Clearance

Elimination of a drug from the plasma is quantified in terms of its clearance. The term has the same meaning as the familiar renal creatinine clearance, which is a measure of removal of endogenous creatinine from the plasma. Clearance values can provide useful information about the biological fate of a drug. There are pharmacokinetic methods for calculating total body and renal clearance, and the difference between these is commonly taken to represent hepatic clearance. Renal clearance of a drug that is eliminated only by filtration by the kidney obviously cannot exceed the glomerular filtration rate (adult male 124 ml/min, female 109 ml /min). If a drug is found to have a renal clearance in excess of this, then it must in addition be actively secreted by the kidney tubules, e.g. benzylpenicillin (renal clearance 480 ml/min).

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