The Hepatotoxic Effect of Sildenafil Citrate and Its Combination with Tramadol on Male Wistar Rats is Ameliorated with Vitamin E Supplementation

Abstract

Aims: This study investigated the effect of vitamin E on serum liver enzymes and bilirubin concentrations in male Wistar rats treated with sildenafil citrate (SC) and a combination of SC and tramadol on the background that these drugs cause oxidative damage to the liver.
 Methods: Thirty male Wistar rats (180-200 g) were randomly divided into six groups (n=5) thus: control (0.2 ml vehicle – olive oil), SC-treated group (Sil) (10 mg/kg of SC), SC+tramadol-treated group (Sil+Tra) (10 mg/kg of SC and 20 mg/kg of tramadol), vitamin E-treated group (Vit E) (100mg/kg of vitamin E), SC+vitamin E-treated group (Sil+Vit E) (received SC and vitamin E) and SC+tramadol+vitamin E-treated group (Sil+Tra+Vit E) (received SC, tramadol and vitamin E). Drugs were administered orally once daily for four weeks after which blood samples were obtained and used to measure serum concentrations of liver enzymes (AST, ALT and ALP) and bilirubin.
 Results: Serum AST, ALT, ALP, total bilirubin (TB) and unconjugated bilirubin (UCB) concentrations were significantly (p<0.001) increased in Sil and Sil+Tra compared with control and Vit E and significantly (p<0.01) decreased in Sil+Vit E and Sil+Tra+Vit E compared with Sil and Sil+Tra. Serum conjugated bilirubin (CB) concentration and percentage conjugation of bilirubin significantly decreased (p<0.001) in Sil and Sil+Tra compared with control and Vit E and increased (p<0.01) in Sil+Vit E and Sil+Tra+Vit E compared with Sil and Sil+Tra.
 Conclusion: SC, administered separately and in combination with tramadol altered liver function. However, vitamin E supplementation was able to ameliorate this alteration in liver function.

Effects of combination of tramadol and sildenafil citrate (Viagra) on hepatic and renal function parameters in Male Albino Rats

“…Sildenafil citrate has been reported to reverse biochemical/histopathological changes in the liver due to jaundice and offer hepatoprotective action against drug-induced hepatotoxicity [31,32]. Some other studies have however reported hepatotoxic effects of increasing doses of sildenafil and the combination of sildenafil and tramadol in experimental models [1,33]. Table 2 shows the renal function parameters of the rats after treatment.…”

“…They attributed the effect to its antioxidant properties, as it significantly decreased thiobarbituric acid reactive substances (TBARs) while increasing glutathione (GSH) and total thiol (T-SH) levels in the tissues evaluated. Other studies have pointed out the risk of increased hepatic and renal damage due to long-term use of tramadol and its combination with sildenafil [15,33].…”