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Is there an interaction between H2-antagonists and alcohol?

A G Fraser1

  • 1Department of Medicine, University of Auckland, New Zealand.

Drug Metabolism and Drug Interactions
|June 15, 1999
PubMed
Summary

H2-receptor antagonists may slightly increase blood alcohol levels at very low alcohol doses, but generally do not interact with alcohol at higher, impairing doses. Further research is needed on cumulative effects and gastric emptying.

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Area of Science:

  • Pharmacology
  • Toxicology
  • Gastroenterology

Background:

  • H2-receptor antagonists are widely prescribed, and alcohol consumption is common.
  • Potential interactions between H2-receptor antagonists and alcohol are significant due to co-administration and possible psychomotor impairment, affecting skills like driving.
  • Alcohol metabolism primarily occurs in the liver via alcohol dehydrogenase (ADH), with uncertainty regarding the role of gastric ADH.

Purpose of the Study:

  • To investigate the interaction between H2-receptor antagonists and alcohol metabolism.
  • To determine if H2-receptor antagonists affect blood alcohol concentrations (BAC) and psychomotor function.
  • To clarify the role of gastric ADH and gastric emptying in any potential interaction.

Main Methods:

  • Review of existing alcohol dosing studies involving H2-receptor antagonists.
  • Analysis of results based on different alcohol doses (0.15 g/kg and 0.3 g/kg and above).
  • Consideration of study designs, including cross-over studies with sufficient participant numbers to account for inter-subject variability.

Main Results:

  • At a low alcohol dose (0.15 g/kg), some H2-receptor antagonists may cause a small increase in BAC under specific conditions, less than the effect of a meal.
  • At higher alcohol doses (0.3 g/kg and above), evidence suggests no significant interaction between H2-receptor antagonists and alcohol.
  • No interaction was observed at alcohol doses expected to impair psychomotor skills (BAC > 25 mg/dl).

Conclusions:

  • H2-receptor antagonists do not significantly interact with alcohol at doses relevant to psychomotor impairment.
  • The potential effect of H2-receptor antagonists on alcohol absorption may be linked to gastric emptying, but findings are conflicting.
  • Further studies are required to understand the cumulative effects of repeated alcohol doses and the precise mechanisms of interaction.

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