Lidocaine elimination: Effects of metoprolol and of propranolol

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Abstract
The effects of administration of metoprolol and propranolol [.beta.-adrenergic-blocking drugs] on lidocaine [used to treat and prevent ventricular arrhythmias] elimination were studied in 6 healthy young men who did not smoke. Each received 3 single i.v. doses of lidocaine (2.5-3.0 mg/kg injected over 10 min): one alone, one after 1 day pretreatment with propranolol (40 mg orally every 6 h) and one after 1 day pretreatment with metoprolol (50 mg orally every 6 h). Lidocaine clearance was 0.88 .+-. 0.28 l .cntdot. h-1 .cntdot. kg-1 before .beta.-blockade, 0.61 .+-. 0.20 l .cntdot. h-1 .cntdot. kg-1 during metoprolol dosing and 0.47 .+-. 0.16 l .cntdot. h-1 .cntdot. kg-1 during propranolol dosing. There was no correlation between the change in lidocaine elimination and the steady-state concentrations of metoprolol or propranolol, nor between the change in lidocaine clearance and the change in resting heart rate produced by either .beta.-blocker. Metoprolol and propranolol reduce lidocaine elimination significantly.