Beta-adrenoceptor blocking drugs and cytochrome P-450: the influence of propranolol treatment on caffeine, antipyrine, D-glucaric acid and indocyanine green elimination in patients with hepatic disorders.

The effect of the beta-adrenoceptor blocking drug propranolol was investigated in patients with alcoholic liver disease and in those without liver disease before and after ten days treatment with 80 mg daily. Caffeine as a marker drug for the 3-methylcholanthrene-inducible subtype had a significantly enhanced clearance after propranolol in liver-diseased patients, while the clearance of antipyrine which represents the phenobarbital-inducible subtype was unchanged. D-glucaric acid excretion as an endogenous compound which serves as an indicator of induced state of drug-metabolizing capacity of the liver was slightly enhanced in liver patients, but significantly decreased in patients without liver disorders. Indocyanine green elimination as a test material for substances limiting liver blood flow was not significantly reduced by this propranolol dosage.