ABSTRACT
Background: Antihypertensive agents like Angiotensin-Converting Enzyme Inhibitors (ACEIs) and Angiotensin-Converting Enzyme Blockers (ARBs) are commonly indicated for patients with both hypertension and diabetes. However, the effect of these agents on blood sugar level or glycated hemoglobin (HbA1c) is still controversial. This study aims at investigating theshort, and long term effects of ACEIs and ARBs on blood sugar level and HbA1c of a group of streptozocin (STZ)-induced NIDDM rats when given in combination with Glimepiride (antidiabetic drug from Sulfonylureas group).Methods: Diabetes mellitus (DM) was induced in 100 Wistar albino adult male and female laboratory rats above 8 weeks old, and weigh between 250-300 gm by the administration of Streptozocin 75% α-anomer. Two weeks later, the100 rats were then randomized into four groups (25 rats each). Groupone was the untreated control group (received placebo only), while other groups (II, III, and IV) were treated by Glimepiride only, Glimepiride plus ARB (Candesartan), and Glimepiride plus ACEI (Enalapril)respectively. HbA1C levels were measured at baseline (pre-test/directly after randomization) to ensure that there was no significant difference between study groups at the baseline, post-test (after two weeks), and delayed-post-test (12 weeks after randomization/ 10 weeks after post-test) to measure short and long-term changes in the study groups.Results: There was no significant difference (p-values >0.05) between the four groups (groups I, II, III, and IV) in the HbA1C mean level at the beginning of this study (two-weeks after randomization and injection of STZ) (mean = 7.62 ±SD = 0.41, 7.72 ±SD = 0.48, 7.66 ±SD = 0.47, and 7.52 ±SD = 0.51respectively). However, two weeks later, treated groups (groups II, III, and IV) showed moderate reduction of HbA1C mean level compared to the untreated (placebo) group I, that was significant in groups III, and IV, and insignificant in group II (mean =7.43±SD 0.54, 6.97±SD 0.33, 6.72±SD 0.26, and 7.71 ±SD 0.44 respectively). Furthermore, treated groups (groups II, III, and IV) showed significant dramatic reduction of HbA1C mean level when compared to the untreated group (group I) (mean = 6.22 ±SD 0.51, 5.24 ±SD 0.62, 5.22 ±SD 0.13, and 7.62 ±SD 0.42 respectively).Overall, treated groups showed significantly lower HbA1C level than placebo groups. Moreover, Glimepiride + Enalapril combination showed a stronger hypoglycemic effect than the Glimepiride + Candesartan combination at post, and post-delayed tests, however, these differences were not significant.Conclusion: The addition of either ACEIs like Enalapril, or ARBs like Candesartan to Sulfonylureas like Glimepiride to in NIDDM patients will synergize its anti-diabetic effect in NIDDM subjects, and might increase the possibility of hypoglycemia. Caution and/or dose adjustment should be considered upon using these agentstogether in patients with hypertension along with diabetes
ABSTRACT
Metformin is widely used for type II diabetes. Sugar replacement sweeteners such as Aspartame and Stevia, are usually consumed concomitantly with other antidiabetics by patients The aim of this work is to investigate possible effects of two types of sweeteners; stevia and aspartame on the pharmacokinetic parameters of metformin in rats. A simple, validated bio-analytical HPLC method was developed to measure metformin in rat plasma. Three groups of rats, each of eight were subjected to this study. The first group was given metformin solution 20mg/kg alone, the second group was given 20 mg/kg metformin with 4mg/kg stevia and the third group was given 20 mg/kg metformin with 10 mg/kg aspartame on fasting state. Blood samples were taken on scheduled time interval up to 6 hours and analyzed for metformin concentration. Pharmacokinetic parameters were calculated by Non-Compartmental Model and data were interpreted. The results showed that administration of these two sweeteners did not have high effect on pharmacokinetics of metformin.
ABSTRACT
An easily, specific, precise, and accurate reversed-phase HPLC method was developed and validated for simultaneous estimation of esomeprazole ( Nexium®) and tadalafil (Cialis®) in pharmaceutical formulation. The separation was achieved by using Hypersil BDS C18 column (250 mm × 4.6 mm; 5.0 μm) and acetonitrile: 0.05 M potassium dihydrogen phosphate buffer at pH 6 adjusted with phosphoric acid as a mobile phase at a flow rate of 1 mL/min. Detection was carried out at wavelength 285nm. The retention time of esomeprazole and tadalafil were 3.1, 3.7 min, respectively. The linearity was established over the concentration ranges of 60-180μg/mL and 40-120μg/mL with correlation coefficients 0.9998 and 0.9996 for esomeprazole and tadalafil, respectively. The mean recoveries were found to be in the ranges of 98–102% for esomeprazole and tadalafil. The proposed method has been validated as per ICH guidelines and successfully applied to the simultaneous estimation of esomeprazole and tadalafil in pharmaceutical formulation.