Dibaei Maryam, Hosseini Asieh, Lavasani Hoda, Kiani-Dehkordi Banafsheh, Rouini Mohammadreza
Razi Drug Research Center, Iran University of Medical Sciences, Tehran, Iran.
Biopharmaceutics and Pharmacokinetic Division, Department of Pharmaceutics, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
Heliyon. 2024 Jul 23;10(15):e35070. doi: 10.1016/j.heliyon.2024.e35070. eCollection 2024 Aug 15.
The presence of phytochemicals in herbal medicines can lead to herb-drug interactions, altering the levels of these compounds and conventional drugs in the bloodstream by influencing CYP450 activity. Considering curcumin's effect on the CYP enzymes responsible for tramadol metabolism, it is essential to assess the potential interaction between curcumin and tramadol when administered together.
The pharmacokinetics of tramadol were examined in rats receiving either single or multiple doses of curcumin (80 mg/kg) compared to rats without curcumin treatment. Tramadol liver perfusion was conducted on all rat groups and perfusate samples were collected at specified intervals. Tramadol and its main metabolite were detected using an HPLC system coupled with a fluorescence detector.
Tramadol concentrations were notably higher in the co-administered group compared to both the control and treatment groups. Conversely, lower concentrations of M1 were observed in the co-administered and treatment groups compared to the control group. The AUC parameters for tramadol were as follows: 32944.8 ± 1355.5, 22925.7 ± 1650.1, and 36548.0 ± 2808.4 ng⋅min/ml for the control, treatment, and co-administered groups, respectively. Both the co-administered and treatment groups exhibited a lower AUC of M1 compared to the control group. The lack of significant difference in C and AUC of M1 between the treatment and co-administered groups suggests that single and multiple doses of curcumin have comparable effects on CYP2D6.
These results indicate a potential for drug interactions when curcumin and tramadol are taken together. Furthermore, the influence of curcumin on tramadol metabolism varied between single and multiple oral administrations of curcumin. Hence, it is vital to highlight this interaction in clinical settings and conduct additional research to fully understand the clinical implications of combining curcumin and tramadol.
草药中的植物化学物质可能导致草药与药物相互作用，通过影响细胞色素P450（CYP450）活性改变这些化合物和传统药物在血液中的水平。考虑到姜黄素对负责曲马多代谢的CYP酶的作用，评估姜黄素与曲马多合用时的潜在相互作用至关重要。
与未接受姜黄素治疗的大鼠相比，在接受单剂量或多剂量姜黄素（80毫克/千克）的大鼠中检测曲马多的药代动力学。对所有大鼠组进行曲马多肝脏灌注，并在特定时间间隔收集灌注液样本。使用配备荧光检测器的高效液相色谱（HPLC）系统检测曲马多及其主要代谢物。
与对照组和治疗组相比，联合给药组的曲马多浓度显著更高。相反，与对照组相比，联合给药组和治疗组中M1的浓度较低。曲马多的AUC参数如下：对照组、治疗组和联合给药组分别为32944.8±1355.5、22925.7±1650.1和36548.0±2808.4纳克·分钟/毫升。与对照组相比，联合给药组和治疗组的M1的AUC均较低。治疗组和联合给药组之间M1的C和AUC无显著差异，表明单剂量和多剂量姜黄素对CYP2D6具有相似的作用。
这些结果表明姜黄素与曲马多合用时存在药物相互作用的可能性。此外，姜黄素对曲马多代谢的影响在姜黄素单次和多次口服给药之间有所不同。因此，在临床环境中突出这种相互作用并进行更多研究以充分了解姜黄素与曲马多联合使用的临床意义至关重要。
