Does chronic renal insufficiency alter the pharmacokinetics of oral propranolol compared to normal renal function?
Patients with chronic renal insufficiency achieve substantially higher peak serum concentrations of oral propranolol compared to healthy controls, suggesting altered pharmacokinetics.
Eight volunteers with normal renal function and 11 patients with chronic renal insufficiency were each given propranolol (P), 80 mg orally while in the fasting state. Sera were collected over a 24 hour period and assayed for P by spectl'Ophotofluorometer. Absorption was rapid in both groups. In the patients P appeared in the serum within 0.5 hour of oral administration and maximal concentrations, with mean 154.6 ± 40 ng/ml in 1.5 ± 0.3 hr, whereas in the control group, maximal concentrations, mean 51.6 ± 1.0 ng/ml developed in 2.0 ± 0.19 hr. The mean T% for the patient group was 3.2 ± 0.67 hr and that for the control wa:s 4.4 ± 1.0 hr (p > 0.3).011 chronic administration, the higher the daily dose, the higher the serum level of P and the lower the peripheral renin activity. In vivo hemodialysis of P was very small compared with that in vitro, probably due to protein binding of P.
Löwenthal et al. (Fri,) studied this question.