H2–Receptor Antagonists and Hepatic Drug Disposition

Abstract
The effect of four H2–receptor antagonists (Cimetidine, burimamide, oxmetidine, and ranitidine) on antipyrine elimination was studied in the isolated perfused rat liver. The first three drugs are substituted imidazoles, whereas ranitidine contains a furanyl nucleus. Isolated livers were perfused using a 100–ml, recycling, constant flow circuit for 4 hr. Antipyrine elimination was studied with or without an H2–receptor antagonist present. In all experiments, antipyrine concentrations declined monoexponentially. In control experiments (no other drug present), antipyrine clearance was 32.5 ± 9.0 ml per hr. This was greatly reduced in the presence of Cimetidine (clearance = 10.1 ± 0.8 and 5.8 ± 1.5 ml per hr after 1 and 5 mg doses, p < 0.001) and burimamide (4.5 ± 0.6 and 3.0 ± 1.7 ml per hr, p < 0.001). By contrast, neither oxmetidine nor ranitidine significantly altered antipyrine pharmacokinetics. These results indicate that the inhibitory effect on hepatic mixed–function oxidases is rapid in onset, independent of H2–receptor antagonist activity, and is not an inevitable consequence of the presence of an imidazole nucleus.