Inhibition of antipyrine metabolism by beta-adrenoceptor antagonists

1 The effects of two beta-adrenoceptor antagonists (propranolol and metoprolol), and of the beta-adrenoceptor agonist, terbutaline, on the plasma kinetics of antipyrine were studied in five normal subjects. In addition, the influence of propranolol on the clearance of antipyrine to three of its major metabolites was investigated. 2 At the same level of beta-adrenoceptor blockade, assessed by lowering of exercise tachycardia, propranolol decreased antipyrine clearance by 37.3 +/- 9.9 s.d. % (P less than 0.001) and metoprolol decreased it by 18.0 +/- 4.7 s.d. % (P less than 0.01). Terbutaline had no effect on antipyrine clearance. The volume of distribution of antipyrine was unchanged following treatment with all three drugs. 3 Only the metabolic clearance of antipyrine to its 3-hydroxymethyl product was impaired to a statistically significant degree by propranolol. However, four of the five subjects also showed impaired clearance to 4-hydroxyantipyrine and three of the five to norantipyrine after propranolol treatment. In four of the five subjects propranolol lowered the renal clearance of antipyrine. 4 Inhibition of the metabolism of antipyrine by beta-adrenoceptor antagonists may be related to their lipid-solubility and extent of metabolism and is independent of their effect on beta-adrenoreceptors.