Synergistic Drug Interactions

Abstract

Synergy is derived from the Greek word σuvεργóζ meaning working together. In pharmacological terms it has a precise meaning, which is distinct from interaction between two or more active substances where the interaction may be on the absorption, distribution, metabolism or excretion of one or more of the substances. For a synergistic therapeutic effect to occur there need not necessarily be an interaction of this type but the effect should be to the patient’s therapeutic advantage.

Historically, the seeking for the universal panacea or cure for all ills has to some extent hinged on the philosophy of empirical polypharmacy. This can be traced back to philosophies such as that evolved by Mithridates VI, King of Pontus 133 B.C.-63 B.C. (see Griffin 1994). Pontus abounded in medicinal plants and Mithridates acquired considerable knowledge of them. Like every despot of that period he lived in fear of being assassinated by poisoning, in consequence of which he sought the universal antidote to all poisons. Mithridates proceeded along a simple line of reasoning. Having investigated the powers of a number of single ingredients, which he found to be the antidote to various venoms and poisons individually, he evaluated them experimentally on condemned criminals. He then compounded all the effective substances into one antidote hoping thereby to produce universal protection. A daily dose was taken prophylactically to give the immunity he sought.