Interaction of Ethanol with Other Drugs

  • Richard A. Deitrich
  • Dennis R. Petersen


The interactions between alcohol and other drugs can be categorized into (1) pharmacological interactions, where ethanol and the second drug act on the same biochemical system; (2) physiological interactions, where ethanol and a second drug act on different systems; and (3) metabolic interactions, where the interaction takes place at the level of metabolism of ethanol or the second drug. Of course, more than one mechanism may be operative for any given drug-ethanol combination.


Chloral Hydrate Aldehyde Dehydrogenase Biochemical Pharmacology Metabolic Interaction Delirium Tremens 
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. Altshuler, H. L., Phillips, P. E., & Feinhandler, D. A. Alteration of ethanol self-administration by naltrexone. Life Science, 1980, 26, 679–688.Google Scholar
  2. Adriani, J., & Morton, R. C. Drug dependence: Important considerations from the anesthesiologist’s viewpoint. Anesthesia and Analgesia, 1968, 47, 472–481.Google Scholar
  3. Arkey, R. A., Veverbrants, E., & Abrason, A. Irreversible hypoglycemia: A complication of alcohol and insulin. Journal of the American Medical Association, 1968, 206, 575–578.Google Scholar
  4. Baker, R., Melchior, C., & Deitrich, R. The effect of halothane on mice selectively bred for differential sensitivity to alcohol. Pharmacology, Biochemistry and Behavior, 1980, 12, 691–695.Google Scholar
  5. Baldessarini, R. J. Drugs used in the treatment of psychiatric disorders. In A. G. Gilman, L. S. Goodman, & A. Gilman (Eds.), The pharmacological basis of therapeutics (6th ed.). New York: Macmillan, 1980.Google Scholar
  6. Barker, J. D., Jr., deCarle, D. J., & Anuras, S. Chronic excessive acetaminophen use and liver damage. Annals of Internal Medicine, 1977, 87, 299–301.Google Scholar
  7. Barnett, A. H., Leslie, R. D. G., & Pyke, D. A. Chlorpropamide-alcohol flushing and proteinuria in non-insulin-dependent diabetics. British Medical Journal, 1981, 282, 522–523.Google Scholar
  8. Barnett, A. H., Mace, P. J. E., & Pyke, D. A. Chlorpropamide-alcohol flushing and microangiopathy in insulin-dependent diabetes. British Medical Journal, 1981, 282, 523.Google Scholar
  9. Barnett, A. H., & Pyke, D. A. Chlorpropamide alcohol flushing and large vessel disease in non-insulin dependent diabetes. British Medical Journal, 1980, 281, 261–262.Google Scholar
  10. Barnett, A. H., & Pyke, D. A. Chloropropamide alcohol flushing. Lancet, 1981, I, 222.Google Scholar
  11. Barros, S., & Rodriguez, G. Naloxone as an antagonist in alcohol intoxication. Anesthesiology, 1981, 54, 174.Google Scholar
  12. Benzer, D., & Cushman, P. Alcohol and benzodiazepine: Withdrawal syndromes. Alcoholism: Clinical and Experimental Research, 1980, 4, 243–247.Google Scholar
  13. Berger, H. J. Chlorpromazine and ethanol combination: Effects on respiration, random motor activity and conditioned avoidance-escape in mice. Quarterly Journal of Studies on Alcohol, 1969, 30, 862–869.Google Scholar
  14. Borowsky, S. A., & Lieber, C. S. Interaction of methadone and ethanol metabolism. The Journal of Pharmacology and Experimental Therapeutics, 1978, 207, 123–129.Google Scholar
  15. Bouchier, I. A. D., & Williams, H. S. Determination of faecal blood loss after combined alcohol and sodium salicylate intake. Lancet, 1969, 1, 178–180.Google Scholar
  16. Bowes, H. A. The role of librium in an outpatient psychiatric setting. Diseases Nervous System, 1960, 27(Suppl.), 20–22.Google Scholar
  17. Burns, M., & Moskowitz, H. Effects of diphenhydramine and alcohol on skills performance. European Journal of Clinical Pharmacology, 1980, 17, 259–266.Google Scholar
  18. Caldwell, J., & Sever, P. S. The biochemical pharmacology of abused drugs. II. Alcohol and barbiturates. Clinical Pharmacology and Therapeutics, 1974, 16, 737–749.Google Scholar
  19. Carulli, N., Manenti, F., Gallo, M., & Salvioli, G. F. Alcohol-drugs interaction in man: Alcohol and tolbutamide. European Journal of Clinical Investigation, 1971, 1, 421–424.Google Scholar
  20. Creaven, P. J., & Roach, M. K. Effect of chloral hydrate on the metabolism of ethanol. Journal of Pharmacy and Pharmacology, 1969, 21, 332–333.Google Scholar
  21. Cullen, B. F., & Miller, M. G. Drug interactions and anesthesia: A review. Anesthesia and Analgesia, 1979, 58, 413–423.Google Scholar
  22. Curry, S. H. Homergic interactions, isobols and drug concentrations in blood. In D. G. Grahame-Smith (Ed.), Drug interactions. London: University Park Press, 1977.Google Scholar
  23. Deitrich, R. A., & Erwin, V. G. Mechanism of the inhibition of aldehyde dehydrogenase in vivo by disulfiram and deithyldithiocarbamate. Molecular Pharmacology, 1971, 7, 301–307.Google Scholar
  24. Deitrich, R. A., & Erwin, V. G. Biogenic amine-aldehyde condensation products tetrahydroisoquinolines and tryptolines carbolines). Annual Review of Pharmacology and Toxicology, 1980, 20, 55–80.Google Scholar
  25. Deitrich, R. A., & Hellerman, L. Diphosphopyridine nucleotide-linked liver aldehyde dehydrogenase: II. Inhibitors. Journal of Biological Chemistry, 1963, 238, 1683–1689.Google Scholar
  26. Deitrich, R. A., & Petersen, D. R. Interaction of ethanol with other drugs. In E. Majchrowicz & E. P. Noble (Eds.), Biochemistry and pharmacology of ethanol (Vol. 2). New York: Plenum Press, 1979.Google Scholar
  27. Deitrich, R. A., Troxell, P. A., & Worth, W. S. Inhibition of aldehyde dehydrogenase in brain and liver by cyanamide. Biochemical Pharmacology, 1976, 25, 2733–2737.Google Scholar
  28. DeSchepper, P. J., Tjandramaga, T. B., Verhaest, L., Dauro, C., & Steelman, S. L. Diflunisal versus aspirin: A comparative study of their effect on faecal blood loss, in the presence and absence of alcohol. Current Medical Research and Opinion, 1978, 5, 520–524.Google Scholar
  29. DeSilva, N. E., Tunbridge, W. M. G., & Alberti, K. G. M. M. Low incidence of chlorpropamide-alcohol flushing in diet-treated non-insulin-dependent diabetes. Lancet, 1981, 1, 128–131.Google Scholar
  30. Desmond, P. V., Patwardhan, R. V., Schenker, S., & Hoyumpa, A. M. Short-term ethanol administration impairs the elimination of chlordiazepoxide (LibriumR) in man. European Journal of Clinical Pharmacology, 1980, 18, 275–278.Google Scholar
  31. Downs, D. A. Interactions of acetylmethadol or methadone with oher drugs in Rhesus monkeys. Pharmacology, Biochemistry and Behavior, 1979, 10, 407–414.Google Scholar
  32. Dreyer, M., Kuhnau, J., & Rudiger, H. W. Chlorpropamide-alcohol flushing is not useful for individual genetic conseling of diabetic patients. Clinical Genetics, 1980, 18, 189–190.Google Scholar
  33. Favazza, A. R., & Martin, P. Chemotheapy of delirium tremens: A survey of physicians preferences. American Journal of Psychiatry, 1974, 131, 1031–1033.Google Scholar
  34. Frye, G. D., Breese, G. R., Mailman, R. B., Vogel, R. A., Ondrusek, M. G., & Mueller, R. A. An evaluation of the selectivity of fenmetozole (DH-524) reversal of ethanol induced changes in central nervous system function. Psychopharmacology, 1980, 69, 149–155.Google Scholar
  35. Goldberg, L. Effects of ethanol in the central nervous system. In R. E. Popham (Ed.), Alcohol and Alcoholism. University of Toronto Press, 1970.Google Scholar
  36. Goldman, P. Metronidazole. New England Journal of Medicine, 1980, 303, 1212–1217.Google Scholar
  37. Goulston, K., & Cooke, A. R. Alcohol, aspirin and gastrointestinal bleeding. British Medical Journal, 1968, 4, 664–665.Google Scholar
  38. Harvey, S. Hypnotics and sedatives. In A. G. Gilman, L. S. Goodman & A. Gilman (Eds.), The pharmacological basis of therapeutics (6th ed.). New York: Macmillan, 1980.Google Scholar
  39. Hayes, S. L., Pablo, G., Radomski, T., & Palmer, R. Ethanol and diazepam absorption. New England Journal of Medicine, 1977, 296, 186–189.Google Scholar
  40. Ho, A. K. S., & Ho, C. C. Toxic interactions of ethanol with other central depressants: Antagonism by naloxone to narcosis and lethality. Pharmacology, Biochemistry and Behavior, 1979, 11, 111–114.Google Scholar
  41. Ho, A. K. S., Chen, R. C. A., & Ho, C. C. Interaction toxicity between ethanol and narcotics in mice with reference to alpha-1-acetyl-methadol (LAAM). Pharmacology, Biochemistry and Behavior, 1978, 9, 195–200.Google Scholar
  42. Ho, C. C., & Ho, A. K. S. Interaction between methaqualone and ethanol in rats and mice during acute and chronic states. Clinical and Experimental Pharmacology and Physiology, 1978, 5, 665–671.Google Scholar
  43. Hollister, L. E. Psychiatric Disorders. In G. S. Avery (Ed.), Drug Treatment (2nd ed.). New York: Avery Press, 1980.Google Scholar
  44. Hoyumpa, A. M., Jr., Desmond, P. V., Roberts, R. K., Nichols, S., Johnson, R. F., & Schenker, S. Effect of ethanol on benzodiazepine disposition in dogs. Journal of Laboratory and Clinical Medicine, 1980, 95, 310–322.Google Scholar
  45. Ikeda, M., Ezaki, M., Kokeguchi, S., & Ohmori, S. Studies on NADPH-dependent chloral hydrate reducing enzymes in rat liver cytosol. Biochemical Pharmacology, 1981, 30, 1931–1939.Google Scholar
  46. Isbell, H., & Chrusciel, T. L. Dependence liability of nonnarcotic drugs. World Health Organization, 1970, 5–31.Google Scholar
  47. Jackson, G. W., & Richman, A. Alcohol use among narcotic addicts. Alcohol World, 1973, 1, 25–28.Google Scholar
  48. Jeffcoate, W. J., Cullen, M. H., Herbert, M., Hasting, A. G., & Walder, C. P. Prevention of effects of alcohol intoxication by naloxone. Lancet, 1979, 2, 1157–1159.Google Scholar
  49. Kalant, H., LeBlanc, A. E., Guttman, M., & Khanna, J. M. Metabolic and pharmacologic interaction of ethanol and metronidazole in the rat. Canadian Journal of Physiology and Pharmacology, 1972, 50, 476–484.Google Scholar
  50. Kater, R. M. H., Zieve, P., Tobon, F., Roggin, G., & Iber, F. L. Accelerated metabolism of drugs in alcoholics. Gastroenterology, 1969, 56, 412.Google Scholar
  51. Khouw, L. B., Burbridge, T. N., & Sutherland, V. G. The inhibition of alcohol dehydrogenase. I Kinetic Studies. Biochimica Biophysica Acta, 1963, 73, 173–185.Google Scholar
  52. Kissin, B. Interactions of ethyl alcohol and other drugs. In B. Kissin & H. Begleiter (Eds.) The biology of alcoholism (Vol. 3). New York: Plenum Press, 1974.Google Scholar
  53. Kitson, T. M. The disulfiram-ethanol reaction. A review. Journal Studies on Alcohol, 1977, 38, 96–113.Google Scholar
  54. Kobberling, J., Bengsh, N., & Bruggeboes, B. The chlorpropamide alcohol flush. Lack of specificity for familial non-insulin-dependent diabetes. Diabetologia, 1980, 19, 359–363.Google Scholar
  55. Koblin, D. D., & Deady, J. E. Anaesthetic requirement in mice selectively bred for differential ethanol sensitivity. British Journal Anaesthesia, 1981, 53, 5–10.Google Scholar
  56. Koblin, D. D., Deady, J. E., Dong, D. E., & Eger, E. I. II. Mice tolerant to nitrous oxide are also tolerant to alcohol. Journal of Pharmacology and Experimental Therapeutics, 1980, 213, 309–312.Google Scholar
  57. Kreek, M. J. Metabolic interactions between opiates and alcohol. Annals of the New York Academy of Sciences, 1981, 362, 36–49.Google Scholar
  58. Lehman, H. E., Ban, T. A., & Naltchayan, E. Metronidazole in the treatment of the alcoholic. Psychiatric Neurology, 1966, 152, 395–401.Google Scholar
  59. Leslie, R. D. G., & Pyke, D. A. Chlorpropamide-alcohol flushing: A dominantly inherited trait associated with diabetes. British Medical Journal, 1978, 2, 1519–1521.Google Scholar
  60. Leslie, R. D. G., Barnett, A. H., & Pyke, D. A. Chlorpropamide alcohol flushing and diabetic retinopathy. Lancet 1979, 1, 997–999.Google Scholar
  61. Lieber, C. S. Metabolism of ethanol. In C. S. Lieber (Ed.), Metabolic aspects of alcoholism. Baltimore: University Park Press, 1977.Google Scholar
  62. Linton, P. H., & Hain, J. D. Metronidazole in the treatment of alcoholism. Quarterly Journal of Studies on Alcohol, 1967, 28, 544–546.Google Scholar
  63. Liljequist, S., Berggren, U., & Engel, J. The effect of catecholamine receptor antagonists on ethanol-induce locomotor stimulation. Journal of Neural Transmission, 1981, 50, 57–67.Google Scholar
  64. Linnoila, M., & Häkkinen, S. Effects of diazepam and codeine alone and in combination with alcohol on simulated driving. Clinical Pharmacology and Therapeutics, 1974, 15, 368–373.Google Scholar
  65. Linnoila, M., & Mattila, M. J. Drug interaction on psychomotor skills related to driving: diazepam and alcohol. European Journal of Clinical Pharmacology, 1973, 5, 186–194.Google Scholar
  66. Logie, A. W., Galloway, D. B., & Petrie, J. C. Drug interactions and long-term antidiabetic therapy. British Journal of Clinical Pharmacology, 1976, 3, 1027–1032.Google Scholar
  67. MacKenzie, A. I. Naloxone in alcohol intoxication. Lancet 1979, 1, 733–734.Google Scholar
  68. MacLeod, S. M., Giles, H. G., Patzalek, G., Thiessen, J. J., & Sellers, E. M. Diazepam actions and plasma concentrations following ethanol ingestion. European Journal of Clinical Pharmacology, 1977, 11, 345–349.Google Scholar
  69. McGuire, J. L., Awourters, F. & Niemegeers, C. J. E. Interaction of loperamide and diphenoxylate with ethanol and methohexital. Archives International Pharmacodynamics, 1978, 236, 51–59.Google Scholar
  70. Medical News. Alcohol-acetaminophen issue explored. Journal American Medical Association, 1980, 244, 636–642.Google Scholar
  71. Mendelson, J. H. The search for alcohol antagonists: New research possibilities. Advances in Alcoholism, 1980, 1 (23).Google Scholar
  72. Mendelson, W. B., Goodwin, D. W., Hill, S. Y., & Reichman, J. D. The morning after: Residual EEG effects of triazolam and Flurazepam alone and in combination with alcohol. Current Therapeutic Research, 1976, 19, 155–163.Google Scholar
  73. Middaugh, L. D., Read, E., & Boggan, W. O. Effects of naloxone on ethanol induced alterations of locomotor activity in C57BL/6 mice. Pharmacology, Biochemistry and Behavior, 1978, 9, 157–160.Google Scholar
  74. Milner, G., & Landauer, A. A. Alcohol, thioridazine and chlorpromazine effects on skills related to driving behavior. British Journal of Psychiatry, 1971, 118, 351–352.Google Scholar
  75. Misra, P. S., Lèfevre, A., Ishil, H., Rubin, E., & Lieber, C. S. Increase of ethanol, meprobamate and pentobarbital metabolism after chronic ethanol administration in man and rats. American Journal of Medicine, 1971, 51, 346–351.Google Scholar
  76. Mørland, J., Setekleiv, J., Haffner, J. F. W., Stromsaether, C. F., Danielsen, A., & HolstWethe, G. Combined effects of diazepam and ethanol on mental and psychomotor functions. Acta Pharmacologic et Toxicoogica, 1974, 34, 5–15.Google Scholar
  77. Moss, L. M. Naloxone reversal of non-narcotic induced apnea. Journal of the American College of Emergency Physicians, 1973, 1, 46–48.Google Scholar
  78. Munoz, C., & Guivernau, M. Antagonistic effects of propranolol upon ethanol-induced narcosis in mice. Research Communications in Chemical Pathology and Pharmacology, 1980, 29, 57–65.Google Scholar
  79. Myers, R. D., & Melchior, C. L. Alcohol drinking: Abnormal intake caused by tetrahydropapaveroline. Science, 1977, 196, 554–556.Google Scholar
  80. Needham, C. D., Kyle, J., Jones, P. F., Johnston, S. J., & Kerridge, D. F. Aspirin and alcohol in gastrointestinal haemorrhage. Gut, 1971, 12, 819–821.Google Scholar
  81. Owen, B. E., & Taberner, P. V. Studies on the hypnotic effects of chloral hydrate and ethanol and their metabolism in vivo and in vitro. Biochemical Pharmacology, 1980, 29, 3011–3016.Google Scholar
  82. Palva, E. S., Linnoila, M. & Mattila, M. J. Effect of active metabolites of chlordiazepoxide and diazepam alone or in combination with alcohol. Modern Problems in Pharmacopsychiatry, 1976, 11, 79–90.Google Scholar
  83. Pirola, R. C. Drug metabolism and alcohol. Baltimore: University Park Press, 1978.Google Scholar
  84. Rech, R. H., Vomachka, M. K., & Rickert, D. E. Interactions between depressants (alcohol-type) and stimulants (amphetamine-type). Pharmacology, Biochemistry and Behavior, 1978, 8, 143–151.Google Scholar
  85. Ritchie, J. M. The aliphatic alcohols. In A. G. Gilman, L. S. Goodman, & A. Gilman (Eds.), The pharmacological basis of therapeutics (6th ed.) New York: Macmillan, 1980.Google Scholar
  86. Ross, D. H., Medina, M., & Cardenas, H. L. Morphine and ethanol: Selective depletion of regional brain calcium. Science, 1974, 186, 63–65.Google Scholar
  87. Rosser, W. W. The interaction of propoxyphene with other drugs. Canadian Medical Association Journal, 1980, 122, 149–150.Google Scholar
  88. Rubin, E., Bacchin, P., Gang, H., & Lieber, C. S. Induction and inhibition of hepatic microsomal and mitochondrial enzymes by ethanol. Laboratory Investigations, 1970, 22, 569–580.Google Scholar
  89. Rubin, E., Gang, H., Misra, P. S., & Lieber, C. S. Inhibition of drug metabolism by acute ethanol intoxication: A hepatic microsomal mechanism. American Journal of Medicine, 1970, 49, 801–806.Google Scholar
  90. Sato, C., Matsuda, Y., & Lieber, C. S. Increased hepatotoxicity of acetaminophen after chronic ethanol consumption in the rat. Gastroenterology, 1981, 80, 140–148.Google Scholar
  91. Sellers, E. M., Naranjo, C. A., Giles, H. G., Frecker, R. C., & Beeching, M. Intravenous diazepam and oral ethanol interaction. Clinical Pharmacology and Therapeutics 1980, 28, 638–645.Google Scholar
  92. Seppälä, T. Effect of chlorpromazine or sulpiride and alcohol on psychomotor skills related to driving. Archives Internationales de Pharmacodynamic et de Theapie, 1976, 223, 311–323.Google Scholar
  93. Seppälä, T., Palva, E., Mattila, M. J., Korttila, K., & Shrotriya, R. C. Tofisopam, a novel 3,4,-benzodiazepine: Multiple-dose effects on psychomotor skills and memory. Comparison with diazepam and interactions with ethanol. Psychopharmacology, 1980, 69, 209–218.Google Scholar
  94. Sharkawi, M. Pharmacological and metabolic interactions between ethanol and the dopamine-β-hydroxylase inhibitor FLA 63 in mice. Neuropharmacology, 1980, 19, 277–280.Google Scholar
  95. Shirota, F. N., DeMaster, E. G., Elberling, J. A., & Nagasawa, H. T. Metabolic depropargylation and its relationship to aldehyde dehydrogenase inhibition in vivo. Journal of Medicinal Chemistry, 1980, 23, 669–673.Google Scholar
  96. Smith, A. C., Freeman, R. W., & Harbison, R. D. Ethanol enhancement of cocaine-induced hepatotoxicity. Biochemical Pharmacology, 1981, 30, 453–458.Google Scholar
  97. Sorensen, S. C., & Mattisson, K. Naloxone as an antagonist in severe alcohol intoxication. Lancet, 1978, 2, 688–689.Google Scholar
  98. Sutherland, V. C., Burbridge, T. N., Adams, J. E., & Simon, A. Cerebral metabolism in problem drinkers under the influence of alcohol and chlorpromazine hydrochloride. Journal of Applied Physiology, 1960, 15, 189–196.Google Scholar
  99. Tabakoff, B., Vugrincic, C., Anderson, R., & Alvisatos, S. G. A. Reduction of chloral hydrate to trichloroethanol in brain extracts. Biochemical Pharmacology, 1974, 23, 455–460.Google Scholar
  100. Teschke, R., Stutz, G., & Strohmeyer, G. Increased paracetamol-induced hepatotoxicity after chronic alcohol consumption. Biochemical and Biophysical Research Communication, 1979, 91, 368–374.Google Scholar
  101. Todzy, I., Coper, H., & Fernandes, M. Interaction between d-amphetamine and ethanol with respect to locomotion, stereotypes, ethanol sleeping time, and the kinetics of drug elimination. Psychopharmacology, 1978, 59, 143–149.Google Scholar
  102. Tottmar, O., Marchner, H., & Lindberg, P. Inhibition of rat-liver aldehyde dehydrogenases in vivo by disulfiram, cyanamide and the alcohol-sensitizing compound coprine. In R. G. Thurman, J. R. Williamson, H. R. Dratt, & B. Chance (Eds.), Alcohol and aldehyde metabolizing systems (Vol 2). New York: Plenum Press, 1977.Google Scholar
  103. Vapaatalo, H., & Karppunen, H. Combined toxicity of ethanol with chlorpromazine, diazepam, chlormethiozole or pentobarbital in mice. Agents and Actions, 1969, 1, 43–45.Google Scholar
  104. Wiseman, J. S., & Abeles, R. H. Mechanism of inhibition of aldehyde dehydrogenase by cyclopropanone hydrate and the mushroom toxin coprine. Biochemistry, 1979, 18, 427–435.Google Scholar
  105. Wiseman, J. S., Tayrien, G., & Abeles, R. H. Kinetics of the reaction of cyclopropanone hydrate with yeast aldehyde dehydrogenase: A model for enzyme-substrate interaction. Biochemistry, 1980, 19, 4222–4231.Google Scholar
  106. Wong, L. K., & Biemann, K. A study of drug interaction by gas chromatography-mass spectrometry-synergism of chloral hydrate and ethanol. Biochemical Phamacology, 1978, 27, 1019–1022.Google Scholar
  107. Zirkle, G. A., McAtee, O. B., & King, P. D. Meprobamate and small amounts of alcohol. Effects on human ability. Coordination and judgment. Journal of the American Medical Association, 1960, 173, 1823–1825.Google Scholar

Copyright information

© Plenum Press, New York 1983

Authors and Affiliations

  • Richard A. Deitrich
    • 1
  • Dennis R. Petersen
    • 2
  1. 1.Alcohol Research Center, Department of PharmacologyUniversity of Colorado Medical CenterDenverUSA
  2. 2.Alcohol Research Center, School of PharmacyUniversity of ColoradoBoulderUSA

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