International Journal of Biochemistry Research & Review

Drug-induced liver injury (DILI) continues to be a major global health challenge, particularly when associated with misuse or overdose of multi-component pharmaceutical preparations. Reality Extra, a widely used analgesic–anti-inflammatory combination drug containing paracetamol, ibuprofen, diclofenac sodium, and caffeine, has been increasingly implicated in hepatic toxicity under overdose conditions. The present study integrates both biochemical and histopathological perspectives to evaluate the hepatoprotective efficacy of ginger (Zingiber officinale) extract in adult albino mice exposed to high doses of Reality Extra. Twenty rats were divided into four experimental groups: control, Reality Extra, ginger only, and ginger + Reality Extra. Serum alkaline phosphatase (ALP) and albumin were measured as indicators of hepatic biochemical function, whereas histopathological sections stained with hematoxylin and eosin (H&E) were examined for structural hepatic integrity. Reality Extra produced a marked elevation in ALP (243.25 ± 52.43 U/L) accompanied by a reduction in albumin (1.56 ± 0.37 g/dL), alongside extensive hepatic necrosis, inflammatory infiltration, vacuolization, and vascular congestion. In contrast, the ginger + Reality Extra group demonstrated near-normal ALP (61.00 ± 21.66 U/L), improved albumin (2.83 ± 0.13 g/dL) and preserved hepatic architecture. Collectively, the findings confirm that ginger extract confers significant biochemical and structural protection against multi-drug-induced liver injury, making it a potential natural adjunctive therapeutic agent against hepatotoxicity.