Summary
Fifty-two patients with cirrhosis receiving continuous administration of propranolol in doses reducing the heart rate by 25% were studied. The doses and plasma levels varied widely — 185±98 mg/day (mean ± SD) and 208±153 ng/ml, respectively. These values were significantly correlated. No significant correlation was found between the dose of the drug or plasma level and the liver function tests. Although propranolol significantly decreased cardiac output and the hepatic venous pressure gradient, no correlation was found between drug dose or plasma level and these haemodynamic effects.
This is a preview of subscription content, log in via an institution to check access.
References
Lebrec D, Poynard T, Hillon P, Benhamou J-P (1981) Propranolol for prevention of recurrent gastrointestinal bleeding in patients with cirrhosis. A controlled study. N Engl J Med 305: 1371–1374
Pessayre D, Lebrec D, Descatoire V, Peignoux M, Benhamou J-P (1978) Mechanism for reduced drug clearance in patients with cirrhosis. Gastroenterology 74: 566–571
Wood AJJ, Kornhauser DM, Wilkinson GR, Shand DG, Branch RA (1978) The influence of cirrhosis on steady-state blood concentrations of unbound propranolol after oral administration. Clin Pharmacokinet 3: 478–487
Nygard G, Shelver WH, Khalil SKW (1979) Sensitive high-pressure liquid chromatographic determination of propranolol in plasma. J Pharm Sci 68: 379–381
Lebrec D, Hillon P, Munoz C, Goldfarb G, Nouel O, Benhamou J-P (1982) The effect of propranolol on portal hypertension in patients with cirrhosis: a hemodynamic study. Hepatology 2: 523–527
DiBianco R, Singh SN, Shah PM, Newton GC, Miller RR, Nahormek P, Costello RB, Laddu AR, Gottdiener JS, Fletcher RD (1982) Comparison of the antianginal efficacy of acebutolol and propranolol. A multicenter, randomized, double-blind placebo-controlled study. Circulation 65: 1119–1128
Nilsson OR, Melander A, Tegler L (1980) Effects and plasma levels of propranolol and metoprolol in hyperthyroid patients. Eur J Clin Pharmacol 18: 315–320
Routledge PA, Shand DG (1979) Clinical Pharmacokinetic of propranolol. Clin Pharmacokinet 4: 73–90
Shand DG, Rangno RE (1972) The disposition of propranolol. I. Elimination during oral absorption in man. Pharmacology 7: 159–168
Steinberg SF, Bilezikian JP (1983) Total and free propranolol levels in sensitive and resistance patients. Clin Pharmacol Ther 33: 163–171
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Jirón, M.I., Delhotal, B. & Lebrec, D. Relationship between dose, blood level and haemodynamic response in patients with cirrhosis receiving propranolol. Eur J Clin Pharmacol 28, 353–355 (1985). https://doi.org/10.1007/BF00543337
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00543337