Related Experiment Video
Updated: Feb 12, 2026

Author Spotlight: Developing a Simple and Robust Hepatic Model for Pharmacological and Toxicological Applications
Published on: October 20, 2023
Hepatic Elimination of Drugs in Gestational Diabetes
Claudio Daniel Gonzalez1,2, Jorge Alvarinas3, Ricardo Bolanos4
1Universidad de Buenos Aires, Facultad de Medicina, Departamento de Farmacología y Toxicología, Centro de Vigilancia y Seguridad de Medicamentos, 1053 Buenos Aires, Argentina.
Background:
The liver is the major metabolic clearance organ for chemical agents from the human body. Pregnancy is associated with several physiological changes that may affect one or more of these factors, and also induces changes in the hepatic clearance of certain drugs. The aim of this paper was to review some of the currently available information in the field to provide some insights about the relevance of these changes on the clearance of some drugs.
Methods:
A comprehensive literature search was carried out to identify eligible studies from MEDLINE/PubMed, EMBASE and SCIELO databases through 1970 first semester.
Results:
Gestational Diabetes Mellitus (GDM) is a frequent disease commonly associated with other entities as obesity, hypertension, dyslipidemia, non-alcoholic fatty liver disease, prothrombotic conditions, changes in intestinal microbiome. These entities, together with the glycemic fluctuations associated with GDM might affect the determinants of the hepatic clearance (hepatic blood flow, the unbound fraction of drugs, and the hepatic intrinsic clearance). GDM is frequently associated with multi-drug treatments. While many of these drugs are cleared by the liver, little is known about the clinical relevance of these GDM associated pharmacokinetic changes.
Conclusion:
Considering the frequency of the disease and the effects that these pharmacokinetic changes might have on the mother and child, the need for further research seems advisable. In the meantime, cautious clinical judgment in the management of drug administration in women affected by this disease is recommended.
Related Concept Videos
Diabetes Mellitus: Type 2 and Gestational
Kinetics of Drug Elimination
Drug clearance depends on the rate of drug elimination and its plasma concentration. Another important parameter is the half-life of a drug, which is the time required for its concentration to decrease by half. In most cases, drug clearance follows first-order...
Drug Elimination: Overview
Excretion refers to removing a drug from the body, either in its unchanged form or as its metabolites. Nonvolatile and polar drugs are primarily excreted through the kidneys, with other pathways including bile, sweat, saliva, and milk. Volatile drugs such as anesthetic gases are excreted via the...
Drug Elimination: Non-Renal Routes
Drug Elimination: The Concept of Clearance
Drug clearance is not limited to renal excretion but encompasses all organs involved in drug elimination,...
Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow

