ABSTRACT
Aim: This study aimed to evaluate the effect of magnesium supplement to atorvastatin on hyperlipidemic patients and to elucidate the possible ability of oral magnesium supplement to counteract or delay statins induced myalgia. Study Design: Forty hyperlipidemic male and female patients were randomly divided into two groups: group one consisted of twenty patients, who received atorvastatin 10 mg once daily for 6 weeks then 20 mg once daily for another 6 weeks; group two consisted of twenty patients, who received the same dose of atorvastatin plus once daily oral low dose magnesium sulfate trihydrate 419.5 mg equivalent to 50 mg of magnesium. Place and Duration of Study: The Laboratory of Pharmaceutical Research Center of Faculty of Pharmacy, Tanta University, Egypt, between July to December 2013. Methodology: Two samples of venous blood (2 ml + 8 ml =10 ml total), were collected from all individuals, and were drawn from the antecubital vein before, 1.5 and 3 months after treatment. Sera and plasma were separated immediately for biochemical analyses of lecithin cholesterol acyltransferase (L-CAT) (ELISA), creatine kinase (CK), serum Ca+, Mg++, Na+, K+, lipid profile and aspartate transaminase (AST) (colorimetrically), and serum creatinine (S.Cr) spectrophotometrically. Results: The statistical analysis revealed that, 3 months after treatment, both groups showed significant amelioration in lipid profiles and significant elevation in L-CAT level regarding to baseline data obtained before initiation of treatment. In addition, the patients received atorvastatin plus magnesium supplement showed significantly higher levels of serum magnesium, plasma L-CAT and HDL-cholesterol concentrations and significantly lower total cholesterol, LDL-cholesterol and triglycerides concentrations with non significant lower CK level as compared to the patients group received atorvastatin solely. Conclusion: Mg++ supplement to atorvastatin improve all lipid profile and provide better control on dyslipidemia than atorvastatin alone. However, Mg++ supplement to atorvastatin doesn’t prevent elevation in CK; it may delay and provide some protection against statin induced myopathy that in turn may increase patient compliance.
ABSTRACT
Methotrexate (MTX) has been used in combination with nonsteroidal antiinflammatory drugs (NSAIDs) in the treatment of inflammatory diseases and malignancies. Severe adverse effects with this combination may occur, usually resulting from inhibition of renal transporters. Solid Ehrlich Carcinoma was induced by implantation of Ehrlich Ascites Carcinoma (EAC) cells subcutaneously into the thigh of mice and after 30 days, mice were divided into 3 groups , Group I served as control group received MTX (50 mg/kg, i.p.), Group II received Ketoprofen (100 mg/kg, i.p.) then after half an hour received MTX (50 mg/kg, i.p.), Group III received Indomethacin (10 mg/kg, i.p.) then after half an hour received MTX (50 mg/kg, i.p.). Plasma and tissue samples were collected at different times then MTX concentrations were determined by HPLC. The injection of Ketoprofen or Indomethacin before MTX injection caused significant increase in the AUC and CPmax of MTX (p < 0.05) and significant decrease in CL/F and Vd/F of MTX (p < 0.05) in mice plasma. The study showed that administration of ketoprofen or indomethacin prior to MTX caused significant decrease in MTX elimination and significant increase in MTX extent of absorption which may lead to severe adverse effects if coadministered in human.