# Assessing the Safety of Combined Therapy, Croton membranaceus and Tamsulosin, in the Self-Prescribed Treatment Protocol for Benign Prostatic Hyperplasia

## TL;DR

This study tested the safety of combining a herbal extract and a drug for prostate enlargement in rats, finding no extra benefit from the combination.

## Contribution

The study evaluates the safety and efficacy of combining Croton membranaceus and tamsulosin for BPH treatment in an animal model.

## Key findings

- The combination of low-dose CM and tamsulosin reduced PSA levels compared to the control group.
- Higher doses of CM combined with tamsulosin caused structural changes in prostate acini with reduced activity.
- Relative organ weights were found to be a better evaluation metric than total organ weights for BPH treatment assessment.

## Abstract

Background: The safety of combining tamsulosin (an allopathic drug) and Croton membranaceus aqueous extract, a medicinal plant for managing benign prostatic hyperplasia (BPH), was investigated.

Methods: The roots of CM were used and processed into a water extract by maceration and decoction. Thirty-five Sprague Dawley rats were divided into seven groups of five rats each. Groups 2–7 were orchidectomy/testosterone injections BPH-induced. Group 1 was designated as the control group. Group 2 was designated as the model group (untreated). Group 3 was treated with 0.03 mg/kg b.wt. of tamsulosin. Group 4 received 30 mg/kg b.wt. of CM (low dose [LD]). Group 5 received 300 mg/kg b.wt. of CM (high dose [HD]); Group 6 received 0.03 mg/kg b.wt. of tamsulosin plus 30 mg/kg b.wt. of CM. Group 7 received 0.03 mg/kg b.wt. plus 300 mg/kg b.wt. of CM. Tamsulosin and CM were administered by oral gavage for 28 days. Prostate-specific antigen (PSA) levels, renal and liver function tests, and histology were assessed.

Results: PSA decreased after treatment with LD CM (0.44 ± 0.03 ng/mL) and tamsulosin (0.43 ± 0.04 ng/mL) combined, compared with the control group (0.63 ± 0.03 ng/mL) (p < 0.006). Prostate gland/accessory organ weights were as follows: tamsulosin < CM LD < CM HD/T < CM LD/T < CM HD < model. In the CM LD/T group, the acini appeared empty and the acini fluid contained fatty droplets with a slender outer boundary that had very little active mucous surface. At a higher dose, CM HD/T caused a reduction in the sizes and shapes of active acini with most being empty and having little active mucous surfaces.

Conclusion: The results suggest that the combination of C. membranaceus and tamsulosin does not provide additional therapeutic benefits for treating BPH. Relative organ weights provide a better evaluation metric than total organ weights.