Zantac and Alcohol Don't Mix
Feb. 15, 2000 (Atlanta) -- The common antacid medication Zantac (and the
generic equivalent, ranitidine) can significantly increase blood alcohol levels
and impair driving ability, shows a new study in the American Journal of
"The effect was striking," says author Charles Lieber, MD. In a
three-hour test period, conducted under conditions similar to social drinking,
the study showed that ranitidine can increase blood alcohol content by 38%.
Levels reached in the study exceeded the legal drinking limit -- and the
effects lasted up to two hours after drinking stopped.
Lieber's previous studies have shown that a similar medication, Pepcid
(famotidine), had little effect on blood alcohol levels. Studies of ranitidine
showed that it also had little effect -- but was only tested with one small
"But, of course, social drinkers just don't drink one little drink, they
drink several. In this study, we showed that if you do that after taking
ranitidine, there's a cumulative effect, and it's quite significant. The blood
levels impair driving function. People should be warned that when they drink
moderately, they would find themselves driving home somewhat impaired. We felt
this was an important point. In some countries, like Denmark, there's a warning
label, but we don't have that yet," he tells WebMD. Lieber is professor of
medicine and pathology at Mt. Sinai School of Medicine in New York and chief of
the Alcohol Research Center at Bronx Veterans Affairs Medical Center.
In this study, Lieber and colleagues first screened 12 volunteers to find
those who were able to process alcohol normally. Up to 30% of healthy people
actually develop higher blood alcohol levels after drinking due to differences
in their livers.
To simulate a social situation, the remaining nine volunteers were first
given a standard breakfast, then were given four 10-ounce drinks at 45-minute
intervals (potato chips were also provided during the drinking period) and
blood levels were frequently measured. For the next week, each volunteer then
took 150 mg ranitidine (comparable to two Zantac) daily, and the test was then
repeated. That time, blood levels were higher after each drink -- high enough
to significantly impair driving or judgment.
When asked for objective commentary, Patrick Waring, MD, professor of
medicine at Emory University and co-director of Emory's Swallowing Center,
tells WebMD, "We've always thought there was some interaction, but didn't
think it was to the point that you would choose one drug over the
Better medications are available to treat gastrointestinal problems, says
Waring. "Frankly, I don't prescribe a lot of ranitidine. ... More and more
people are using the proton pump inhibitors like Prilosec, Prevacid, and
AcipHex, and I don't think there are significant problems with alcohol use with
those medications. When we talk to people about their [gastrointestinal]
problem, their ulcer or reflux, we tell them that alcohol can aggravate their
medical problem. If they are taking ranitidine for these symptoms, they
shouldn't be drinking for that reason."
Arnold Wald, MD, gastroenterologist with University of Pittsburgh Medical
Center, tells WebMD, "I thought [the study] was done very well. ... It's a
very good lab. Charles Lieber is well known for alcohol research. ... But at
the risk of being flip, I think you shouldn't drink four drinks and drive,
whether you're taking ranitidine or not."