Propranolol does not further decrease the clearance of antipyrine in patients with alcoholic cirrhosis

We determined the clearance of antipyrine before, and during, the administration of propranolol in eight male patients with alcoholic cirrhosis and a recent episode of gastrointestinal bleeding. The clearance of antipyrine in these patients was markedly reduced as compared with that in eight male, age-matched control subjects but was not further decreased after 1 month of propranolol administration. Antipyrine is the prototype of a drug with a low hepatic clearance. We suggest that the hepatic metabolism of some low clearance drugs may not be further decreased when patients with alcoholic cirrhosis are placed on propranolol therapy for the prevention of recurrent gastrointestinal bleeding.