Blocker Extreme
Why is propranolol dangerous for patients with hepatic impairment?
Why must a person with hepatic impairment use extreme caution when using propranol (adrenergic blocker)?
Propranolol is mainly metabolized in the liver, which means that the liver converts it to inactive metabolites. If a person has decreased liver function (hepatic impairment), then they will not be able to convert the Propranolol to inactive forms. This means that the Propranolol will remain active for longer and could potentially lead to excess levels. This would result in more adverse effects, such as a slow heart rate or decreased blood pressure. It would be preferable to use to a beta blocker that is not metabolized by the liver in a person with hepatic impairment. For example, Nadolol is not metabolized by the liver and is eliminated by the kidneys. For this reason, it would be preferred over Propranolol in a person with liver disease.
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