Study of drug interactions between Mexidol and thrombolytic drugs

A.V. SHCHULKIN, I.V. CHERNYKH, Yu.V. ABALENIKHINA, M.V. GATSANOGA, M.M. GRADINAR,
P.D. ANANYEVA, E.N. YAKUSHEVA

FGBOU in the Ryazan State Medical University named after Acad. I.P. Pavlova "of the Ministry of Health of Russia, Ryazan, Russia

Place of publication:
S.S. Korsakov Journal of Neurology and Psychiatry 2025, Vol. 125, No. 9, pp. 139–144
https://doi.org/10.17116/jnevro2025125091139

Abstract
: The aim of the study was to study the effect of Mexidol on the fibrinolytic activity of actilyse, metalyse, and fortelizin.

Material and methods . The study was performed in vitro on thrombi obtained from the blood of Wistar rats and a healthy donor. Thrombi were incubated with blood plasma to which Mexidol (0.1; 1; 10 μg/ml), thrombolytics actilyse (15; 2; 0.5 μg/ml), metalyse (10; 1; 0.1 μg/ml), fortelizin (5; 1.5; 0.5 μg/ml) or a combination of an antioxidant and thrombolytics were added for 3 h at 37 °C. To assess the effectiveness of thrombolysis, the percentage change in thrombus mass was analyzed, as well as the level of D-dimer (a fibrin degradation product) in the blood plasma after the end of incubation, which was studied using the enzyme immunoassay method.

Results . Mexidol in all tested concentrations of 0.1-10 μg/ml did not affect thrombus mass or D-dimer levels. Actilyse in concentrations of 15 and 2 μg/ml caused a decrease in thrombus mass by 27.68±9.45% (p<0.0001) and 15.72±4.38% (p=0.0011), and at a concentration of 15 μg/ml, an increase in D-dimer concentration by 70.9% (p=0.055) was observed compared to the control. Metalyse at a concentration of 10 μg/ml caused a decrease in thrombus mass by 22.53±2.83% (p<0.0001), at a concentration of 1 μg/ml — by 9.57±2.31% (p<0.0001), at a concentration of 0.1 μg/ml — by 3.76±1.04% (p=0.0115).
At a concentration of 10 μg/ml, metalyse also caused an increase in the concentration of D-dimer compared to the control by 37.4% (p=0.0022). The combination of actilyse and metalyse with Mexidol in all tested concentrations did not have a reliable effect on the effectiveness of thrombolytics. Fortelizin in all concentrations did not cause lysis of thrombi obtained from rat blood, but at a concentration of 5 μg/ml it caused a decrease in the mass of thrombi from human blood by 39.69±15.97% (p<0.001), at a concentration of 1.5 μg/ml — by 33.12±2.48% (p=0.001), and at a concentration of 0.5 μg/ml — by 17.79±5.24% (p=0.078). Mexidol in all tested concentrations did not affect the effectiveness of the thrombolytic.

Conclusion. The obtained results indicate that Mexidol does not affect the fibrinolytic activity of actilyse, metalyse, and fortelizin.