Effects of Zingiber officinale on the Plasma Pharmacokinetics and Lung Penetrations of Ciprofloxacin and Isoniazid

Abstract

The study was carried out to determine the effect of ginger on the plasma pharmacokinetics of ciprofloxacin and Isoniazid in a rat model in phase 1. The effects of the herb on the penetration of ciproflacin and Isoniazid into the lung tissues were also determined in phase 2. In phase 1, Albino rats of both sexes (n = 20) were divided into 4 groups of 5 rats per group. Two groups received oral ciprofloxacin (20 mg/kg) and isoniazid (15 mg/kg). Other groups were fed with ginger (5 mg/kg) for 10 days followed by the drug administration on the 11th day. Blood samples were collected from each group at 0-, 0.5-, 1-, 2-, 5-, 8-, 12-, and 24-hour intervals. Plasma concentrations of the drugs were determined by a spectrophotometric method and the pharmacokinetic parameters determined using noncompartmental method as implemented in the winNonlin program. In phase 2, where the effects of the herb on the penetration of the drugs were determined, the concentrations of ciprofloxacin and isoniazid attained in the lung fluid of rats in the presence and absence of the herb were compared after a single oral dose of the drugs used in the same dose range as in phase 1. In the first phase, treatment with ginger significantly increased the area under the concentration-time curve of ciprofloxacin, whereas Vz and Cl were decreased. Ginger significantly decreased the area under the concentration-time curve of isoniazid, whereas Vz and Cl were increased. Ginger enhanced the penetration of ciprofloxacin and Isoniazid into the lung tissues; however, their rates of penetration were delayed.

Ginger Update

“…Although there are inconsistent reports as to the capacity of ginger to augment the actions of anticoagulant and antiplatelet drugs, caution may be warranted for those consuming ginger and being treated with blood thinners 117–122 . As measured in preclinical models, ginger and its constituents were reported to affect the activities of several cytochrome P450s and drug transporters that determine the metabolic disposition of various drugs 123–127 . Specifically, ginger was reported to alter the pharmacokinetics of the antibiotics ciprofloxacin, metronidazole, and isoniazid; the immunosuppressive agents tacrolimus and cyclosporine; and the anticancer medication crizotinib 128–131 .…”

“…[117][118][119][120][121][122] As measured in preclinical models, ginger and its constituents were reported to affect the activities of several cytochrome P450s and drug transporters that determine the metabolic disposition of various drugs. [123][124][125][126][127] Specifically, ginger was reported to alter the pharmacokinetics of the antibiotics ciprofloxacin, metronidazole, and isoniazid; the immunosuppressive agents tacrolimus and cyclosporine; and the anticancer medication crizotinib. [128][129][130][131] Thus, caution is indicated for those taking such medications, and it is wise to consult a physician or clinical pharmacist prior to self-dosing.…”

Comparative Bioavailability Assessment of Four Brands of Ciprofloxacin Tablets Marketed in South-East Nigeria

“…Cipro oxacin is one of the mostly used quinolones and it belongs to the second generation uoroquinolones with broad spectrum of activity against infective agents and its well absorbed from the gastrointestinal tract with an absolute bioavailability of 70 -85% following oral administration [8]. It is widely distributed throughout the body with the tissue concentrations often greater than the serum concentrations and hence it serves as an excellent substitute in the therapy of gastrointestinal, skin and bone infection, complicated urinary tract infection, sexually transmitted infections and lower respiratory tract infection among others [9,10]. Among the quinolone antibacterial agents, cipro oxacin was reported to fail in the treatment of enteric fever caused by Salmonella enterica serotype Paratyphi A in Kuwait [11].…”