Abstract
The study of pharmacological interactions between herbal remedies and conventional drugs is important because consuming traditional herbal remedies as supplements or alternative medicine is fairly common and their concomitant administration with prescribed drugs could either have a favorable or unfavorable effect. Therefore, this work aims to determine the pharmacological interactions of a turmeric acetone extract (TAE) and its main metabolite (curcumin) with common anti-ulcer drugs (ranitidine and bismuth subsalicylate), using an ethanol-induced ulcer model in Wistar rats. The analysis of the interactions was carried out via the Combination Index-Isobologram Equation method. The combination index (CI) calculated at 0.5 of the affected fraction (fa) indicated that the TAE or curcumin in combination with ranitidine had a subadditive interaction. The results suggest that this antagonistic mechanism is associated to the mucoadhesion of curcumin and the TAE, determined by rheological measurements. Contrastingly, both the TAE and curcumin combined with bismuth subsalicylate had an additive relationship, which means that there is no pharmacological interaction. This agrees with the normalized isobolograms obtained for each combination. The results of this study suggest that mucoadhesion of curcumin and the TAE could interfere in the effectiveness of ranitidine, and even other drugs.
Highlights
Medicinal plants were the primary source of health care
Ranitidine is a histamine-2 receptor antagonist, which decreases acid secretion[17], and bismuth subsalicylate protects the gastric mucosa from damage by covering and protecting the stomach from luminal acid and increases the mucus secretion[18]; it has been reported that it protects against stress, an inadequate diet and alcohol-induced injuries[19]
All treatments showed less damaged area than the ulcerated control group it is important to notice that the combinations turmeric acetone extract (TAE)-ranitidine and curcumin-ranitidine showed more damaged area than the other treatments
Summary
Medicinal plants were the primary source of health care. Herbal remedies are still used by ~70% of the population, according to the World Health Organization (WHO)[1]. Several studies show the gastroprotective activity of Curcuma extracts in different ulcer models in rats. These extracts accelerate the gastric mucosal healing, decrease the acid release and increase the expression of cyclooxygenase-2 (COX-2) and superoxide dismutase (SOD)[6,7,8]. It has been reported that the ethyl acetate extract of Curcuma longa prevents the gastric mucosal damage in pylori-ligated rats, decreasing the acid release by antagonizing histamine-2 receptors; TAE Curcumin Ranitidine Bismuth subsalicylate TAE-Ranitidine Curcumin-Ranitidine TAE-Bismuth subsalicylate Curcumin-Bismuth subsalicylate. Despite that Proton Pump Inhibitors (PPIs) are the most common worldwide treatment for peptic ulcer, it is reported that omeprazole increases duodenal ethanol injury in rats[16]. When finding an unfavorable interaction, drug combinations should be adequately handled
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