Racial differences in propranolol pharmacokinetics.
Racial differences in the antihypertensive response to propranolol are well documented. This study was conducted to determine whether differences between black subjects and white subjects in propranolol enantiomer pharmacokinetics and protein binding exist that may contribute to the response differences. Twenty-six healthy men (13 black and 13 white subjects) took 80 mg propranolol orally three times daily for 16 doses. Serum samples were collected for 12 hours after the last dose for analysis by chiral HPLC. Protein binding was determined by equilibrium dialysis. Area under the serum concentration-time curve (AUC) for both propranolol enantiomers was lower in black subjects than in white subjects (e.g., l-propranolol AUC: 292 +/- 100 versus 394 +/- 121 ng.hr/ml, p less than 0.05) and apparent oral clearance was higher in black subjects than in white subjects (e.g., l-propranolol apparent oral clearance: 27.6 +/- 8.2 versus 20.6 +/- 7.0 ml/min/kg, p less than 0.05). Fraction unbound and unbound AUC were not statistically different between black subjects and white subjects for either enantiomer, although the lack of statistical significance may have been attributable to the small sample size. In summary, racial differences in unbound l-propranolol concentration probably do not explain the clinically observed differences in response to propranolol. However, the racial differences in apparent oral clearance suggest there may be racial differences in hepatic metabolism of propranolol.