Figure 2. Consequences of reduced clearance in the elderly. For any given drug, impairment of the capacity for drug elimination (reduced clearance) will cause an elevation in steady-state concentrations (Css) with a resulting increase in the likelihood of toxicity. Reduced clearance also may cause a prolongation of elimination half-life, and a consequent delay in the rate of attainment of the steady-state condition. An increase in volume of distribution (Vd) may also contribute to a prolongation of elimination half-life.
