Increased Clearance of Propranolol in Thyrotoxicosis

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Abstract
The pharmacokinetics of oral propranolol were studied during chronic treatment in 6 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 [SE of mean]) and free (30.5 .+-. 4.7 to 25.5 .+-. 4.1 l/min) propranolol but 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. The pharmacokinetics of propranolol are significantly altered in thyrotoxicosis.

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