Drug half-life and clinical pharmacokinetics
The half-life (t½) is the time for the drug concentration to fall by half. It determines dosing frequency, time to steady state, and how long a drug stays in the body after stopping it.
Steady state is reached after 4-5 half-lives. At 4 half-lives you're at 94% of steady state; at 5 half-lives, 97%. This is why amiodarone (t½ 40-55 days) takes months to reach therapeutic levels and months to wash out after stopping.
Key equations
| What you want | Formula |
|---|---|
| Time to steady state | ~4-5 × t½ |
| Remaining concentration at time t | C = C₀ × (0.5)^(t/t½) |
| Elimination constant (ke) | ke = 0.693 / t½ |
| Time to eliminate | ~5 × t½ (97% eliminated) |
Renal and hepatic impairment
Most drugs that are renally cleared have significantly prolonged half-lives in kidney disease. Gentamicin's t½ goes from 2-3 hours in normal renal function to 50-70 hours with severe CKD. The Cockcroft-Gault equation predicts creatinine clearance, which guides dosing adjustments. For drugs with hepatic elimination, Child-Pugh score guides dose modification. See Creatinine Clearance Calculator.
Related tools
For drug dosing by weight, see Weight-Based Dose Calculator. For renal dose adjustment, see Creatinine Clearance. For IV infusion rates, see IV Drip Rate Calculator.