Co-enzyme Q10 and Glycyrrhizic acid mitigate the renal toxicity induced by carbamazepine and erythromycin in pre-adult rats.

Background: Carbamazepine (CBZ) is a widely used anticonvulsant and mood stabilizer with potent antiepileptic activity. However, co-administration with erythromycin (EM) may enhance CBZ toxicity, potentially inducing renal injury. Co-enzyme Q10 (CoQ10) and glycyrrhizic acid (GA) possess antioxidant and cytoprotective properties that may mitigate drug-induced nephrotoxicity. Methods: Rats were divided into five groups: (I) negative control; (II) CBZ+EM; (III) CBZ+EM+CoQ10; (IV) CBZ+EM+GA; and (V) CBZ+EM+CoQ10+GA. CBZ (750 mg/day) was administered orally for 21 consecutive days, while EM (800 mg/day) was given during the last 5 days. CoQ10 (120 mg/day) and GA (150 mg/day) were administered for 21 days. Renal oxidative stress markers, including reduced glutathione (GSH), superoxide dismutase (SOD), and malondialdehyde (MDA), were assessed. Serum urea and creatinine levels were measured as indicators of renal function. Results: CoQ10 and/or GA administration significantly increased GSH levels and SOD activity while significantly reducing MDA levels compared with the CBZ+EM group. Additionally, serum urea and creatinine levels were significantly decreased. The combined therapy demonstrated superior renoprotective effects compared with either agent alone. Conclusion: Concurrent administration of CoQ10 and GA effectively attenuated CBZ- and EM-induced renal injury, likely through antioxidant mechanisms, with combined treatment providing enhanced protection. Additionally, inflammatory markers (TNF-α and Caspase-3) were significantly improved.