Pharmakokinetik des β-Rezeptorenblockers Metipranolol bei Patienten mit Leberzirrhose

The pharmacokinetics after oral administration of the beta-blocker metipranolol (Disorat) were investigated in 20 patients with liver cirrhosis, 8 of them with portocaval shunt. Twenty healthy persons were used as controls. Kinetic data in patients were not notably different from the normal group, in particular there was no significant difference in the mean serum concentration over 24 hours. In patients with advanced disease the only noteworthy difference was an increase of the linear rate of increase of serum concentrations. Maximal serum concentrations were found with a median of only 0,37 and 0,59 hours after intake, and in controls 0,76 hours after intake. It appears that metipranolol has no hepatic first-pass-effect and that its total clearance remains largely uninfluenced even in severe liver damage. A reduction of dosage in these diseases is thus not required from the pharmacological point of view.