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Table 2 Half-life and clearance of β-adrenergic antagonists during extracorporeal treatments

From: Extracorporeal treatment for poisoning to beta-adrenergic antagonists: systematic review and recommendations from the EXTRIP workgroup

Drug

ECTR

T1/2 (Hours)

Clearance (mL/min)

References

During ECTR

Endogenous

ECTR

Endogenous

Median

n

Range

Normal GFR

ESKD

Median

n

Range

Normal GFR

ESKD

Acebutolol

HD

6.1 (Met = 7.2)

7

2.2–7

4–10

45 (Met = 33.6)

12

30.5–55.1

600–800

N/A

[68, 69, 80, 109, 113]

HF-HP

0.3

1

 

151

1

 

Atenolol

HD

4.6

48

0.5–17.8

5–8

50–100

119.5

25

18–311

140–180

20

[73, 76, 78, 79, 85, 90, 91, 100, 101, 105, 118, 123, 124, 128]

CKRT

22

2

14.5–29.5

47

3

19.9–48

HD-HP

3.4

1

 

N/A

PD

23

17

19.2–34

2.6

7

1.3–3.7

Betaxolol

HD

N/A

14–16

25–35

17.5 ± 0.7

12

 

220–270

100–150

[86]

PD

N/A

11.7 ± 1.2

12

 

Bisoprolol

HD

7.8

16

6.4–9.6

9–12

25–35

41.8

16

30.5–70

200–250

50

[93, 98, 101]

PD

23.6

3

20.8–26.4

N/A

Carvedilol

HD

4.6

8

4.1–5.3

6–7

12.1

14

12.1–38.6

600

[96, 101]

Esmolol

HD

0.12 ± 0.1

6

 

0.2

Met = 76.8 ± 39.1

6

 

10,000–15,000

[95]

PD

0.13 ± 0.1

6

 

Met = 2.7 ± 0.5

6

 

Labetalol

HD

1.8

7

0.6–3.8

3–10

10–12

37.4

14

25.7–97

1200–2000

[92, 94]

PD

13.1 ± 6.3

8

 

1.9 ± 1.7

8

 

Mepindolol

HD

3.0

2

 

3–6

31

2

 

650

N/A

[88]

Metipranolol

HD

1.4 ± 0.5

8

 

2.5–3.0

N/A

1100–1300

N/A

[97]

Metoprolol

HD

2.9 (Met = 5)

8

2.3–3

3–5

101

8

 

800–1200

[73, 101, 106]

HP

2.2

1

 

96.1

1

 

Nadolol

HD

3.5

6

3.0–8.5

10–15

30–45

82

15

46.4–102

120–250

30

[75, 89]

Oxprenolol

HD

Met = 5.6

3

 

1–2

N/A

600–750

550

[84]

Practolol

HD

14 (Met = 5)

14

8–30

10–13

60–80

 > 100*

6

 

135

20

[65, 67]

Propranolol

HP

5.6

3

4.9–8.9

3–5

189

2

188–191

800–1200

[66, 70, 73, 74, 87, 102]

HD

3.4

23

1.5–8

9.4

11

3.8–26.5

TPE

1.2

1

 

N/A

Sotalol

HD

7

9

3.5–9.5

5–9

35–60

80

3

67–80

120–160

20–25

[13, 15, 71, 83, 108, 115, 122]

HP-HD

2.8

1

 

N/A

CKRT

18

1

 

53.1

1

 

Talinolol

HD

N/A

10–12

20–25

28

7

 

320–380

[99, 104, 107]

HP

3.3

2

2.7–3.8

109

2

96–121

Timolol

HD

3.8

2

2.3–5.2

3–5

N/A

450–580

N/A

[72]

  1. Legend: HD, Hemodialysis; HP, Hemoperfusion; HF, Hemofiltration; TPE, therapeutic plasma exchange; PD, Peritoneal dialysis; CKRT, Continuous kidney replacement therapy; ECTR, Extracorporeal treatment; ESKD, End-stage kidney disease; Met, metabolite; GFR, Glomerular filtration rate; N/A, Not available; n, number
  2. In order to make data consistent and comparable for analysis, some transformations were performed (if necessary): half-lives were calculated graphically; clearances were calculated from removal data; when both clearance from arterio-venous differences and dialysate collections were provided, these were averaged; in some cases, clearance reported by some authors were calculated by using blood flows and plasma concentrations which may lead to overestimations [13, 98, 109], and so were recalculated
  3. *Reported dialysate flow assumed to be > 300 mL/min