Ascorbic Acid Ameliorates Cardiac and Hepatic Toxicity Induced by Azithromycin-Etoricoxib Drug Interaction

Abstract

The complexity of prescribing safe and effective drug therapy is still challenging. Due to the increased number of medications taken by patients, the potential for drug-drug interactions has clinically important consequences. This study focuses on the potential drug-drug interaction between azithromycin and etoricoxib and the possibility of counteracting this adverse reaction by giving ascorbic acid intraperitoneally to male albino rats. Sixty adult male albino rats weighing 150–180 g were used. The rats were allocated into six equal groups. One group was a control, and the others were given azithromycin, etoricoxib, either alone or combination, with one group treated with ascorbic acid and the last group treated with the drug combination and ascorbic acid. Blood samples were collected for measuring AST, ALT, LDH, CK-MB, and troponin alongside antioxidant enzymes and histopathological examination for both liver and heart tissue. The results showed both hepatic and cardiac damage in azithromycin and etoricoxib groups represented by increasing levels of heaptoc enzymes (ALT, AST, LDH, CK-MB, and troponin) with declining antioxidant enzymes and elevation of malondialdehyde and the appearance of hepatic and cardiac toxicities. Upon administration, ascorbic acid ameliorated all the mentioned biochemical parameters. In conclusion, ascorbic acid has great antioxidant capacities and hepatic and cardiac ameliorative effects and can alleviate drug interaction toxicity.

Zinc Oxide Nanoparticles and Vitamin C Ameliorate Atrazine-Induced Hepatic Apoptosis in Rat via CYP450s/ROS Pathway and Immunomodulation

“…The co-treatments of ATZ-exposed rats with zinc oxide nanoparticles or ascorbic acid in our study modulated the alteration in ALT and AST enzymes and come in line with Mahmoud et al [ 54 ] and Hamza et al [ 83 ], respectively, which also restored the normal levels of total proteins and albumin as in agreement with Hassan et al [ 84 ] and Abou-Kassem et al [ 85 ], respectively, indicating their cytoprotective and antioxidant qualities. Previous studies have shown that vitamin C ameliorated the elevated serum ALT and AST activities in rat models of malathion hepatotoxicity [ 86 ] and organophosphate pesticide toxicity [ 87 ].…”

Pathological and pharmacovigilance monitoring as toxicological imputations of azithromycin and its residues in broilers

“…Hamza et al . [ 53 ] reported findings similar to these. Higher Az doses were linked to nephrotoxicity and reduced renal function [ 54 ].…”

“…Az1 exhibited significant caspase-3 immunoreactivity in hepatocytes and bile ductal epithelium. Hamza et al [53] reported findings similar to these. Higher Az doses were linked to nephrotoxicity and reduced renal function [54].…”

“…High levels of serum creatinine and uric acid suggest potential nephrotoxic effects, hinting at increased risks of renal damage with higher Az doses [ 54 ]. Previous study has shown that Az treatment can result in acute interstitial nephritis and renal failure [ 53 ]. Az accumulation in the kidney correlates with kidney damage as shown by imaging mass microscopy [ 55 ].…”

Editorial for Special Issue “Natural Products as Potential Source of Antidiabetic Compounds”

“…Various drugs have been withdrawn from the drug market due to serious DDIs, which include mibefradil, terfenadine, and cerivastatin. Hamza et al [ 10 ] evaluated the DDIs between etoricoxib and azithromycin and administered ascorbic acid intraperitoneally to male rats in order to identify any adverse reactions resulting from the treatment. The authors demonstrated that ascorbic acid had significant hepatic, antioxidant, and cardiac ameliorative effects and can alleviate drug interaction toxicity.…”