K.V. SPEEG JR., M.D., PH.D.; D.C. CHRISTIAN, M.D.; M.C. MITCHELL, M.D.
To the editor: We read with interest the recent editorial (1) comparing ranitidine and cimetidine. We agree that ranitidine will acquire its own profile of adverse effects but think the effect of ranitidine on cytochrome P-450 activity can be clarified.
Ranitidine binds to cytochrome P-450 and if present in sufficient concentration would be expected to inhibit oxidation of other drugs by this microsomal enzyme system (2, 3). Ranitidine is much less potent as an inhibitor of cytochrome P-450 than cimetidine in all systems tested. The inhibition by ranitidine of acetaminophen metabolism cited in the editorial requires comment because this observation
SPEEG K, CHRISTIAN D, MITCHELL M. Ranitidine and Acetaminophen Hepatotoxicity. Ann Intern Med. ;100:315–316. doi: 10.7326/0003-4819-100-2-315_2
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Published: Ann Intern Med. 1984;100(2):315-316.
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