A recent study published in the West African Journal of Pharmacy has raised concerns about the simultaneous use of sildenafil citrate, commonly used to treat erectile dysfunction, and popular herbal alcoholic bitters. Researchers from Olabisi Onabanjo University and Babcock University in Ogun State found significant changes in liver, kidney and reproductive hormone markers in male laboratory rats. The study examined the effects of sildenafil citrate administered alongside three herbal bitters — Orijin, Action and Coco Samba.
The study used 40 healthy adult male Wistar rats, which were randomly divided into eight groups of five. One group served as the control, while another received sildenafil citrate. Three groups received Orijin, Action or Coco Samba bitters, respectively, while the remaining three groups received sildenafil citrate in combination with each of the three bitters. The substances were administered orally for 42 days. At the end of the experiment, blood samples were collected and analysed for markers associated with liver and kidney function, as well as testosterone and luteinising hormone levels.
The researchers found significant increases in alanine aminotransferase (ALT), aspartate aminotransferase (AST), urea, luteinising hormone (LH) and testosterone across the experimental groups compared with the control group. Elevated levels of ALT and AST can be associated with liver-cell injury or stress, while increased urea and creatinine levels may indicate changes in kidney function. The study suggests that the combined use of sildenafil citrate and herbal bitters may have potential toxic effects on the liver and kidneys.
The study also found significant differences in serum urea levels between the experimental groups and the control group. The researchers reported a significant increase in creatinine, particularly among the animals that received Coco Samba alone and those that received Coco Samba together with sildenafil citrate. This suggests that Coco Samba may have a potentially greater toxic effect on the kidneys than the other polyherbal formulations investigated.
The researchers observed significant increases in testosterone and LH among the experimental animals. They suggested that increased LH could contribute to increased testosterone production and said the observed hormonal changes could be related to the combined effects of sildenafil and the phytochemical components of the herbal bitters. The study's findings underscore the importance of further investigation into the simultaneous use of prescription medicines and herbal alcoholic preparations.
The study's results are particularly relevant in Nigeria, where herbal alcoholic bitters are widely used and often marketed with claims of improved sexual performance and stronger erections. Despite these claims, limited research has examined their safety and purported effects on erectile function, particularly when used alongside conventional medicines. The researchers noted that herbal medicines are often self-prescribed and may be taken alongside conventional medicines without healthcare professionals being informed about their use.
While the study's findings cannot be directly applied to humans, they provide experimental evidence of measurable biochemical and hormonal changes following concurrent exposure to sildenafil and the products investigated. The researchers emphasized the need for awareness of the possible consequences of concomitant use of sildenafil citrate and herbal bitters, and for further research into the safety and efficacy of these products.
Key points
- The study found significant changes in liver, kidney and reproductive hormone markers in male laboratory rats taking sildenafil citrate and herbal bitters.
- The combined use of sildenafil citrate and herbal bitters may have potential toxic effects on the liver and kidneys.
- The study's findings highlight the need for further research into the simultaneous use of prescription medicines and herbal alcoholic preparations.
