Cisapride increases peak plasma and saliva ethanol levels under fasting conditions

Abstract

Objectives. Alcohol absorption is influenced by gastric first-pass metabolism through an alcohol dehydrogenase and the gastric emptying time. Whilst an influence of antisecretory drugs and aspirin on gastric alcohol metabolism has been described, the role of prokinetic drugs has not been determined. Design. A randomized, placebo-controlled double- blind cross- over study was performed. Setting. Out-patient facilities of a referral hospital. Subjects. Eight male volunteers (age range 25-46 years). Intervention. Treatment with two doses of either placebo or cisapride 150 μg/kg 7 h and 20 mm before drinking 0.5 g/kg alcohol either in a fasting state or during a standardized meal (12 kcal/kg). Main outcome measures. Plasma and saliva ethanol concentrations were measured during 4 h. Results. Cisapride increased peak plasma ethanol levels in fasting subjects from 15.6 (SD 1.4. 95%-KI 14.7:16.6) to 17.8 (SD 2.7. 95%-KI 15.9:19.7) mmol/L and saliva ethanol 30 min after alcohol ingestion from 11.4 (SD 2.2. 95%-KI 9.9:12.9) to 15.9 (SD 4.3.95%-KI 12.9;18.8) mmol/L. A significant interaction between fasting state and drug intake was found for the 30 min saliva ethanol values (P < 0.05. ANOVA for repeated measurements). Conclusions. Cisapride may increase ethanol levels under fasting conditions. Patients treated with prokinetic drugs should be informed about this possibility.