Supra-Additive Interaction of Docosahexaenoic Acid and Naproxen and Gastric Safety on the Formalin Test in Rats.

Preclinical Research The aim of this work was to evaluate the effect of docosahexaenoic acid (DHA) on the pharmacokinetics and pharmacodynamics-nociception-of naproxen in rats, as well as to determine the gastric safety resulting from this combination versus naproxen alone. Female Wistar rats were orally administered DHA, naproxen or the DHA-naproxen mixture at fixed-ratio combination of 1:3. The antinociceptive effect was evaluated using the formalin test. The gastric injury was determined 3 h after naproxen administration. An isobolographic analysis was performed to characterize the antinociceptive interaction between DHA and naproxen. To determine the possibility of pharmacokinetic interactions, the oral bioavailability of naproxen was evaluated in presence and absence of oral DHA. The experimental effective dose ED30 values (Zexp) were decreased from theoretical additive dose values (Zadd; P < 0.05). The isobolographic analysis showed that the combination exhibited supra-additive interaction. The oral administration of DHA increased the pharmacokinetic parameter AUC0-t of naproxen (P < 0.05). Furthermore, the gastric damage induced by naproxen was abolished when this drug was combined with DHA. These data suggest that oral administration of DHA-naproxen combination induces gastric safety and supra-additive antinociceptive effect in the formalin test so that this combination could be useful to management of inflammatory pain. Drug Dev Res 78 : 332-339, 2017. © 2017 Wiley Periodicals, Inc.

Synergistic antinociceptive effect and gastric safety of the combination of docosahexaenoic acid and indomethacin in rats.

The use of analgesics is limited by the presence of significant adverse side effects. Thus, combinations of non-steroidal anti-inflammatory drugs (NSAIDs) with other antinociceptive agents are frequently used to decrease these adverse reactions. The aims of this work were to evaluate the antinociceptive interaction of the systemic administration of the combination of DHA and indomethacin through an isobolographic analysis of the theoretical and experimental antinociceptive effect and to demonstrate the gastric safety of the mixture compared with indomethacin alone. Female Wistar rats were orally administered indomethacin (1-10 mg/kg), DHA (100-300 mg/kg), or the DHA-indomethacin mixture at a fixed-ratio combination (1:1, 1:3, 3:1), and the antinociceptive effects of these treatments were evaluated through the formalin (1%) test. An isobolographic analysis was performed to characterize the antinociceptive interaction between DHA and indomethacin. The degree of gastric injury in all of the rats was determined 1 h after the formalin test. The theoretical ED30 values (Zadd) for the 1:1, 1:3, and 3:1 combinations were 73.48 ± 8.96, 37.75 ± 4.50, and 109.2 ± 13.43 mg/kg, p.o., respectively, and the experimental ED30 values (Zexp) were 43.63 ± 5.18, 13.13 ± 1.61, and 54.20 ± 6.53, respectively. The isobolographic analysis showed that the three fixed-ratio combinations studied exhibited a synergistic interaction. Furthermore, the gastric damage induced by indomethacin was abolished when this drug was combined with DHA. These data suggest that the systemic administration of the DHA-indomethacin combination induces a synergistic and gastric safety effect.