moss H, et al. Effects of single doses of alprazolam and diazepam, alone and in combination with ethanol, on psychomotor and cognitive performance and on autonomic nervous system reactivity in healthy volunteers. Eur J Clin Pharmacol 1990; 39: 21–8PubMedCrossRefGoogle Scholar
  128. 128.
    Sellers EM, Busto U. Benzodiazepines and ethanol: assessment of the effects and consequences of psychotropic drug interactions. J Clin Psychpharmacol 1982; 2: 249–62Google Scholar
  129. 129.
    Hayes SL, Pablo G, Radomski T, et al. Ethanol and oral diazepam absorption. N Eng J Med 1977; 296: 186–9CrossRefGoogle Scholar
  130. 130.
    Lichtor JL, Zacny JP, Coalson DW, et al. The interaction between ethanol and the residual effects of thiopental anaesthesia. Anaesthesiology 1993; 79: 28–35CrossRefGoogle Scholar
  131. 131.
    Motherway C, Colreavy F, Denish N, et al. Induction dose of propofol: the effect of alcohol intake. Br J Anaesth 1995; 74Suppl. 1: 82Google Scholar
  132. 132.
    Fassoulaki A, Farinotti R, Servin F, et al. Chronic alcoholism increases the induction dose of propofol in humans. Anesth Analg 1993; 77: 553–6PubMedCrossRefGoogle Scholar
  133. 133.
    Swift RM, Davidson D, Whelihan W, et al. Ondansetron alters human alcohol intoxication. Biol Psychiatry 1996; 40: 514–21PubMedCrossRefGoogle Scholar
  134. 134.
    Moser L, Huther KJ, Koch-Weser J, et al. Effects of terfenadine or diphenhydramine alone, and in combination with diazepam or alcohol on pyschomotor performance and subjective feelings. Eur J Clin Pharmacol 1978; 14: 417–23PubMedCrossRefGoogle Scholar
  135. 135.
    Patat A, Stubbs D, Dunmore C, et al. Lack of interaction between two antihistamines, mizolastine and cetrizine, and ethanol in pyschomotor and driving performance in healthy subjects. Eur J Clin Pharmacol 1995; 48: 143–50PubMedCrossRefGoogle Scholar
  136. 136.
    Richens A. Pharmacokinetic and pharmacodynamic drug interactions during treatment with vigabatrin. Acta Neurol Scand Suppl 1995; 162; 43–6PubMedGoogle Scholar
  137. 137.
    MacMahon S. Alcohol consumption and hypertension. Hypertension 1987; 9: 111–21PubMedCrossRefGoogle Scholar
  138. 138.
    Schuckit MA. Alcohol and depression: a clinical perspective. Acta Psychiatr Scand Suppl 1994; 89Suppl. 377: 28–32CrossRefGoogle Scholar
  139. 139.
    Krentz AJ, Ferner RE, Bailey CJ. Comparative tolerability profiles of oral antidiabetic agents. Drug Saf 1994; 11: 223–41PubMedCrossRefGoogle Scholar
  140. 140.
    Chan JCN, Cockram CS, Critchley JAJH. Drug-induced disorders of glucose metabolism: mechanisms and management. Drug Saf 1996; 15: 135–57PubMedCrossRefGoogle Scholar
  141. 141.
    Ginsburg ES, Mello NK, Mendelson JH, et al. Effects of ethanol ingestion on estrogens in postmenopausal women. JAMA 1996; 276: 1747–51PubMedCrossRefGoogle Scholar
  142. 142.
    Sellers EM, Frecker RC, Romach MK. Drug metabolism in the elderly: confounding of age, smoking and ethanol effects. Drug Metab Rev 1983; 14: 225–50PubMedCrossRefGoogle Scholar
  143. 143.
    Berstein LR, Folkman S, Lazarus RS. Characterisation of the use and misuse of medications by an elderly ambulatory population. Med Care 1989; 27: 654–63CrossRefGoogle Scholar
  144. 144.
    Adams WL. Potential for adverse drug-alcohol interactions among retirement community residents. J Am Geriatr Soc 1995; 43: 1021–5PubMedGoogle Scholar
  145. 145.
    Forster LE, Pollow R, Stoller EP. Alcohol use and potential risk for alcohol-related adverse drug reactions among community based elderly. J Comm Health 1993; 18: 225–39CrossRefGoogle Scholar
  146. 146.
    Melander O, Lidaaen A, Melander A. Pharmacokinetic interactions of alcohol and acetylsalicylic acid. Eur J Clin Pharmacol 1995; 48: 151–3PubMedCrossRefGoogle Scholar
  147. 147.
    Sharma SC, Feely J. The influence of aspirin and paracetamol on blood concentrations of alcohol in young adults. Br J Clin Pharmacol 1996; 41: 467Google Scholar
  148. 148.
    Roine R, Gentry T, Hernandez-Munoz R, et al. Aspirin increases blood alcohol concentrations in humans after ingestion of ethanol. JAMA 1990; 264; 2406–8PubMedCrossRefGoogle Scholar
  149. 149.
    Deykin D, Janson P, McMahon L. Ethanol potentiation of aspirin-induced prolongation of the bleeding time. N Eng J Med 1982; 306: 852–4CrossRefGoogle Scholar
  150. 150.
    Henry D, Dobson A, Turner C. Variability in the risk of major gastrointestinal complications from nonaspirin nonsteroidal anti-inflammatory drugs. Gastroenterology 1993; 105: 1078–88PubMedGoogle Scholar
  151. 151.
    Johnson GR, Wen SF. Syndrome of flank pain and acute renal failure after binge drinking and non-steroidal anti-inflammatory drug ingestion. J Am Soc Nephrol 1995: 5: 1647–52PubMedGoogle Scholar

Copyright information

© Adis International Limited 1997

Authors and Affiliations

  1. 1.Department of MedicineUniversity of AucklandAucklandNew Zealand

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