Drug induction of hepatic enzymes in the elderly

Previous workers have suggested that hepatic enzyme induction by drugs does not occur in the elderly. We have studied the effect of a potent enzyme inducer--glutethimide--on a group of nine patients over the age of 70 years, using antipyrine clearance as a measure of hepatic drug metabolism. After six days treatment with glutethimide, antipyrine clearance rose from 22.8 +/- 4.5 ml/min to 38.3 +/- 7.6 ml/min (P less than 0.001). The results suggest that the elderly are at risk for the full range of drug interactions due to hepatic microsomal enzyme induction.