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Pharmacokinetics in liver disease

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Abstract

Some general pharmacokinetic principles, relevant to understand and predict altered disposition of drugs in liver disease, are reviewed. It is appropriate to differentiate between high- and low-clearance drugs as to the influence of hepatic dysfunction. On intravenous administration highclearance drugs generally show reduced systemic clearance predominantly caused by decreased liver blood flow, whereas on oral administration a considerable increase in systemic availability may occur caused by reduced enzyme activity and (in cirrhosis) bij portacaval shunting. Low-clearance drugs are sensitive to reduced enzyme activity and reduced protein binding. It seems that oxidative reactions are far more affected than conjugation reactions in liver disease. Large inter-patient variability exists in the kinetics of a drug in any type of hepatic disease. The conventional liver-function tests are of no value in predicting altered drug disposition.

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Authors and Affiliations

  1. Center for Bio-Pharmaceutical Sciences, Division of Pharmacology, State University of Leiden, P.O. Box 9503, 2300, RA Leiden, The Netherlands

    D. D. Breimer

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  1. D. D. Breimer
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Breimer, D.D. Pharmacokinetics in liver disease. Pharmaceutisch Weekblad Scientific Edition 9, 79–84 (1987). https://doi.org/10.1007/BF01960740

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  • DOI: https://doi.org/10.1007/BF01960740

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