Aging and renal clearance of procainamide and acetylprocainamide

Clin Pharmacol Ther. 1980 Dec;28(6):732-5. doi: 10.1038/clpt.1980.228.


Thirty-two patients had blood and urine collected simultaneously for measurement of procainamide, acetylprocainamide, and creatinine. The ratios of drug clearance to creatinine clearance were calculated for each. The procainamide:creatinine clearance ratio averaged 2.9 +/- 1.6 (SD) and fell as age of the patients rose (r = 0.5, p < 0.01). The acetylprocainamide:creatinine clearance ratio averaged 1.7 +/- 0.8 and also fell with age. The combination of decline in overall renal function with age with this decrease in the rate of renal tubular secretion of these drugs led to a progressive age-related rise in the steady-state serum level of procainamide (r = 0.56, p < 0.01) and acetylprocainamide (r = 0.36, p < 0.1) achieved by any dose of procainamide. Thus, the dosage of procainamide must be individualized for both overall renal function (GFR) and the age-related variations in renal tubular secretion that are of most note in children and the elderly.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Acecainide / metabolism*
  • Adult
  • Aged
  • Aging*
  • Child
  • Creatinine / metabolism
  • Humans
  • Metabolic Clearance Rate
  • Middle Aged
  • Procainamide / analogs & derivatives*
  • Procainamide / metabolism*


  • Acecainide
  • Creatinine
  • Procainamide