SUMMARY:

World widely, the prevalence of erection dysfunction (ED) ranged from 2% in men younger than 40 years to 86% in men 80 years or older. Sildenafil citrate. a potent and selective inhibitor of cyclic guanosine monophosphate (cGMP), is widely prescribed for ED treatment. Pomegranate (Punica granatum) juice has a high content of polyphenolic flavonoids with antioxidant and anti-atherosclerotic properties. The food-drug interaction was assessed in this study to elucidate the role of pomegranate uptake on the pharmacokinetics of sildenafil citrate in a dose-dependent manner. A set of 30 rats was divided into 5 groups (group A to group E). In the experiment, group (A) had received sildenafil aqueous solution alone, while groups from (B) to (E) had received sildenafil solution with 2, 4, 6, and 8 mL of pomegranate juice, respectively. There was a significant increase in AUC for sildenafil in a proportion of 6% and 9% in groups of D and E, respectively. The maximum serum concentration (Cmax) of Sildenafil in the control group and the time required to reach maximum concentration (Tmax) were 131.12 ± 33.82 ng/mL and 0.5 h, respectively. The area under the serum curve (AUC) was 520.96 ± 64.04 (ng/mL*hr). The Cmax of Sildenafil with pomegranate in group D (129.11 ± 30.12) and group E (127.35 ± 27.9689) ng/mL were lower than Sildenafil alone, whilst Tmax was longer 1 and 1.5 h and AUC bigger (564.19 ± 54.46 and 547.78 ± 39.12 ng/mL.h, P < 0.05). There was a sustained release for sildenafil when administered with pomegranate as the elimination rate has decreased and the values of T1/2 have increased. Pomegranate has increased the bioavailability of sildenafil by affecting both absorbance and concentrations of sildenafil in blood stream in a dose-dependent manner; therefore, food-drug interactions should be taken in consideration when treating ED patients