Hepatic clearance

Hepatic clearance (ClH) is the irreversible removal of a drug either through drug metabolism in the liver (the most important mechanism), or through secretion of a drug in the bile so that it appears in the faeces. Hepatic clearance is the product of hepatic blood flow (QH; relatively constant in most people, at around 90 litres/hour) and the hepatic extraction ratio (EH). So CLH = QH x EH. Thus, the major determinant of variations in hepatic clearance between drugs or between individual patients is the hepatic extraction ratio.

Click here to watch a short vodcast demonstrating the possible fates of a drug passing through the liver.

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An ABC of PK/PD Copyright © 2023 by Dr. Andrew Holt is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, except where otherwise noted.

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