Abstract
Inflammatory diseases are widespread, and the cornerstone of their treatment is nonsteroidal anti-inflammatory drugs (NSAIDs), which effectively relieve pain and inflammation. However, long-term use of NSAIDs is limited by the risk of serious side effects, particularly damage to the gastrointestinal tract, liver, and kidneys. Therefore, a relevant direction is the development of combination drugs where synthetic active substances are combined with natural components capable of mitigating their negative effects. The aim of this study was to provide scientific justification for creating such a combination based on an NSAID and glycyrrhizinic acid (GA), an active component of licorice root known for its anti-inflammatory, antioxidant, and hepatoprotective properties. A literature review over the past 15 years confirmed that GA can protect liver cells from damage caused by NSAIDs by activating antioxidant enzymes and stabilizing cell membranes. Additionally, it has been found that GA enhances the anti-inflammatory and analgesic effect of NSAIDs (for example, nimesulide), allowing reduction in therapeutic dose without loss of efficacy. This leads to decreased ulcerogenic action and overall toxicity of therapy. In addition to pharmacological synergy, GA may act as an auxiliary substance improving bioavailability and stability of NSAIDs in drug formulations.