Naglaa Gamil Shehab1,2
,
Rawoof Khan Gafoor Khan3,
Eiman Shams Eldin Elgailani4,
Kholoud Yousuf Abu Shawish2
1Department of Pharmacognosy, Faculty of Pharmacy, Cairo University, Cairo, Egypt;
2Pharmaceutical Chemistry and Natural Products Department;
3Pharmacology and Toxicology Department;
4Clinical Pharmacy and Pharmacy Practice Department, Dubai Pharmacy College, Dubai, United Arab Emirates.
For correspondence:- Naglaa Shehab
Email: naglaa@dpc.edu Tel:+71503212716
Accepted: 22 September 2018
Published: 31 October 2018
Citation:
Shehab NG, Khan RK, Elgailani ES, Shawish KY.
Possible intrusive food interaction with oral dabigatran’s anticoagulant activity in a rat models. Trop J Pharm Res 2018; 17(10):2031-2036
doi:
10.4314/tjpr.v17i10.20
© 2018 The authors.
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Abstract
Purpose: To evaluate the synergistic or antagonistic interaction between oral dabigitran etexilate (Pradaxa) and some foods.
Methods: Aqueous extracts of sweet orange, cabbage, ginger, green tea, garlic and pineapple were prepared and lyophilized, and total phenolic acids and flavonoid contents evaluated. The residues of the aqueous extracts were given daily to the rats (500 mg/kg dose, oral) 1 h after administration of dabigatran (1.83 mg/kg dose) for 14 days. Bleeding time, International Normalized Ratio (INR), prothrombin time (PT) as well as alanine aminotransferase (ALT), aspartate aminotransferase (AST) and alkaline phosphatase (ALP) in blood were measured.
Results: Oral administration of Pradaxa with all the test food (except cabbage) significantly increased bleeding time, INR and PT. Pradaxa interaction with cabbage significantly decreased bleeding tendencies but the drug did not produce any major elevation of liver enzyme levels (ALT, AST and ALP). Conversely, significant elevation in ALP level was observed only after aqueous extract of ginger was administered with Pradaxa. Green tea and garlic significantly increased ALT and AST levels.
Conclusion: Synergistic interaction occurrs between dabigatran etexilate with the selected foods, but interaction with cabbage antagonistic
Keywords: Dabigatran etexilate, Anticoagulant, Foods, Liver enzymes, International Normalized Ratio, Prothrombin time