Effect of chronic caffeine administration on theophylline concentrations required to produce seizures in rats

Caffeine as well as the antiasthmatic drug theophylline can cause seizures when administered to humans or animals in excessive doses. Studies on rats have shown rapid development of functional tolerance to caffeine-induced seizures whereas repeated pretreatment with theophylline had no significant effect on the theophylline concentrations required to produce seizures. The purpose of this investigation was to determine whether chronic exposure to caffeine can affect susceptibility to the convulsant effect of theophylline. Rats received caffeine, 40 mg/kg, or solvent twice a day for 7 days as an intravenous injection. On the eighth day, theophylline was infused intravenously until the onset of maximal seizures. At this pharmacologic end point, rats pretreated with caffeine had significantly higher theophylline concentrations in the brain and cerebrospinal fluid than did control (solvent-pretreated) animals. Although the concentration differences were relatively small (approximately 11%), they demonstrate in principle the development of caffeine-induced tolerance to the neurotoxic effect of theophylline. Additional experiments showed that the caffeine effect on theophylline neurotoxicity is not acutely mediated by paraxanthine, a major metabolite of caffeine.     

Effect of enoxacin on theophylline neurotoxicity

Concomitant use of the bronchodilator theophylline and the antibacterial agent enoxacin has been associated with significant neurologic and other adverse effects. Enoxacin and certain other quinolones are known to inhibit the biotransformation of theophylline, thereby increasing the plasma concentrations of the bronchodilator. It was considered possible that this may not be the only interaction because theophylline as well as enoxacin are known to have neurotoxic potential. To explore the possibility of a pharmacodynamic interaction, rats pretreated orally with enoxacin or water (controls) were slowly infused i.v. with theophylline until the onset of a maximal seizure. Neither 100 nor 400 mg/kg enoxacin 1 hour before the infusion had any significant effect on the infused dose or on the concentrations of theophylline in serum, brain and cerebrospinal fluid at onset of seizures. On the other hand, 400 mg/kg enoxacin reduced the total serum clearance of a 12 mg/kg i.v. bolus dose of theophylline from 2.56 +/- 0.37 to 1.00 +/- 0.13 ml min-1kg-1 (mean +/- SD). It is concluded that acutely administered enoxacin in a dose sufficient to inhibit the elimination of theophylline has no direct effect on theophylline neurotoxicity in rats.     

Theophylline neurotoxicity in pregnant rats

The purpose of this investigation was to determine whether the neurotoxicity of theophylline is altered in advanced pregnancy. Sprague-Dawley rats that were 20 days pregnant and nonpregnant rats of the same age and strain received infusions of aminophylline until onset of maximal seizures which occurred after 28 and 30 minutes respectively. Theophylline concentrations at this endpoint in serum (total) and CSF were similar but serum (free) and brain concentrations were slightly different in pregnant rats. Theophylline serum protein binding determined by equilibrium dialysis was lower in pregnant rats. Fetal serum concentrations at onset of seizures in the mother were similar to maternal brain and CSF concentrations and correlated significantly with the former. It is concluded that advanced pregnancy has a negligible effect on the neurotoxic response to theophylline in rats.     

Rapid development of functional tolerance to caffeine-induced seizures in rats

The concentration and time dependence of caffeine-induced neurotoxicity was determined by infusing rats intravenously with caffeine at a rate of about 5, 12.5, and 25 mg kg-1 min-1 until the onset of generalized seizures which occurred at about 82, 28, and 11 min, respectively. The concentration of caffeine in the serum, brain, and cerebrospinal fluid at onset of seizures increased with decreasing infusion rate; the concentrations of caffeine metabolites were negligible and serum protein binding was not affected by the infusion rate. In another experiment, one group of rats was infused with caffeine for 60 min at about 2.2 mg kg-1 min-1 whereas another group was infused with solvent only. Both groups were then immediately infused with caffeine at about 22 mg kg-1 min-1 until onset of seizures. Caffeine concentrations at that time in serum, brain, and cerebrospinal fluid were significantly higher in the caffeine-pretreated animals than in the solvent-pretreated controls. The same pretreatment 17 hr before the fast infusion of caffeine had no apparent effect on caffeine concentrations at onset of seizures. These results show that functional tolerance to the seizure-inducing effect of caffeine in rats develops within minutes and that it is reversible within hours or less.     

Therapeutic advantage of unequal dosing of theophylline in patients with nocturnal asthma

Two theophylline treatments were compared in a randomized, multiple-dose, crossover study on 20 patients present with nonallergic bronchial asthma. Both products (E = Euphyllin CR, A = Afonilum Retard) were capsules containing micropellets. They were administered according to the recommendations of the manufactures and differed in the total daily theophylline dose (642 mg versus 500 mg), the partition of this dose (1/3 in the morning and 2/3 in the evening versus equal amounts in the morning and evening) and the timing of the evening dose (2200 hr versus 2000 hr). The patients were off oral theophyllines at least 2 days prior to study onset and no other drugs were allowed to be administered during the testing periods. On the 4th day of each study period, serum theophylline concentrations (STC) and peak expiratory flow rate (PEF) were determined every 2 hr. Compared with the 24-hr PEF reference profile taken prior to study onset, both theophylline treatments produced a significantly higher 24-hr PEF average (mesor). Treatment E resulted in significantly higher mesor than A; in addition, the PEF amplitude relative to the mesor was reduced by treatment E when compared with placebo.     

Effects of theophylline on chromosomal breakage and sister-chromatid exchange

Frequencies of both sister-chromatid exchange (SCE) and chromosomal breakage (CB) were studied in the lymphocytes of normal individuals (10 and 7 individuals respectively). The cells were exposed in vitro to 3 different concentrations of theophylline (1, 10 and 100 micrograms/ml). A significant concentration effect of the drug was demonstrated for both SCEs and CB. Utilizing a Dunnett's test for individual comparisons, the 10 and 100 micrograms/ml concentrations both demonstrated a significant elevation of SCEs and CB compared to the untreated control cultures. This study suggests that in vitro concentrations of theophylline equal to or greater than 10 micrograms/ml, corresponding to serum levels attained during therapy, increase the frequency of SCEs and chromosome breakage in human lymphocytes.     

Concentration-dependent interaction of theophylline with d-tubocurarine

The interaction of theophylline with d-tubocurarine chloride (dTC) was examined in rabbits. After steady-state subtherapeutic (less than 10 mg/l), therapeutic (10-20 mg/l), and toxic (greater than 20 mg/l) concentrations of theophylline, dose-response curves for dTC were determined and compared with controls that received no theophylline. At therapeutic concentrations of theophylline the effective dose for 50% inhibition of twitch (ED50) for dTC (mean +/- SE, 0.115 +/- 0.016 mg/kg) was significantly shifted to the left in comparison with the control (0.165 +/-0.008 mg/kg). The ED50 of dTC for the subtherapeutic group was 0.143 +/- 0.011 mg/kg, which was less than the control but not of statistical significance (P = 0.1). The ED50 for the toxic theophylline group was 0.168 +/- 0.003 mg/kg, which was not significantly different from controls but significantly different from the theophylline therapeutic and subtherapeutic groups. Thus, toxic concentrations of theophylline reversed the potentiating effects of therapeutic and subtherapeutic concentrations of dTC dose-response curves. Therefore, depending on concentration, theophylline exhibits a biphasic interaction with dTC. Surgical patients on theophylline may require less dTC intraoperatively. More importantly, the use of theophylline in the postoperative period to reverse anesthetic effects may result in recurarization.     

Effects of enprofylline and theophylline may show the role of adenosine

It is well established that at low and clinically relevant concentrations theophylline (and caffeine) exerts antagonism at cell surface receptor sites for adenosine. However, it is not known which actions of theophylline are due to adenosine antagonism, because theophylline apparently activates other cellular mechanisms at the same low concentrations. Investigations into the actions of xanthines and their structure activity relationships have identified xanthine compounds like enprofylline (3-propylxanthine) that only has some actions in common with theophylline and that has a negligible ability to antagonize adenosine. Enprofylline is a more potent smooth muscle relaxant and antiasthmatic drug than theophylline but does not produce, e.g., theophylline-like diuretic effects, CNS-stimulant behavioural effects (restlessness - seizures), gastric secretory effects and release of free fatty acids. It is proposed that pharmacodynamic dissimilarities between enprofylline and theophylline may indicate physiological roles of adenosine.     

The effect of chronic cadmium exposure on the pharmacokinetics of theophylline and ciprofloxacin in rats

Cadmium has been associated with a number of adverse health effects but the impact of those effects on the pharmacokinetics of different drugs has not been investigated. Therefore, the pharmacokinetics of theophylline and ciprofloxacin were studied in cadmium-exposed and control rats (72 rats) following i.p. (6.5mg/kg) and p.o. (10mg/kg) administration, respectively. The third-generation offsprings of rats exposed to 100 microg/mL of cadmium chloride in drinking water were used in this study. Following 8 weeks of exposure, animals received the drugs as a single dose. Blood samples were withdrawn at different time-points and the plasma concentrations of both drugs were analyzed by HPLC. The pharmacokinetic parameters of theophylline and ciprofloxacin were altered significantly in the cadmium-exposed animals. For theophylline, a statistically significant increase (p<0.0001) in C(max) (69%) and AUC(0-)(infinity) (68%) of theophylline in the cadmium-exposed rats as compared to the control were observed. A corresponding significant (p<0.0001) reduction of 41% in clearance (CL/F) of theophylline was detected in the exposed group. Neither the half-life nor the mean residence time (MRT) showed any significant change due to the exposure to cadmium. For ciprofloxacin, no significant difference was seen in the C(max) of the exposed group as compared to the control animals. However, a delay in T(max) was observed in the exposed group (from 0.16(+/-0.003) to 0.37(+/-0.14)h). A small, but significant increase in t(1/2) (p<0.05) was detected (1.74(+/-0.25) vs. 1.45(+/-0.12)h). A significant reduction (p<0.05) of CL/F from 30.54(+/-1.9) to 24.01(+/-3.81)mL/min/kg was seen in the treated group. The current investigation showed that chronic exposure to cadmium could have a very significant impact on altering the pharmacokinetic parameters of various drugs. Therefore, in cadmium-polluted areas, dose adjustments and drug monitoring, especially for drugs with a narrow therapeutic window, should be carried out.     

大鼠支气管肺白念珠菌感染后血清IL-17水平及意义

目的探讨大鼠支气管肺白念珠菌感染后血清白细胞介素17(IL-17)的变化及意义。方法将24只Sprague Dawley(以下简称SD)健康雄性鼠随机分为3组,每组8只,免疫低下+白念珠菌感染组(阳性对照组);免疫低下+生理盐水组(阴性对照组);免疫正常+白念珠菌感染组(实验组)。因为实验过程中存在大鼠死亡,最终每组各有6只大鼠完成实验。系统应用糖皮质激素建立免疫低下的大鼠模型;实验组及阳性对照组使用标准白念珠菌菌株混悬液经气管插管注入而建立感染模型;阴性对照组使用生理盐水作对照。感染后第1、3、5、7天使用尾静脉取血分离血清;酶联免疫吸附法(ELISA)检测血清IL-17水平;第7天取血后处死大鼠,取右肺下叶组织进行HE染色观察。结果第3、5天实验组血清IL-17水平高于对照组,而第1、7天3组间无差异;两对照组IL-17水平无差异。肺组织病理:实验组呈明显炎症反应;阳性对照组呈轻微炎症反应;阴性对照组未见明显炎性细胞浸润。结论大鼠白念珠菌支气管肺感染后,免疫正常的大鼠在感染中期血清IL-17水平升高,IL-17可能通过促进中性粒细胞在气道的聚集而参与炎症反应;IL-17的水平与机体炎症反应呈正相关;IL-17在气道白念珠菌感染后炎症介导及机体防御机制的调动中起一定作用。     

Assay of perinatal testosterone and influence of anti-progesterone and theophylline on induction of sterility

Mean serum levels of testosterone (T) determined by radioimmunoassay were found to be reliably higher in male than female rats at 21 days of gestation and 6 hr and 3 days after birth. However, serum T concentrations in individual female samples were frequently equal to or greater than those found in male samples. Another study was performed to evaluate whether protection against androgen in females might be associated with mechanisms involving circulating progesterone and cellular adenosine 3′5′-cyclic monophosphate (cAMP). Female rats were injected on the day of birth with 1.0 μg testosterone propionate (TP) or sesame oil in combination with theophylline, antiserum to progesterone or saline. Females injected with TP lost vaginal cyclicity. The duration of time after puberty before reaching the sterility criterion was approximately 86% and 35% shorter for TP-groups receiving theophylline and antiprogesterone, respectively, than for those injected with saline. Thus, progesterone might provide some protection against the defeminizing effects of T and cAMP could be involved in hormone action during the perinatal period.     

Hyperoxia attenuated nitrotyrosine concentration in the lung tissue of rats with experimental pneumonia

Although nitrated proteins have been repeatedly used as markers of lung injury, little is known about their formation and metabolism under hyperoxia. We therefore measured 3-nitrotyrosine (3NTYR) concentrations in lung tissue and serum of rats with carrageenan-induced pneumonia exposed to hyperoxia. Twenty-nine Wistar male rats were assigned to one of 4 groups. Two experimental groups were treated by intratracheal application of carrageenan (0.5 ml of 0.7 % solution) and then one was exposed to hyperoxia for 7 days (FIO2 0.8), the other to air. Rats of two control groups breathed either hyperoxic gas mixture or air for 7 days. At the end of exposure the ventilation was determined in anesthetized, intubated animals in which 3NTYR concentrations were measured in the lung tissue and nitrites and nitrates (NOx) were estimated in the serum. Carrageenan instillation increased 3NTYR concentrations in lung tissue (carrageenan-normoxic group 147+/-7 pmol/g protein, control 90+/-10 pmol/g protein) and NOx concentration in the serum (carrageenan-normoxic group 126+/-13 ppb, control 78+/-9 ppb). Hyperoxia had no effect on lung tissue 3NTYR concentration in controls (control-hyperoxic 100+/-14 pmol/g protein) but blocked the increase of lung tissue 3NTYR in carrageenan-treated rats (carrageenan-hyperoxic 82+/-13 pmol/g protein), increased NOx in serum (control-hyperoxic 127+/-19 ppb) and decreased serum concentration of 3NTYR in both hyperoxic groups (carrageenan-hyperoxic 51+/-5 pmol/g protein, control-hyperoxic 67+/-7 pmol/g protein, carrageenan-normoxic 82+/-9 pmol/g protein, control 91+/-7 pmol/g protein). The results suggest that hyperoxia affects nitration of tyrosine residues, probably by increasing 3NTYR degradation.     

Effect of Ethanol and Theophylline on Circadian Rhythm of Rat Locomotion

The effect of ethanol and theophylline on the circadian rhythm of rat locomotion was investigated. Male Wistar rats synchronized to 12: 12 h light-dark cycles were divided into four groups for treatment with saline, ethanol, theophylline, and ethanol plus theophylline. Animals in each group were orally administered saline, ethanol (2.0 g/kg body wt), theophylline (10 mg/kg body wt), and ethanol plus theophylline, respectively, six times every 2 h during the 12-h light span. Spontaneous loco-motor activity was continuously monitored by an animal activity recorder at 15-min intervals. Total activity count, circadian rhythm characteristics of activity (amplitude, acrophase, and mesor), power spectral patterns, and slope of fluctuation (a measurement of ultradian periodicity) were calculated. Ethanol administration decreased the total activity count by 60% and phase-delayed the onset of activity rhythm by 9.5 h on the day after treatment. The absolute value of the slope of fluctuation was increased by ethanol administration. The mean recovery time evaluated by rhythm detection was 3.8 days. Theophylline administration increased the light phase activity, but caused no phase delay of the onset time of the locomotor activity rhythm. The decrease in total activity count and phase delay of onset of the activity rhythm caused by ethanol were partially antagonized by theophylline. However, the prolonged effects of ethanol, represented by a late recovery time and an increase in the slope of fluctuation, were not influenced by theophylline.     

Effect of Ethanol and Theophylline on Circadian Rhythm of Rat Locomotion

The effect of ethanol and theophylline on the circadian rhythm of rat locomotion was investigated. Male Wistar rats synchronized to 12: 12 h light-dark cycles were divided into four groups for treatment with saline, ethanol, theophylline, and ethanol plus theophylline. Animals in each group were orally administered saline, ethanol (2.0 g/kg body wt), theophylline (10 mg/kg body wt), and ethanol plus theophylline, respectively, six times every 2 h during the 12-h light span. Spontaneous loco-motor activity was continuously monitored by an animal activity recorder at 15-min intervals. Total activity count, circadian rhythm characteristics of activity (amplitude, acrophase, and mesor), power spectral patterns, and slope of fluctuation (a measurement of ultradian periodicity) were calculated. Ethanol administration decreased the total activity count by 60% and phase-delayed the onset of activity rhythm by 9.5 h on the day after treatment. The absolute value of the slope of fluctuation was increased by ethanol administration. The mean recovery time evaluated by rhythm detection was 3.8 days. Theophylline administration increased the light phase activity, but caused no phase delay of the onset time of the locomotor activity rhythm. The decrease in total activity count and phase delay of onset of the activity rhythm caused by ethanol were partially antagonized by theophylline. However, the prolonged effects of ethanol, represented by a late recovery time and an increase in the slope of fluctuation, were not influenced by theophylline.     

Herb–drug interaction of Andrographis paniculata extract and andrographolide on the pharmacokinetics of theophylline in rats

Herb–drug interaction has become a serious problem since herbal medicine is extensively used in the modern world. This study investigates effects of Andrographis paniculata extract (APE) and its major component, andrographolide (AG), on the pharmacokinetics of theophylline, a typical substrate of cytochrome P450 1A2 enzyme, in rats. After APE or AG pretreatment for 3 days, on the fourth day rats were administered theophylline via femoral vein cannula. The blood theophylline levels were monitored by microdialysis sampling combined with HPLC-UV. The results indicated that the clearance of theophylline was significantly increased and the area under concentration–time curve (AUC) was reduced in both AG and APE pretreated groups at low-dose theophylline administration (1 mg/kg). The elimination half-life (t_1/2β) and mean residence time (MRT) of theophylline were shortened by 14% and 17%, respectively, in the AG pretreated group when high-dose theophylline (5 mg/kg) was given. However, theophylline accumulated in rat of the group with APE pretreatment. This phenomenon suggests that some other herbal components contained in APE may interact with theophylline and retard its elimination when theophylline was administered at a high dose. Our results suggest that patients who want to use CYP1A2-metabolized drugs such as caffeine and theophylline should be advised of the potential herb–drug interaction, to reduce therapeutic failure or increased toxicity of conventional drug therapy.     

Relation of oral dose of oxtriphylline to serum theophylline level.

Serum theophylline levels were studied in relation to oral doses of oxtriphylline in 30 patients with reversible airway obstruction. A wide scattering of levels was observed and was attributed to widely differing rates of metabolism of the drug. From the data obtained it was concluded that the most commonly prescribed daily dose of oxtriphylline, 800 mg, will produce a therapeutic level of theophylline in only about one quarter of patients. A daily starting dose of 15 to 20 mg/kg, however, will produce therapeutic levels in approximately one third of patients without significant toxic effects. Once the patient''s conditions is stable the serum theophylline concentration should be measured; if it is subtherapeutic the dose of oxtriphylline should be increased slowly and the serum theophylline concentration remeasured until a level of 10 to 20 microgram/ml is achieved.     

Topiramate modulates hippocampus NMDA receptors via brain Ca2+ homeostasis in pentylentetrazol-induced epilepsy of rats

Background: Increase in neuronal Ca²⁺, activation of hippocampus N-methyl-D-aspartate receptor (NMDAR) and defects in enzymes such as brain cortex microsomal membrane Ca²⁺-ATPase (MMCA) are thought to play a role in epilepsy. Topiramate (TOP) is a novel drug with broad antiepileptic effect, and its effect on brain cortex MMCA is not known. We investigated effects of TOP on pentylentetrazol (PTZ)-induced MMCA activity and NMDAR subunits in rat brain.

Materials and methods: Thirty-two rats were randomly divided into four equal groups. The first group and second groups were used for the control and PTZ groups, respectively. 50 and 100?mg TOP were administered to rats constituting the third (TOP50) and fourth (TOP100) groups for 7 days, respectively. At the end of 7 days, all groups except the first received a single dose PTZ. Brain and hippocampus samples were taken at 3?hrs after PTZ administration.

Results: The microsomal MMCA activity was lower in the PTZ group than in control although the MMCA activities were higher in the treatment group than in PTZ group. Brain cortex total calcium levels, the hippocampus NMDAR 2A and 2B subunit concentrations were higher in the PTZ group than in control although their concentrations were decreased by TOP50 and TOP100 administration. Total brain cortex calcium and hippocampus NMDAR 2A and 2B subunit concentrations were higher in TOP100 group than in TOP50 group.

Conclusion: The two doses of TOP modulated MMCA activity, total brain cortex calcium and hippocampus NMDAR 2A and 2B subunit concentrations in the epileptic rats.     

Treatment of nocturnal asthma: the role of sustained-release theophylline and oral beta-2-mimetics

In two double-blind, multiple-dose cross-over studies the therapeutic effects of SR theophylline preparations given once each night (mean 11.2 mg/kg per day) versus twice daily in equal doses (mean 10.3 mg/kg per day) (study I) and SR-terbutaline in equal doses (mean 0.25 mg/kg per day) versus SR theophylline in unequally divided daily doses (mean 5.3 mg/kg morning dose, 10.6 mg/kg evening dose) study II) were compared in 19 patients with nocturnal asthma. At the end of each treatment period drug serum concentrations and PEFR were measured every 2 hr over a 24-hr period. With the twice-daily, equally divided regimen, serum theophylline concentrations were lower at night than during the day (mean 9.4 +/- 0.9 versus 11.3 +/- 1.0 mg/l). With the single evening administration, serum theophylline concentrations were considerably higher at night (Cmax 16.3 +/- 1.4 mg/l) and the circadian variation of PEFR was significantly reduced. PEFR was higher during night and early morning (283 +/- 14 versus 217 +/- 11 l/min, P less than 0.005). During daytime in study II, PEFR values were slightly higher with theophylline than terbutaline. There was no significant difference in peak flow between either treatment during the night and early morning. However, additional use of inhaled beta-2-mimetics because of asthmatic attacks occurred more often during terbutaline (79 times in 8/10 patients) than theophylline treatment (29 times in 5/10 patients). Symptom scores, number of attacks and side-effects clearly favor the theophylline regimen. We conclude that for patients with nocturnal asthma a once-nightly dose of SR theophylline can be sufficient for stabilization of the airways.     

Elevated levels of group-III metabotropic glutamate receptors in the inferior colliculus of genetically epilepsy-prone rats following intracollicular administration of l-serine-O-phosphate

The selective group-III metabotropic glutamate receptor agonist, L-serine-O-phosphate (L-SOP), when injected bilaterally into the inferior colliculus of the sound sensitive genetically epilepsy-prone (GEP) rats produces a short proconvulsant excitation followed by a long phase of protection against sound-induced seizures lasting for 2-4 days. We have studied this prolonged suppression of audiogenic seizures using pharmacological and molecular biological approaches including semiquantitative RT-PCR and western blotting. The intracerebroventricular injection of the protein synthesis inhibitor cycloheximide (120 microg) 30 min beforehand significantly reduces the proconvulsant seizure activity and the prolonged anticonvulsant effect of intracollicular L-SOP (500 nmol/side). The sensitive semiquantitative RT-PCR revealed a significant up-regulation in mGlu(4) and mGlu(7) mRNA levels in the inferior colliculus at 2 days (maximum suppression of audiogenic seizures) after intracollicular L-SOP injection compared with the non-injected, 2-day post-vehicle treated and 7-day (return to expressing audiogenic seizures) post-drug or vehicle-treated groups. No significant changes were observed in mGlu(6) or mGlu(8) mRNA expression levels in drug-treated compared with control groups. Examination of mGlu(4a) and mGlu(7a) protein levels using western blotting showed a significant increase in mGlu(7a) but no significant change in mGlu(4a) protein levels 2 days after L-SOP treatment compared with the control groups (non-injected and 2-day vehicle-injected group). These results suggest that up-regulation of mGlu(7) receptors is involved in the prolonged anticonvulsant effect of L-SOP against sound-induced seizures in GEP rats. The potential use of mGlu(7) agonists as novel anti-epileptic agents merits investigation.     

Exposure to Hyperbaric Oxygen Intensified Vancomycin-Induced Nephrotoxicity in Rats

It has been suggested that oxidative stress is a potential mechanism for vancomycin-induced nephrotoxicity and hyperbaric oxygen therapy (HBO) has been shown to be effective in treating renal toxicity that has been pharmacologically induced in animal models. The aim of this study was to investigate the effect of HBO therapy on vancomycin-induced nephrotoxicity in rats. The study group comprised 36 Sprague Dawley male rats. We treated 30 with 500 mg/kg of intraperitoneal vancomycin once a day for 7 days. Half of these rats received a daily 1-hour treatment with HBO at 2 Atmospheres (ATM) on the same 7 days and formed the HBO+ group. The other 15 subjects received no HBO treatment (HBO- group). The remaining six rats served as the control group, three received HBO treatments alone and no treatment was administered to the other three rats. Laboratory results were obtained on day 8 and the intervention and control groups were compared. Rats in the HBO+ group gained less weight than the HBO- group (11.6 grams vs 22.6 grams; P = 0,008) and had significantly higher serum blood urea nitrogen (99.6 vs 52.6 mg/dL; P<0.001), serum creatinine (0.42 vs 0.16 mg/dL; P = 0.001) and magnesium (3.6 vs 3.1mg/dL; P = 0.014). The vancomycin blood levels were also higher in the HBO+ group (27.8 vs 6.7 μg/mL; P = 0.078). There were no pathological kidney changes in the control group. All the kidneys from the treated groups (vancomycin +HBO and vancomycin HBO-) showed moderate to severe histopathological changes with no statistical significance between them. This study demonstrated that exposure to hyperbaric oxygen intensified vancomycin-induced nephrotoxicity in rats.