Synergistic interactions between the antinociceptive effect of Rhodiola rosea extract and B vitamins in the mouse formalin test

Aim In this study, the pharmacological interactions between a Rhodiola rosea ethanol extract and B-vitamins such as thiamine (B₁), riboflavine (B₂), pyridoxine (B₆), cyanocobalamin (B ₁₂) and a mixture of vitamins B₁ + B₆ + B ₁₂ was investigated in the mouse formalin test. Methods Individual dose response curves of the Rhodiola rosea ethanol extract, as well as B-vitamins alone or in a mixture were evaluated in mice in which nociception was induced with 2% formalin intraplantarly. The antinociceptive mechanisms of the Rhodiola rosea were investigated by exploring the role of the opioid and serotonin receptors and the nitric oxide pathway. Isobolographic analysis was used to evaluate the pharmacological interactions between the Rhodiola rosea ethanol extract and each B-vitamin individually or the mixture of vitamins B₁ + B₆ +B₁₂ by using the ED₃₀ and a fixed 1:1 ratio combination. Results Administration of the Rhodiola rosea extract alone or in combination with all of the vitamins produced a significant and dose-dependent antinociceptive response. The antinociceptive effect of the Rhodiola rosea extract (ED₅₀ = 81 mg/kg, p.o.) was significant and reverted in the presence of antagonists of the 5-HT_1A, GABA/BDZs and opioid receptors and by blocking mediators of the nitric oxide/cGMP/K ⁺ channels pathway. Isobolograms demonstrate that all of the combinations investigated in this study produced a synergistic interaction experimental ED₃₀ values were significantly smaller than those calculated theoretically. Conclusions These results provide evidence that a Rhodiola rosea ethanol extract in combination with B-vitamins produces a significant diminution in the nociceptive response in a synergistic manner, which is controlled by various mechanisms. These findings could aid in the design of clinical studies and suggest that these combinations could be applied for pain therapy.