Drug Clearance: How Fast Your Body Removes a Drug
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[Glossary · How doses act in the body]

Clearance

Also called drug clearance, CL, apparent clearance, CL/F · Reviewed

Definition: Clearance is the volume of blood plasma the body clears of a drug per unit of time, so it is written as volume over time, such as liters per hour. The kidneys and liver do most of the work. Together with volume of distribution, it sets the half-life.

How clearance adds up

StatPearls describes total clearance as kidney clearance plus liver clearance plus clearance by all other tissues. Its example: a drug with a kidney clearance of 20 mL/min and a liver clearance of 5 mL/min has a total clearance of 20 + 5 = 25 mL/min.

StatPearls also stresses that clearance does not tell you the amount of drug removed. It is a volume of plasma per minute or hour. How much drug that volume held depends on the level at the time.

Worked example: label clearance per day and week

Turning label figures into days and weeks

  1. Ozempic label: apparent clearance of semaglutide is about 0.05 L/h. Per day: 0.05 × 24 = 1.2 L. Per week: 1.2 × 7 = 8.4 L.
  2. Mounjaro label: apparent clearance of tirzepatide is 0.061 L/h. Per day: 0.061 × 24 = about 1.46 L. Per week: about 10.2 L.
  3. Compare that with each drug's volume of distribution on the same labels: about 12.5 L for semaglutide and 10.3 L for tirzepatide. A week of clearance is a large share of the volume, which fits half-lives of about 1 week and about 5 days.

These are averages from study groups. Individual numbers vary with body size, kidney and liver function and the product itself.

Why it matters when you track doses

Clearance is the reason levels fall between doses. StatPearls notes the kidneys and liver do most of the removal, so problems with either one can change it. That is one reason labels have sections on kidney and liver impairment.

Read more on Dose Track: Half-life calculator · Tirzepatide guide

General education drawn from labels and published studies, not personal medical advice. Your prescriber, pharmacist and the label that came with your product are the final word.
Half-lifeHalf-life is the time it takes for the amount of a drug in your body to fall by half. After one half-life,… Volume of distributionVolume of distribution (Vd) links the total amount of drug in the body to its level in the blood: Vd =… Steady stateSteady state is the point, after repeated doses on a fixed schedule, where the amount cleared between… AUC (area under the curve)AUC (area under the curve) is the area under a graph of drug level against time. It sums up total exposure… PK/PD (pharmacokinetics and pharmacodynamics)Pharmacokinetics (PK) is what the body does to a drug: absorbing it, spreading it around, breaking it down…

Frequently asked questions

What is drug clearance in simple terms?+
It is how much blood plasma the body clears of a drug each minute or hour. A higher clearance means the drug is removed faster.
Is clearance the same as half-life?+
No. Clearance is a volume per unit of time. Half-life is a time. Half-life depends on both clearance and how widely the drug spreads in the body.

Sources

  1. Horde GW, Gupta V. Drug Clearance. StatPearls 2023. PMID 32491690
  2. Ozempic (semaglutide) US prescribing information, sections 2 and 12.3, DailyMed
  3. Mounjaro (tirzepatide) US prescribing information, sections 2 and 12.3, DailyMed
  4. FDA guidance for industry: Bioavailability Studies Submitted in NDAs or INDs, General Considerations (April 2022)

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