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Increased Clearance of Propranolol in Thyrotoxicosis

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▸Requests for reprints should be addressed to John Feely, M.D.; Department of Pharmacology and Therapeutics, Ninewells Hospital; Dundee, DD1 9SY, Scotland.

Dundee, Scotland

Ann Intern Med. 1981;94(4_Part_1):472-474. doi:10.7326/0003-4819-94-4-472
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The pharmacokinetics of oral propranolol were studied during chronic treatment in six patients when thyrotoxic and again when euthyroid. The mean total plasma propranolol steady-state concentration was 42% lower when the patients were thyrotoxic. After treatment of thyrotoxicosis there was a fall (p < 0.05) in the oral clearance of both total (4.2 ± 0.6 to 2.7 ± 0.4 L/min, mean ± SEM) and free (30.5 ± 4.7 to 25.5 ± 4.1 L/min) propranolol although the half-life of propranolol did not change significantly. The free fraction of propranolol was higher (p < 0.05) in the thyrotoxic (14.2% ± 1.3%) than in the euthyroid (11.4% ± 0.8%) state. These results suggest that the pharmacokinetics of propranolol are significantly altered in thyrotoxicosis.





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