PubMed · 577169
[First-past Effect (author's transl)].
Abstract
Metabolism or decay of a drug prior to, during or shortly after its enteral absorption necessarily reduces the amount of unchanged drug reaching the systemic circulation. This influences the pharmacokinetic properties of a drug and is called first-pass effect. Every drug metabolized in the liver theoretically undergoes a first-pass metabolism after enteral application. Whether it results in a pharmacokinetically obvious first-pass effect depends on extent and rate of this metabolic step. The pharmacokinetic relevance of a first-pass effect does not automatically mean also its therapeutic relevance. For the assessment of the therapeutic relevance of a first-pass effect, extent and slope of its dose-effect curve in man and the therapeutic index of a drug must be taken into accounts.
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G Leopold. 1977. [First-past Effect (author's transl)].. https://pubmed.ncbi.nlm.nih.gov/577169/
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