To the Editor.
—The article by DiPadova et al1 described an increase in blood alcohol concentrations following cimetidine or ranitidine in a study using relatively small amounts of alcohol in men with a history of low alcohol intake, under fed conditions, in the morning. However, as DiPadova et al and others have shown, the interaction of H2-receptor antagonists and alcohol may not occur if the conditions are different (eg, larger amounts of alcohol, female subjects, subjects with a higher baseline alcohol intake, fasting subjects, or studies performed in the evening2,3). This was appropriately acknowledged by the authors in their discussion when they stated that "the possibility exists that some patients" may be affected by this interaction (emphasis added).Although several other studies have failed to find a clinically important effect of H2-receptor antagonists on blood alcohol concentration, the article by DiPadova et al discussed
Hansten PD. Effects of H2-Receptor Antagonists on Blood Alcohol Levels. JAMA. 1992;267(18):2469-2470. doi:10.1001/jama.1992.03480180055018