Allopurinol, indomethacin and riboflavin enhance radiation lethality in mice

Two widely used drugs, allopurinol and indomethacin, and the vitamin riboflavin increased the response of mice to ionizing radiation. In mice a dose of 10.5 Gy of gamma rays from a 60Co source resulted in a dose-dependent shortening of survival times after pretreatment with the three agents, applied at doses which were well tolerated alone. When the dose dependency of these drugs on the influence on survival was tested, two response patterns emerged. Indomethacin (25 mg/kg) shifted the survival curve to the left and reduced the LD50 from approximately 6.5 Gy to approximately 4.5 Gy. Allopurinol (100 mg/kg) diminished the survival rate to approximately 50% irrespective of the radiation dose (ranging from 0.75 to 6.0 Gy). A similar though less striking trend was seen with riboflavin (120 mg/kg), which reduced the survival rate to approximately 65% in the dose range from 3 to 6 Gy. Mortality in mice treated with allopurinol or riboflavin and irradiated with nonlethal exposures (from radiation alone) occurred within the first few days after irradiation, suggesting a different type of injury than is usually associated with radiation death. Although doses of the three drugs used clinically are clearly lower than those providing enhanced radioresponse in our experiments, subtle and nonovert injury caused by combined exposure to the drugs and radiation cannot be completely excluded.