Wood A J, Feely J
Clin Pharmacokinet. 1983 May-Jun;8(3):253-62. doi: 10.2165/00003088-198308030-00004.
Propranolol is widely used in clinical practice and is frequently administered along with other drugs. The co-administration of propranolol and other drugs may result in either propranolol-induced changes in the disposition of other drugs or in effects of the other drugs on the pharmacokinetics of propranolol. These changes may be due to alteration in absorption, metabolism or to haemodynamic effects such as altered liver blood flow. Understanding the pharmacokinetics of propranolol is important to the rational interpretation of the effects of other drugs on propranolol's disposition. The absorption, protein binding and metabolism of propranolol may all be affected by the co-administration of other drugs. Induction of propranolol's metabolism by halofenate, phenytoin, phenobarbitone, rifampicin and alcohol have all been implicated in altering propranolol clearance, while inhibition of hepatic drug metabolising enzymes by chlorpromazine and cimetidine appear to reduce propranolol clearance. Propranolol may also affect the metabolism of other drugs such as antipyrine, chlorpromazine, theophylline and thyroid hormones. Suggestions that propranolol may alter quinidine's elimination have not been substantiated. By reducing liver blood flow propranolol may reduce the systemic clearance of other high extraction drugs such as lignocaine.
普萘洛尔在临床实践中广泛应用，且常与其他药物联合使用。普萘洛尔与其他药物联合使用可能导致普萘洛尔引起其他药物处置的变化，或者其他药物对普萘洛尔药代动力学产生影响。这些变化可能是由于吸收、代谢改变，或者是由于血流动力学效应，如肝血流量改变。了解普萘洛尔的药代动力学对于合理诠释其他药物对普萘洛尔处置的影响很重要。普萘洛尔的吸收、蛋白结合和代谢都可能受到其他药物联合使用的影响。卤芬酯、苯妥英、苯巴比妥、利福平和酒精对普萘洛尔代谢的诱导作用均与普萘洛尔清除率改变有关，而氯丙嗪和西咪替丁对肝药酶的抑制作用似乎会降低普萘洛尔的清除率。普萘洛尔也可能影响其他药物的代谢，如安替比林、氯丙嗪、茶碱和甲状腺激素。关于普萘洛尔可能改变奎尼丁消除的说法尚未得到证实。通过减少肝血流量，普萘洛尔可能会降低其他高摄取药物如利多卡因的全身清除率。
